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Educational Handbook for Health Personnel Sixth Edition J.-J. Guilbert o o -t- lffi; '$/orld Health Organization, Geneva l.987 W H O O f f s e t P u b l i c a t i o n N o . 3 5 R e p r i n t e d 1 9 8 9 W H O o f f s e t p u b l i c a t i o n s a r e i n t e n d e d t o m a k e g e n e r a l...
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t Ce livre est publi6 en frangais par l'OMS sous le titre: Guide p6dagogique pour les personnels de sant6. I I n f o r m a t i o n c o n c e r n i n g A r a b i c , B u l g a r i a n . C z e c h , F a r s i , G e r m a n , H u n g a r i a n , l n d o n e s i a n , l t a l i a n , P o l i s h , Portuguese...
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The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitati...
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How to help educators to increase their skills so as to make learning easier for the students o o 1987 objectives of the handbook When you have studied this handbook you should be able to: define the professional taslts which will provide ttre basis for determining educational objectives plan a curriculum cons...
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Identification ofyour needs as an educator o Objectives of the Handbook o For whom is this Educational Handbook intended? o How to use the Handbook o o Pre-test o List of educational objectives o Theoretical background that will help you reach the educational objectives o Table of exercises proposed in ...
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Formative and cenifying evaluation Evaluation planning o What is evaluation? o o Aims of student evaluation o . o Qualities of a measuring instrument (validity, objectivity and practicabiliry) o How to organise an evaluation system Selection of an evaluation method Advantages and disadvanta...
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Test and measurement techniques . Why evaluate? o Guidelines for evaluating a training programme a o Guidelines for evaluating educational objectives a o Programme evaluation by the students Evaluation of students' level of performance Poins to consider in evaluating programme changes Assessment of...
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like Chief, Educational Planning, Methodology and Evaluation Division of Health Manpower Development \World Health Organization l2I1- Geneva 27 Switzerland Your suggestions will always be welcome. There is a special sheet you can use for them at the end of this handbook. I Dr. S. Abrahamson and Dr...
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comments and The first edition was prepared on the basis of documents distributed during a workshop organized by the Regional Office for Africa, the Brazzaville, in medical assistance of education.l It has been widely used in the Region and served as a basic document for many educational planning...
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in December 1969 with consultants It then became evident that it would be useful to give the reader better guidance during his progression through the whole educational planning cycle. Although this objective would most likely be achieved by a completely programmed presentation it seemed that the...
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Dear Colleagues, In our common struggle to achieve the objective of "Health for all by the year 20OO", the place of basic training and continuous education of health personnel is a crucial one. The Conference of Alma-Ata recommended, among other things, that governments "[define] the technical role, supportive ...
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All these reasons lead me to regard the publication of this revised edition of the Educational Handbook for Healtb Personnel as particularly useful, in that it will facilitate the application of those recommendations. It is also a practical example of the technical support that an international organizati...
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Director{eneral l2ll GENEVA2T-SWITZERLAND Telegr.: UNISANTE-GENEVA Telex: 2782lOMS l2llGENEVE2T-SUISSE Tdtdgt.: UNISANTE-GENEVE for whom is this educational handbook intended? t969, the first edition was in Originally, teachers of the health sciences. written for Subsequently, however, the Handb...
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A survey of 2OO users carried out in 197 5 revealed the following opinions. A very small minority (10%) felt that the Handbook should be supplied only to partici- in controlled educational activities pants (workshops, seminars, courses, etc.) or reserved for "teachers of teachers". Tbe maiorit...
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organization. The latest poll, conducted in 1978, produced very apposite comments from about 100 users in all parts of the world and the consensus is still in favour of the widest possible distribution. Many teachers of the various health professions (dentists, nurses, sanitary engineers, physicians,...
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most of the examples relate to the medical and nursing professions, it is the author's hope that each user of the Handbook will make a personal effort at adaptatioz, replacing the examples given by other more suitable ones whenever necessary.
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jargon and meaning of words the previous editions have Many users of asked for special care to be taken to simplify the language used. We hope they will be satisfied. It has not, however, been possible to avoid using certain technical terms (for example, discrimination index). Neither has it b...
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please accept the definitions proposed in Handbook, at least while you are using So this i t . how to use the handbook The presentation and layout of this Handbook are unusual. It should be stressed at this point that the approaches suggested in this book are the result of a deliberate choice by th...
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various the For each chapter a list of objectives is included (yellow pages) to give you an idea of what you will get out of the chapter. theoretical input (white pages) is The presented in the form of original docu- ments or short quotations from texts listed in the bibliography. ...
