Izinto ezibangela impilo yomphakathi (SDOH) zihlobene kakhulu nezici eziningi zenhlalo nezomnotho. Ukuzindla kubalulekile ekufundeni i-SDH. Kodwa-ke, imibiko embalwa kuphela ehlaziya izinhlelo ze-SDH; eminingi yayo iyizifundo ezihlanganisa izingxenye ezahlukene. Sifune ukwenza ukuhlolwa kwesikhathi eside kohlelo lwe-SDH esifundweni semfundo yezempilo yomphakathi (CBME) esasungulwa ngo-2018 ngokusekelwe ezingeni kanye nokuqukethwe kokuzindla okubikwe ngabafundi nge-SDH.
Umklamo wocwaningo: Indlela ejwayelekile yokufundisa ekuhlaziyweni kwedatha esezingeni eliphezulu. Uhlelo Lwezemfundo: Ukuqeqeshwa okuphoqelekile kwamasonto amane kwezokwelapha ezijwayelekile kanye nokunakekelwa okuyisisekelo eNyuvesi yaseTsukuba School of Medicine, eJapane, kunikezwa bonke abafundi bezokwelapha bonyaka wesihlanu nowesithupha. Abafundi bachithe amasonto amathathu besemsebenzini emitholampilo yomphakathi nasezibhedlela ezindaweni zasemadolobheni nasezindaweni zasemaphandleni zase-Ibaraki Prefecture. Ngemuva kosuku lokuqala lwezinkulumo ze-SDH, abafundi bacelwe ukuba balungiselele imibiko yamacala ehlelekile ngokusekelwe ezimweni abahlangane nazo phakathi nesifundo. Ngosuku lokugcina, abafundi babelane ngolwazi lwabo emihlanganweni yeqembu futhi bethula iphepha nge-SDH. Uhlelo luyaqhubeka nokuthuthukisa nokuhlinzeka ngentuthuko yothisha. Abahlanganyeli besifundo: abafundi abaqede uhlelo phakathi kuka-Okthoba 2018 noJuni 2021. Ukuhlaziya: Izinga lokuzindla lihlukaniswa njengokuzindla, ukuhlaziya noma ukuchaza. Okuqukethwe kuhlaziywa kusetshenziswa ipulatifomu ye-Solid Facts.
Sihlaziye imibiko eyi-118 ka-2018-19, imibiko eyi-101 ka-2019-20 kanye nemibiko eyi-142 ka-2020-21. Bekukhona imibiko emibili (1.7%), eyi-6 (5.9%) kanye neyi-7 (4.8%) yokuzindla, imibiko yokuhlaziya eyi-9 (7.6%), eyi-24 (23.8%) kanye neyi-52 (35.9%), imibiko echazayo engama-36 (30.5%) ngokulandelana, engama-48 (47.5%) kanye neyi-79 (54.5%). Ngeke ngiphawule ngokunye. Inani lamaphrojekthi e-Solid Facts embikweni lingu-2.0 ± 1.2, 2.6 ± 1.3, kanye no-3.3 ± 1.4, ngokulandelana.
Njengoba amaphrojekthi e-SDH ezifundweni ze-CBME ethuthukiswa, ukuqonda kwabafundi nge-SDH kuyaqhubeka nokujula. Mhlawumbe lokhu kwenziwe lula ukuthuthukiswa kothisha. Ukuqonda okubonakalayo kwe-SDH kungadinga ukuthuthukiswa kothisha okwengeziwe kanye nemfundo ehlanganisiwe kwezesayensi yezenhlalo kanye nezokwelapha.
Izinto ezibangela impilo yomphakathi (SDH) ziyizici ezingezona ezezokwelapha ezithonya isimo sempilo, okuhlanganisa nendawo lapho abantu bazalelwa khona, bakhula khona, basebenza khona, baphila futhi baguga khona [1]. I-SDH inomthelela omkhulu empilweni yabantu, futhi ukungenelela kwezokwelapha kukodwa akukwazi ukushintsha imiphumela yempilo ye-SDH [1,2,3]. Abahlinzeki bezempilo kumele baqaphele i-SDH [4, 5] futhi banikele emphakathini njengabameli bezempilo [6] ukuze kuncishiswe imiphumela emibi ye-SDH [4,5,6].
