Clinical education and the Field in Family Medicine Specialty Training
Health care both for acute and chronic diseases is mainly delivered in ambulatory clinics in the community. However the residency programme of the family physicians in Turkey who are trained for the delivery of primary health care services is maintained almost totaly in hospital rotations. So to deal with the suitable cases and to reach the learning objectives of the ambulatory care focused family medicine residency training is limited. Clinical teaching is the training in the health service. Clinical teaching was valid in medicine though it was understructured in the previous years when there was no standards for education and the apprentice was the only model that provides professional education. Also today it is advised to offer the same opportunity to the residents in all disciplines but to structure it. Practice based and community based learning is indispensable for the disciplines which are practice based like family medicine. Training in practice in the community other than the health care delivery in inpatient clinics offers the chance of observing, discussing, demonstrating the real family medicine care, improving the skills by taking feedback and a real competency assessment for residents. In a phrase, a family medicine resident must have teaching in the ambulatory practice that is the real environment to work, to be aware of the differences and to learn. “Training in practice” will provide learning in the real context. The educators of this practice based training will be the family physicians who also deliver health care in the community based offices. The personal effort of this physician will not be enough to give either clinical teaching or health care in high quality. The clinical trainer must be prepared with necessary teaching skills besides the defined curriculum content and assessment methods. In our country “training in practice” must become legal primarily then take place in the curriculum and providing field trainers and training units in the field, establishing a community based education and practice center in the University departments which are ready about the education concept and to set collaboration with the all units.
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