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Rather than try to explain the whys and wherefores of this unusual lavout. which irritating and complicated at some find first, and others as intriguing as a detective story, it seems simpler to invite you to use this book just as it is. You will then draw your own conclusions as to the "...
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This is why we are going to try and help you in this essential but unusual and therefore difficult undertaking. First situation: you are alone (on a desert island) or else you are accustomed and prefer to work alone. You are going to need grit, perseverance and 35 to 50 hours of free time. Good Luc...
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In any case, the first thing to do is to iden- tify yoar needs. You are invited to proceed in three stages. identification of your needs as an educator First Stage What are the educational "questions" that you would like to have answered? (For example: "what is an educational object- ive?", "wha...
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Now ............ Try to draw up a preliminary list of your "questions", "educational tasks" or "problems" for the coming 12-month period. E X E R C I S E identification of your needs as an educator Second stage Would you like to find out how much you know before studying the rest of the Hand-...
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The test will help you make a personal diag- nosis of the teaching areas you need to bring up to date. Your aim in doing this test is not to find the right answer but simply to take note of tbe fact that you do not find it! You may also rest assured that your score in the post-tesr (page 5.34)...
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9 answer sheet for pre-test * Chapter I 8tr8trtr EEgtrE trtrtrtrtr trEEEE trE8trtr trEgEtr trtr EEtr trtrEEE trtrtr8tr tr89trtr trtrEEE 8trtrtrtr ts88trtr BEEEE tsts9trtrtrG trtr9 trE trE trEEEEtrtr trtr gE trtrtr trEgtrtrtrG EEtrEEtrtr Chapter II 1 0 1 1 1 2 1 3 1 4 1.5 r 6 1 7 1 8 I 9 trEEtrE trtr98tr tr8trtr ...
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To guide you in this first choice, do not forget to take into account the "questions and problems" you listed on p.8 and your weak and strong points (results of pre-test, p. s.3a). Limit this initial choice to about f0 tasks, circling the numbers of those that seem most important fo,r you on...
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1 1 educational a obiectives t evaluation 6 planning Z 1. Define the following terms: professional task, activities, functions, role, institut- objective; specific objective; ional domains of practical skills; communic- ation skills and intellectual skills. ,) 3 . +. 5 . 6 . 7. 8 . 9 . the qual...
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Define a professional task and identify its components (domains of practical and skills. intellectual skills). communication skills 'be Draw up a list of the specific educational objectives relating to a professional task, rtatitts explicidv' whaf you feel the able to "do" after a studeit sh...
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Make a critical analysis of specific educational obiectives (listed by a partiiular colleaque). whethtr they include- all the-requisite (act, content, condition, elements criteria). * indicatine in havTng Draw up a list of the possible reactions of colleigues in your ficulty to the idea ...
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tive and certifying evaluation. 13. List the good and bad features of a test. 1 4 . Compare the. advantages and disadvan- tages ot tests m current use. 1 5 . following t€rlnS: validity, Define the reliabilitv. obiectivitv, and describe the relationship tliat exists between them. L 6 . Choose an apP...
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Indicate: (a) (b) (c) important educational the most decisions You have to take; the data to be collected to provide a basis for those decisions; the aims of the lys.teln. and sub- systems in terms of decisions to be the object of each tiken and decision (teachers, students, Pro- grammes). ...
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2 t . ) ) List 10 conditions which facilitate learning on the basis of the list and evaluate a specific learning activity. Indicate the aims and general methods of teaching. 2 3 . Specify at least two advantages and two disadvintaees for each tecTrnique and medium uied in teaching. 30. 3 7 . 3 2 . 33. ...
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Define the advantaqes and limitations of a system of .evaluition of teaching by the students. * Construct an observational rating scale and/or a practical test to evaluite the behaviour of a student in the domain of communication and/or practical skills.{- Propose a question for a written (open...
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2 5 . Indicate structlng a programme. the steps involved in con- 2 6 . Construct a programme or decide whether a .programme or course needs revision, using a specification table. * 27. Construct a selfJearning package.* 2 8 . Define the role which, as a teacher, you would like to assume in orde...
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3 8 . Explain the difference between a rehthte and an absolute criteria test. 3 9 . Calculate the acceptable pass level for a MCQ examination and establish the scoring criteria and norms which permit determination of the passing grade of a mini-test (made up of the questions mentioned in objectives ...