Ukubaluleka kokufundisa i-SDH emfundweni yezokwelapha ye-undergraduate kuqashelwa kabanzi [4,5,7], kodwa kunezinselele eziningi ezihambisana nemfundo ye-SDH. Kwabafundi bezokwelapha, ukubaluleka okubalulekile kokuxhumanisa i-SDH nezindlela zezifo zebhayoloji [8] kungase kujwayeleke kakhulu, kodwa ukuxhumana phakathi kwemfundo ye-SDH nokuqeqeshwa kwezokwelapha kungase kuncishiswe. Ngokusho kwe-American Medical Association Alliance for Accelerating Change in Medical Education, imfundo eyengeziwe ye-SDH inikezwa ngonyaka wokuqala nowesibili wemfundo yezokwelapha ye-undergraduate kunangonyaka wesithathu noma wesine [7]. Akuzona zonke izikole zezokwelapha e-United States ezifundisa i-SDH ezingeni lezokwelapha [9], ubude bezifundo buyahlukahluka [10], futhi izifundo zivame ukuba yizifundo zokuzikhethela [5, 10]. Ngenxa yokuntuleka kokuvumelana ngamakhono e-SDH, amasu okuhlola abafundi nezinhlelo ayahlukahluka [9]. Ukuze kukhuthazwe imfundo ye-SDH ngaphakathi kwemfundo yezokwelapha ye-undergraduate, kubalulekile ukusebenzisa amaphrojekthi e-SDH eminyakeni yokugcina yemfundo yezokwelapha ye-undergraduate nokwenza ukuhlolwa okufanele kwamaphrojekthi [7, 8]. IJapane iphinde yaqaphela ukubaluleka kwemfundo ye-SDH emfundweni yezokwelapha. Ngo-2017, imfundo ye-SDH yafakwa ohlelweni lwezifundo oluyinhloko lwemfundo yezokwelapha yokubonisa, okucacisa imigomo okufanele ifinyelelwe lapho kuphothulwa esikoleni sezokwelapha [11]. Lokhu kugcizelelwa kakhulu ekubuyekezweni kuka-2022 [12]. Kodwa-ke, izindlela zokufundisa nokuhlola i-SDH azikasungulwa eJapane.
Esifundweni sethu sangaphambilini, sihlole izinga lokuzindla emibikweni yabafundi bezokwelapha abaphezulu kanye nezinqubo zabo ngokuhlola ukuhlolwa kwephrojekthi ye-SDH esifundweni semfundo yezokwelapha esisekelwe emphakathini (CBME) [13] eyunivesithi yaseJapan. Ukuqonda i-SDH [14]. Ukuqonda i-SDH kudinga ukufunda okuguqulayo [10]. Ucwaningo, okuhlanganisa nolwethu, lugxile ekucabangeni kwabafundi ekuhloleni amaphrojekthi e-SDH [10, 13]. Ezifundweni zokuqala esizinikeze, abafundi babonakala beqonda ezinye izici ze-SDH kangcono kunezinye, futhi izinga labo lokucabanga nge-SDH laliphansi kakhulu [13]. Abafundi bajulisa ukuqonda kwabo nge-SDH ngokusebenzisa okuhlangenwe nakho komphakathi futhi baguqula imibono yabo ngemodeli yezokwelapha yaba imodeli yokuphila [14]. Le miphumela iwusizo lapho amazinga ekharikhulamu yemfundo ye-SDH kanye nokuhlolwa nokuhlolwa kwayo kungakabikho ngokugcwele [7]. Kodwa-ke, ukuhlolwa kwesikhathi eside kwezinhlelo ze-SDH ze-undergraduate akubikwa njalo. Uma singabonisa njalo inqubo yokuthuthukisa nokuhlola izinhlelo ze-SDH, izosebenza njengesibonelo sokuklama nokuhlola okungcono izinhlelo ze-SDH, okuzosiza ekuthuthukiseni amazinga namathuba e-SDH ye-undergraduate.
Inhloso yalolu cwaningo kwakuwukubonisa inqubo yokuthuthukiswa okuqhubekayo kohlelo lwezemfundo lwe-SDH lwabafundi bezokwelapha kanye nokwenza ukuhlolwa kwesikhathi eside kohlelo lwezemfundo lwe-SDH esifundweni se-CBME ngokuhlola izinga lokuzindla emibikweni yabafundi.
Ucwaningo lusebenzise indlela ejwayelekile yokufundisa futhi lwenza ukuhlaziywa kwemininingwane yephrojekthi minyaka yonke iminyaka emithathu. Luhlola imibiko ye-SDH yabafundi bezokwelapha ababhalise ezinhlelweni ze-SDH ngaphakathi kwezifundo ze-CBME. Ukungeniswa okujwayelekile kuyinqubo ehlelekile yokuhlaziya idatha yemininingwane lapho ukuhlaziywa kungaqondiswa khona yimigomo ethile yokuhlola. Umgomo ukuvumela okutholakele kocwaningo ukuthi kuvele ezindikimbeni ezivamile, ezibusayo, noma ezibalulekile ezitholakala kudatha eluhlaza kunokuba kuchazwe kusengaphambili ngendlela ehlelekile [15].
