Modernizing the Training of Trainers in Primary Health Care

以現代化訓練方式訓練基層保健工作人員

陳喬治(George P. Cernada, Dr. PH)

《中華民國公共衛生學會雜誌》 4期 (1984/12) Pp. 7-18

https://doi.org/10.6288/JNPHARC1984-04-01-02

摘要

目前在開發中國家，如要提高全民的生活素質，則有效的訓練基層保健工作人員，是不可或缺的工作。這類訓練工作常遺遇兩點困難：其一是訓練者（常爲醫師等執會高階層人士）與受訓者（常爲中下層人士）之社會差距遠大；其二是一般使用的傳統式說教教育方式效果不佳。如要解除此二缺點，需盡力採用以實地訓練爲主，受訓者爲中心的方式，使受訓者由訓練準備之始，即積極參與於其計畫、執行及評估各階段工作。本文即對以自發性改進爲基礎的學習哲學，與計畫、組織、執行及評估有關之教育目標及利用非傳統教學技巧、實地經驗、連續回輸（回饋）及受訓者參與教學的學習方式加以探討。這些方法包括：角色扮演、講故事方式、個案研究、自我學習、模擬練習及使用輕便的視聽教村等。

並列摘要

Training community-based health care workers in ”Developing” countries is essential to improving the quality of life in both rural and urban areas. Two major obstacles to such training are the social distance gap between these community workers and their more highly-educated and upper class trainers (often medical officers and also the influence of the almost universal overly didactic, formal educational system. Bridging this gap demands a participant-centered, field-oriented app roach which actively involves the trainee in the design, implementation and evaluation of the training program. A philosophic learning approach based on self-initiated change, educational objectives related to planning, organizing, conducting and evaluating training and specific learning methodologies using participatory learning, non-formal educational techniques, field experience, continuing feedback are reviwed. Included are: structured experiences, flow charts, role playing, story telling, case studies, self-learning exercises, simulation exercises, Portapak videotape, visual illuatrations and models/teaching aids.
The educational objectives set forth in this planned course for trainers of trainers,
however, can be achieved only if they are carried out in a setting similar to the on e in which the primary health care worker will be in the future. This means that at least half the training ought to take place in the village or neighborhood -setting and the training officer should spend his evenings as well as days, intermingling with local people, sleeping. in similar housing, and eating local food: Such total immersion may violate some of the class orientations of the future trainers but should result in at least a minimal empathy with local conditions trainees will have to face. The means of providing sufficient creature comforts to keep the immersion approach from drowning the future trainers remains the job of the master trainer of trainers who will conduct this course.