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4 . 6 3 p p . 4 . 6 5 - 4 . 7 3 and do the corresponding exercises (blue pages): see list on next page. L 4 Recapitulative table of exercises proposed Ilandbook Objective 3 3 Exercise Identifying professional activities Defining the main functions of health personnel 20/26 Analysis of the relevance of a pro...
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T . 5 L r . 5 2 r . 5 + l . ) ) 1 . 5 6 1 . . 5 7 / r . 6 0 2 . 0 9 Statement of educational decisions L 7 L2 Distinguishing between formative evaluation and certifying evaluation 2 . 1 6 t 2 . t 9 13,r4,76Selecting a method of evaluation 1 5 , 7 6 Comparing several methods of evaluation T7 1 8 Gra...
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Identifying obstacles to and strategies for introducing a new programme 1 9 / 2 9 Evaluation of knowledge about programme construction 3 2 33 3 3 3 4 3 4 3 5 3 6 36 3 9 40 Listing advantages and limitations of evaluation by students Drawing up a practical test or project test Constructing an attitude tab...
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+ .29 4 . 3 0 +.39t+.+O +.48 + . 5 5 t + . 5 7 4 . 7 r + .7 5 30/40 Evaluation of knowledge about test and measurement techniques 4.7 5 t4.80 acknowledgments This revised edition of the Handbook has involved a lot of meticulous and time-con- suming work over the last three years. Many people have...
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We should also like to thank all those who have sent us helpful comments and suggestions, H. Jason (Miami),
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I. M. Lovedee (Rangoon)' We trust that anyone who has been overlooked will forgive us. Indeed, among the 1250 collea- grr., *fro have taken part iriworkshops with h"rry whose questions ihe author, there "r. to and opinions have helped in our .ifort, ensurJthat the Handbook is tailored to mee...
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t 6 educational obiectives the concept of educational obiectives The aims of this first chapter are to show the advantages of defining educational objectives; to show that if precision and ctarity of educational objectives are important, relevance to health problems is even more so; and to show that an ...
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And the following publication by the World Heahh Organization. r Criteria for the evaluation of objectives in the education of health personnel, WHO, Technical Report Series, 1977, No. 608. After having studied this chapter and the reference documents mentioned you should be able to: 1. Define the following ...
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2. List the qualities of an educational objective and the sources necessary to ensure its relevance. 3. Define the professional functions of a member of the health team whom your teaching institution is responsible for training (generol educational objectives) so as to deal with the health problems o...
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6. Draw up a list of the specific educational objectives relating to a professional task, stating explicitly what you feel the student 7. Taking a specific objective in a non- (i.e., practical or cognitive domain communicative skills), define in terms of educational objectives what specific theo...
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t.o2 If you are not certain of where you are going you may verY well end up somewhere else (and not even know it ) Mager o Every individual should have access to a type of education that permits maximum development of his potential and capabilities. Education is a process, the chief goal of which is to b...
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A programme will be prepared and implemented to facilitate attainment of educational objectives by the students. The evaluation process will be used to measure the extent to which the objectives have been achieved . . . it will measure the student's final abilities . . . and the effectiveness of programme and teac...
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It would, however, be negative and dangerous merely to accuse of incompetence those at present in positions of teaching responsibiliry. They should be offered help. Societies change and have always been changing, but until the present century their evolution was relatively slow and adaptation to ch...
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There can be no question of continuing to copy the models of the past or, in the case of developing countries, foreign models. Tbe educotional system leadingto tbe deaelop- ment of health personnel, at all leaels, must be re-examined witbin tbe context of tbe needs of tbe coantrJl concerned.r N...
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Professional training programmes must then be tailored to meet these needs. There is room for some degree of optimism in this sphere, for no financial assistance is needed for a move in the right direction. that is needed is a resource distributed All more or less equally around the world: m...
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Definition of professional tasks must Proceed from a study of needs, take account of available resources and indicate clearly and precisely what various categories of personnel will be called upon to do during their pro- in a given type of health fessional sreers service. t The study of ...
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t r ! t L ! . n ! ! ! ! t n 1 . 0 5 the educational spiral Defining Tasks and Educational Objectives lmplementing Evaluation Planning an Evaluation System Preparing and lmplementing an Educational Programme importance of defining professional tasks of being confined limited pers...
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of being confined limited personal experience they will accept the use of more formal educational research methods. to stimulus can be a powerful for This institutional change, particularly when used by faculry members whose experience in the educational process has already alerted them to th...
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and dweloped according institutions This is a very difficult task which may well have daunted the most conscientious. We teachers should be offered consider that assistance in this field. That is the main reason why this Handbook has been prepared and used during work- shops on educat...