Abahlanganyeli ocwaningweni kwakungabafundi bezokwelapha bonyaka wesihlanu nowesithupha e-University of Tsukuba School of Medicine abaphothule ukuqeqeshwa kwezokwelapha okuphoqelekile kwamasonto amane esifundweni se-CBME phakathi kukaSepthemba 2018 noMeyi 2019 (2018-19). Mashi 2020 (2019-20) noma ngo-Okthoba 2020 nangoJulayi 2021 (2020-21).
Isakhiwo sesifundo se-CBME samasonto amane sasifana nezifundo zethu zangaphambilini [13, 14]. Abafundi bathatha i-CBME onyakeni wabo wesihlanu noma wesithupha njengengxenye yesifundo se-Introduction to Medicine, esenzelwe ukufundisa ochwepheshe bezempilo ulwazi oluyisisekelo, okuhlanganisa ukukhuthazwa kwezempilo, ubungcweti, kanye nokubambisana phakathi kochwepheshe. Imigomo yekharikhulamu ye-CBME ukuveza abafundi kokuhlangenwe nakho kodokotela bomndeni abanikeza ukunakekelwa okufanele ezindaweni ezahlukene zezokwelapha; ukubika izinkinga zezempilo kubantu, iziguli, kanye nemindeni ohlelweni lwezempilo lwendawo; nokuthuthukisa amakhono okucabanga emitholampilo. . Njalo emavikini ama-4, abafundi abayi-15-17 bathatha isifundo. Ukushintshaniswa kufaka phakathi isonto eli-1 endaweni yomphakathi, isonto eli-1-2 emtholampilo womphakathi noma esibhedlela esincane, kuze kube yisonto eli-1 esibhedlela somphakathi, kanye nesonto eli-1 emnyangweni wezokwelapha womndeni esibhedlela saseyunivesithi. Ezinsukwini zokuqala nezokugcina, abafundi bahlangana eyunivesithi ukuze bathamele izinkulumo nezingxoxo zeqembu. Ngosuku lokuqala, othisha bachaze izinhloso zesifundo kubafundi. Abafundi kumele bathumele umbiko wokugcina ohlobene nezinhloso zesifundo. Othisha abathathu abayinhloko (i-AT, i-SO, kanye ne-JH) bahlela iningi lezifundo ze-CBME kanye namaphrojekthi e-SDH. Lolu hlelo luhlinzekwa ngabafundisi abayinhloko kanye nabafundisi abangochwepheshe abayi-10-12 abahilelekile ekufundiseni iziqu zokuqala eyunivesithi ngenkathi behlinzeka ngezinhlelo ze-CBME njengodokotela bomndeni abasebenzayo noma abafundisi bezokwelapha abangebona odokotela abajwayelene ne-CBME.
Isakhiwo sephrojekthi ye-SDH esifundweni se-CBME silandela isakhiwo sezifundo zethu zangaphambilini [13, 14] futhi sihlala siguqulwa (Isithombe 1). Ngosuku lokuqala, abafundi baya enkulumweni ye-SDH eqhutshwa ngezandla futhi baqedela izabelo ze-SDH ngesikhathi sokujikeleza kwamasonto ama-4. Abafundi bacelwa ukuba bakhethe umuntu noma umndeni abahlangane nawo ngesikhathi sokuqeqeshwa kwabo futhi baqoqe ulwazi ukuze bacabangele izici ezingaba nomthelela empilweni yabo. I-World Health Organization inikeza i-Solid Facts Second Edition [15], amaphepha okusebenzela e-SDH, kanye namaphepha okusebenzela aqediwe njengezinto zokubhekisela. Ngosuku lokugcina, abafundi bethule amacala abo e-SDH ngamaqembu amancane, iqembu ngalinye lalakhiwe abafundi abangu-4-5 nothisha oyedwa. Ngemva kwesethulo, abafundi banikwa umsebenzi wokuhambisa umbiko wokugcina wesifundo se-CBME. Bacelwa ukuba bawuchaze futhi bawuhlobanise nokuhlangenwe nakho kwabo ngesikhathi sokujikeleza kwamasonto ama-4; bacelwa ukuba bachaze 1) ukubaluleka kochwepheshe bezempilo ukuqonda i-SDH kanye 2) indima yabo ekusekeleni indima yezempilo yomphakathi okufanele idlalwe. Abafundi banikezwa imiyalelo yokubhala umbiko kanye nolwazi oluningiliziwe mayelana nendlela yokuhlola umbiko (izinto ezengeziwe). Ekuhlolweni kwabafundi, amalungu angaba ngu-15 othisha (kufaka phakathi amalungu othisha abayinhloko) ahlole imibiko ngokuqhathanisa nezindlela zokuhlola.
