School environment: a learning need for the general practitioner

EDUMECENTRO 2023;15:e2409

RESEARCH PAPER

 

School environment: a learning need for the general practitioner

Ambiente escolar: una necesidad de aprendizaje por el médico de familia

 

René Quintana Mugica1* http://orcid.org/0000-0001-8305-8758
Guillermo José López Espinosa1 http://orcid.org/0000-0001-8699-8366
Jorge Agustín López Aparicio2 http://orcid.org/0000-0002-8809-2469
Daniel Hernández Torres3 http://orcid.org/0000-0001-8540-0617

 

1 University of Medical Sciences of Villa Clara. Academic Vice President. Villa Clara. Cuba.
2 University of Medical Sciences of Villa Clara. Polyclinic "Juan B. Contreras" Ranchuelo. Villa Clara. Cuba.
3 University of Medical Sciences of Villa Clara. Cardiocenter "Ernesto Guevara". Santa Clara. Villa Clara. Cuba.

 

*Corresponding author. Email: reneqm@infomed.sld.cu

 

 

ABSTRACT

The Cuban Ministry of Public Health is oriented to carry out medical controls for students and workers who do not have basic health equipment in their center, in the community doctor's office. In this article the authors intend to share with the scientific community the theoretical foundations concerning the improvement process, which responds to the learning needs and constitutes a primary way for Gps to gradually contribute to the solution of the academic insufficiencies in certain topics related to the school environment and favor social well-being from their professional and human performance.

MeSH: community medicine; quality of life; students; education, medical.

RESUMEN

El Ministerio de Salud Pública cubano tiene orientada la realización de los controles médicos a los estudiantes y trabajadores que en su centro no cuentan con equipo básico de salud, en el consultorio médico de la comunidad. En el presente artículo los autores se proponen compartir con la comunidad científica los basamentos teóricos concernientes al proceso de superación, el cual responde a las necesidades de aprendizaje y constituye una vía primordial para que, gradualmente, los médicos de familia coadyuven a la solución de las insuficiencias académicas en determinados temas relacionados con el ambiente escolar y favorezcan el bienestar social desde su desempeño profesional y humano.

DeCS: medicina comunitaria; calidad de vida; estudiantes; educación médica.

 

 

Submitted: 19/05/2022
Accepted: 20/12/2022

 

 

The family doctor must be able to provide comprehensive medical care to individuals, families, schools and factories. The Ministry of Public Health (Minsap) is oriented, in the community medical office, to carry out medical controls on students and workers who do not have a Basic Health Team (EBS) in their center and has established that these are take place during sliding schedules or on Saturday mornings.(1)

In educational institutions there is a group of environmental risk factors typical of the activities that are carried out given by: microlocation, water supply, disposal of liquid and solid waste, control of air pollution, noise, vectors, lighting, ventilation and the potential danger of accidents, which when they do not meet the requirements from the hygienic-sanitary point of view can cause damage to the body. In addition, among the health problems that most frequently occur in Cuban teachers are: chronic nodular laryngitis considered as an occupational disease, hypertension, osteomyoarticular diseases, nervous disorders, allergies, decreased visual acuity, and accidents.(2)

School health is a branch of hygiene and epidemiology responsible for the promotion and protection of students and teaching workers, as well as hygienic control of the premises where they carry out their activities. It is inserted in environmental health and its main objective is in line with the current concept of resilience: to identify and promote protective factors in schoolchildren, adolescents, and young people exposed to risks.(3)

The control and advisory visits made by the Directorate of Professional Training of Villa Clara University of Medical Sciences to the doctors´ offices in the different municipalities, allowed the authors to appreciate a gap in the knowledge and performance of the GP to Comprehensive health care for the student population and workers in the educational branch, given difficulties in identifying risks in the school environment, which affects the dispensing process and control planning, as well as unfocused medical examinations of risk and with limited promotion and prevention actions.

In this sense, the Guidelines of the economic and social policy of the Party and the Revolution approved in the VI Congress of the Communist Party of Cuba define in chapter VI Social Policy, Guideline 156: consolidate the teaching and use of the clinical and epidemiological method and the study of the social environment in the approach to health problems, as well as Guideline 159: strengthen health actions in promotion and prevention for the improvement of lifestyle that contribute to increasing the levels of health of the population, which such demands adequate preparation of medical personnel to meet the above requirements.(4)

Being consistent with what has been stated, in the current study plan of the Medicine degree (Plan D), the fifth year students are taught the subject Public Health, where Theme V called Environmental Health, addresses in its content aspects related to with the school environment and its effects on health. Main risks: microlocation, building, classrooms, furniture and equipment. Life regimen. Work capacity and school fatigue. Control of risks in the school environment. Main effects of the school environment. Hygienic-sanitary requirements.(5)

The Comprehensive General Medicine (MGI) specialty program, subject to a modification as of 2018, is planning course 25: Occupational Diseases in its third academic year, with the purpose that the Gp can differentiate them from the conditions common and make your referral immediately. This program states that the graduate must achieve a level of mastery of theoretical content and practical skills during the residency, and later, carry out the continuity of postgraduate studies to develop the skills of their profession based on the improvement of their performance.(6)

In the review of the professional improvement plan of the Villa Clara University of Medical Sciences, which includes the municipalities, it was verified in the last five years the absence of activities in the field of environmental health, specifically, school and occupational health issues, aimed at GPS and nurses, who in their professional work assume the process of dispensing these populations exposed to risk. Likewise, the Department of Statistics of the Provincial Health Headquarters reported an insufficient number of workers referred to the consultation for occupational diseases, as well as an annual decrease in preventive medical examinations (pre-employment, periodic and reinstatement) by the EBS in same period.