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Indeed, if educational objectives are based on faulty principles, then the "best" system of training may well give "bad" results. There is even a danger that a "bad" message will be "better" communicated, and this is certainly not the goal sought. We therefore propose to demonstrate that the pro...
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the Another important point to bear in mind is that it can be useless to try to change a pro- gramme or teaching methods without also changing the system of evaluation (parti- cularly examinations). Experience has shown that if, on the other hand, the evaluation system is modified, this...
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level at the If the teaching staff are given an opportunity to gain the new knowledge they need and to acquire the appropriate modern teaching skills, they will feel more secure and instead t.o7 Organizational diagram showing the relationship between the subsystem "Education" (inside the dotted l...
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this selection has been made Traditionally, by relying on the judgment of experts to determine what a neophyte in the profession ought to know and ought to be able to do. In the past we have relied almost exclusively on this method. As a result curricula are crammed with an ever-bu...
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competent health personnel need to know and need to be able to do in order to fulfil their responsibilities. A number of procedures have now been developed for collecting such data which provide an empirical basis for working out a behavioural description of the essential components of pr...
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The critical incident technique II.
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II. This method consists in collecting data about specific types of behaviour that charactetize professional effectiveness and ineffectiveness and using these data to make an objective, the essential per- empirical assessment of the profession. formance requirements of This technique is an ou...
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them In assigned mission. This request concluded with the statement: "Describe the officer's action. What did he do?" The several thousand this incidents submitted inquiry were analysed and categorized to provide a relatively objective and concrete the "critical requirements" description of ...
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the health To apply professions, several thousand incidents des- cribing observations of especially effective or ineffective colleague behaviour are collected health workers from representing various age groups, geographical areas, professional categories and specialty interests. For example, in a ...
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in gathering clinical petence as "Skill i.e., in taking a competent information," in performing an adequate history and physical examination, or "Skill in relating to the patient and in gaining his cooperation in a treatment plan". In a similar study con- ducted by the University of l...
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of the essential components of competence could then be used to determine the goals of specialty training, the design of programmes their achievement and the criteria and for If their methodology
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evaluation. for I F.o- "An overview of applied research in medical education problems, principles and priorities". Christine H. McGuire, WHO Report on the Workshop on the Needs for Research in Medical Education, Alexandria, March 1974. 1 . 0 9 educational planning were regularly base...
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Task analysis A second method of determining the essential components of professional competence which should define educational objectives consists in detailed task analysis of what various categories of health personnel actually do, and in deriving from that list of tasks a the knowledge and s...
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Wherever this method has been employed, the results have been most enlightening. For studY of example, paediatricians in a typical small U.S. city, researchers found that all the physicians had different but consistent patterns for taking a history and performing a physical examin- the 481 patien...
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For the total group of 481, optic fundi were examined only nine times and rectals were performed in only six cases; two physicians did not percuss the lung fields for any patient. The greatest amount of time was sPent in discussion of nutrition and child development. The single most frequent to...
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I B.rg-"n, A., Probstfield, J. and Wedgewood, R- Per- formance analysis in pediatric practice: preliminary report' J o urnal o f M e dic al E d u cation, Y ol. 42 t 262 (19 67 ). 1 . 1 0 study concluded, "Few aspects of anll'child cdre appedr to require tbe skill of a pbysician . . . the qu...
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Epidemiological studies One of the most interesting of the newer approaches to the use of such studies consists three arbitrarily weighted in combining factors - disease incidence, individual dis- to define ability and social disruption priorities in health care needs and, hence, in educatio...
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condition from three elements: the average length of hospital stay, mortality rates and disruption complication the disruption represents an estimate of that would be produced by a given disease or condition in the social grouP of which the patient is a member; it is based on such factor...
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rates. Social of 2 willi"-*tt,J. a t i o n . Y o l . 2 O l : 9 3 8 et al. Joumal of American Medical Associ' ( 1 9 6 7 ) a n d V o l . 2 O 4 : 3 0 3 ( 1 9 6 8 ) . It is clear that even with unlimited resources not all of these needs could be met in the present state of our knowle...
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In his early studies u3;ing this method to review hospital practice in two large community hospitals in widely separated metropolitan areas in the United States, Dr. Williamson that pregnancy, including uncom- found plicated delivery, ranked first or second in in both hospitals, that cerebral ...
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While the study reported above was limited to hospital practice, the same method could easily be applied to any level of health practice. Secondly, while the findings from such epidemiological studies and the particular weights to be assigned to such factors as individual disability and soc...
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on ambulatory medicine and on the more common causes of disability. Implications of applied research on goals and priorities It can be seen from the above that the means are now at hand for supplementing expert judgment with data derived from empirical studies to assist us in defining the rol...
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Here we should mention some simpler but also more rapid and less costly techniques which can be used to complement or replace other methods. These methods are not mutually exclusive: - Interviews with members of the profession, who are asked to describe what, in the light of their experience...
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services to be able to perform. Comparison of the lists submitted will lead to rapid agree- ment on a common list of sufficiently high quality to provide a basis for a productive discussion on the relevance of the programme, for example.
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"Transformation of the present professionally oriented technologically dominated health system into a patient oriented system is the needed ingredient for any successful curriculum change. The patient should be the primary concern of both education and service". George A. Silver 1 . 1 1 example of services ...
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r Maternal and Child Health work r Communicable Disease Control work r Vital and Health Statistics work I Environmental Sanitation work, and r Medical Care work. I Adapted from "Three approaches to the analysis of health manpower functions". HMD/79.7,pp.69 This list was obtained using the questio...
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8 Referring patients to hospitals. 9 Giving hypodermic, intramuscular and intravenous injections. 10 Supervision of cleanlinessofpregnant women. Ll Carrying out activities. health education 15 Conducting abnormal labour, and transfer to hospital where necessary. L6 Giving hypodermic, intramusc...
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24 Temperature taking. LZ Home visiting for non-attendants and 25 Carrying out medical examination. during the ninth month. (b) Natal Care actiaities: 13 Preparation of delivery bags. L4 Conducting normal deliveries at home. t . t 2 26 Prescribing treatment. 27 Referring patients to hospitals. 2...
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55 Receiving notifications of deaths and search for relations. 56 Examination of the dead and establishment of death certificates. 57 Recording in the appropriate registers. 58 Issuing of burial permits. midwives. Vital and health statistics work: 37 Preparation of drugs for distribution. ...
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60 Making weekly and monthly reports. 6l Calculation of death ratios, etc. 62 Making statistical studies and inter- pretations. Environmental sanitation work, 63 Numbering of houses and population census. 64 Mapping areas and facilities. 65 Ensuring cleanliness in and around dwellings. 66 Hygieni...
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48 Noting names of non-attendants. doctor. 49 Preparation of list of families. 50 Carrying out periodic dusting. 5l Recording in disinfection and dusting registers. 52 Controlling insects and rodents. 73 Supervision of sanitation activities. environmental 74 Examination of food in public place...
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82 Preparing the patient. 83 Taking the history. 84 Recording clinical observations. 85 Weighing the patient. 86 Taking the temperature. 87 Counting the respiration. 88 Counting the pulse. 89 Measurement of blood pressure. 102 Application of hot and/or cold compresses. 1 0 3 Administration of e...
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9I Requesting laboratory tests. 92 Taking blood samples and administer- ing transfusions. 93 Microscopic examination of blood and blood grouping. 94 Urine examination for parasites, chemical analysis and microscopic examination of urine. 95 Requesting X-ray examination. 96 Examination of stools. ...
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124 Recording attendance in waiting- room. 99 Giving oral medication. 725 Supervising housekeeping of the unit. 100 Applying artificial respiration. 126 Supervisingtransportation. ! t r t r n ! n D ! ! t r ! ! ! r - l D l n t r ! ! ! n Please Note! You are reminded that this list, drawn up...
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Then think of lome mtivities whieh fiat same catqory doss not undrtake at pretent but which you feel, in the light of your pe$onal exporionce, it shwld urllds&*o to improw the level of hsalth of the population it sorvsd. Draw asgtram sround each of the mrr@onding items on the lisa 3. Describe belo1y any srttbtd...
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7 . 7 7 relationship between professional acts in the health field and educational obiectives Professional Functions or GeneralObjectives Professional Activities or "l ntermediate" Educational Objectives Tasks and Specific Educational Objectives Note: The size of the circles relates to the number of objectives...
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"lntermediate" objectives: Arrived at by breaking down professional functions into components (activities) which together indicate the nature of those functions. Example: Planning and carrying out a blood sampling session for a group of adults in the community. Specific (or instructional) objectives: Correspo...
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1 . 1 9 data necessary for formulation of educational objectives Health needs, demands and resources of society. Services to the patient (list of tasks). Service to the community (list of tasks). The profession itself. The students. Progress in sciences. The scientitic method. e t c . . . . . . For more de...
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