The role of postgraduate education in the development of human capital is unquestionable, and in the health branch this aspect reaches a greater dimension, starting from demanding a permanent and contextualized education that allows finding relevant answers to health problems.

The improvement of human resources becomes a fact that has more and more meaning for the scientific-technical, economic and social development of a country. The philosophical dictionary defines overcoming as: "...succession in development, relationships of some inferior phenomenon with respect to a superior one...".(7)

Salas Perea(8) stated that among the pillars that guarantee performance improvement in health professionals in Cuba is having a permanent education system, developed in the health services themselves, which responds to the identification of needs of learning recognized in workers, institutions and society.

Continuing and permanent education is the way to acquire competencies in care, teaching and research services, and for this reason, an adequate implementation is required as a strategy in Cuban medical universities. The proposals for professional improvement must respond to the demands of the job position and epistemological, didactic and investigative learning will predominate in its design and implementation, in an articulated manner.(9)

The GP and Nurse Program has as its general objective: "... to contribute to the improvement of the health status of the population through comprehensive actions aimed at the individual, the family, the community and the environment, taking into account the components, instruments and guiding axes of primary health care, as well as the principles of public health and the particularities of Cuban family medicine".(10)

Based on the state of opinion of GPS on the problems that affect the learning of the content related to environmental health, which includes the school, plus the diagnosis of the insufficiencies in knowledge, skills and values reflected previously, so, they require innovative and more relevant ways for professional improvement on these issues, depending on the function of comprehensive medical care to be fulfilled by the Basic Health Teams.

 

BIBLIOGRAPHFIC REFERENCES

1. López Espinosa G, Valcárcel Izquierdo N, Pérez Bada E. Médico de familia y atención integral a la salud del trabajador. Rev Cuba Med Gen Integr [Internet]. 2021 [citado 16/05/2022];37(4):[aprox. 15 p.]. Disponible en: https://revmgi.sld.cu/index.php/mgi/article/view/1695

2. Rodríguez Rodríguez LP. Enfermedades profesionales en Cuba. En: Álvarez Sintes. Medicina General Integral. Vol V. 3ed. La Habana: ECIMED; 2014.

3. O´Farril Montero C, Borroto Perelló S. Salud escolar. En: Álvarez Sintes. Medicina General Integral. Vol I. 3ed. La Habana: ECIMED; 2014.

4. Partido Comunista de Cuba. Lineamientos de la política económica y social del Partido y la Revolución. VI Congreso del Partido Comunista de Cuba. La Habana: PCC; 2011.

5. Ministerio de Salud Pública. Comisión Nacional de Carrera de Medicina. Programa de la asignatura Salud Pública. La Habana: Universidad de Ciencias Médicas de la Habana; 2020.

6. Ministerio de Salud Pública. Vicerrectoría de Desarrollo. Programa de Residencia en Medicina General Integral. La Habana: Universidad de Ciencias Médicas de la Habana; 2018.

7. López Espinosa GJ, Lemus Lago ER, Valcárcel Izquierdo N, Torres Manresa OM. La superación profesional en salud como modalidad de la educación de posgrado. EDUMECENTRO [Internet]. 2019 [citado 23/03/2022];11(1):[aprox. 16 p.]. Disponible en: https://revedumecentro.sld.cu/index.php/edumc/article/view/1180

8. Salas Perea RS, Salas Mainegra L, Salas Mainegra A. Las competencias y la educación médica cubana. La Habana: Editorial Ciencias Médicas; 2022.

9. Valcárcel Izquierdo N, Suárez Cabrera A, López Espinosa GJ, Bada Pérez E. La formación permanente y continuada: principio de la educación médica. EDUMECENTRO [Internet]. 2019 [citado 16/05/2022];11(4):[aprox. 10 p.]. Disponible en: http://www.revedumecentro.sld.cu/index.php/edumc/issue/view/52

10. Ministerio de Salud Pública. Programa del Médico y Enfermera de la Familia. La Habana: Universidad de Ciencias Médicas de La Habana; 2011.

 

 

Declaration of interests

The authors declare no conflict of interest.

 

 

Contribution of the authors

Design and methodology of the article: René Quintana Mugica and Guillermo José López Espinosa
Literature review: René Quintana Mugica, Guillermo José López Espinosa, Jorge Agustín López Aparicio and Daniel Hernández Torres
Preparation and review of the final report: René Quintana Mugica, Guillermo José López Espinosa, Jorge Agustín López Aparicio and Daniel Hernández Torres

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