Ukubuka konke kohlelo lwe-SDH kuhlelo lwezifundo lwe-CBME lwe-University of Tsukuba Faculty of Medicine ngonyaka wezifundo ka-2018-19, kanye nenqubo yokuthuthukiswa kohlelo lwe-SDH kanye nokuthuthukiswa kobungcweti eminyakeni yezifundo ka-2019-20 kanye no-2020-21. Unyaka ka-2018-19 ubhekisela ohlelweni kusukela ngo-Okthoba 2018 kuya kuMeyi 2019, u-2019-20 ubhekisela ohlelweni kusukela ngo-Okthoba 2019 kuya kuMashi 2020, kanti u-2020-21 ubhekisela ohlelweni kusukela ngo-Okthoba 2020 kuya kuJuni 2021. I-SDH: Izinto Ezibangela Impilo Emphakathini, i-COVID-19: Isifo se-Coronavirus 2019
Kusukela yaqalwa ngo-2018, besilokhu sishintsha uhlelo lwe-SDH futhi sahlinzeka ngentuthuko yothisha. Lapho iphrojekthi iqala ngo-2018, othisha abayinhloko abayisungulile banikeza izinkulumo zokuthuthukiswa kothisha kwabanye othisha ababezohlanganyela kuphrojekthi ye-SDH. Inkulumo yokuqala yokuthuthukiswa kothisha igxile ku-SDH kanye nemibono yezenhlalo ezindaweni zezokwelapha.
Ngemva kokuphothulwa kwephrojekthi ngonyaka wesikole ka-2018-19, sabamba umhlangano wokuthuthukiswa kothisha ukuze sixoxe futhi siqinisekise imigomo yephrojekthi futhi sishintshe iphrojekthi ngokufanele. Ohlelweni lonyaka wesikole ka-2019-20, oluqale ngoSepthemba 2019 kuya kuMashi 2020, sinikeze Iziqondiso Zokuqondisa, Amafomu Okuhlola, kanye Nezindlela Zokusebenza Zabaxhumanisi Bezifundo ukuze benze Izethulo Zeqembu Lezihloko ze-SDH ngosuku lokugcina. Ngemva kwesethulo ngasinye seqembu, sabamba izingxoxo zeqembu nomxhumanisi wothisha ukuze sicabange ngohlelo.
Ngonyaka wesithathu wohlelo, kusukela ngoSepthemba 2020 kuya kuJuni 2021, sabamba imihlangano yokuthuthukiswa kothisha ukuze sixoxe ngemigomo yohlelo lwezemfundo lwe-SDH sisebenzisa umbiko wokugcina. Senze izinguquko ezincane ekunikezelweni kombiko wokugcina kanye nenqubo yokuhlola (izinto ezengeziwe). Sishintshe nefomethi kanye nezinsuku zokugcina zokufaka izicelo ngesandla kanye nokufaka ngaphambi kosuku lokugcina kwaba ukufaka nokufaka nge-elekthronikhi zingakapheli izinsuku ezi-3 kusukela ecaleni.
Ukuze sithole izingqikithi ezibalulekile nezivamile kulo lonke umbiko, sihlole izinga izincazelo ze-SDH eziboniswe ngalo futhi sakhipha izici eziqinile zamaqiniso okukhulunywe ngazo. Ngenxa yokuthi ukubuyekezwa kwangaphambilini [10] kucabangele ukuzindla njengendlela yokuhlolwa kwezemfundo nohlelo, sinqume ukuthi izinga elithile lokuzindla ekuhlolweni lingasetshenziswa ukuhlola izinhlelo ze-SDH. Njengoba ukuzindla kuchazwa ngendlela ehlukile ezimweni ezahlukene, samukela incazelo yokuzindla kumongo wemfundo yezokwelapha "njengenqubo yokuhlaziya, ukubuza imibuzo nokwakha kabusha okuhlangenwe nakho ngenhloso yokukuhlola ngezinjongo zokufunda." /noma ukuthuthukisa umkhuba,” njengoba kuchaziwe ngu-Aronson, ngokusekelwe encazelweni kaMezirow yokuzindla okubucayi [16]. Njengasesifundweni sethu sangaphambilini [13], isikhathi seminyaka emi-4 ngo-2018-19, 2019-20 kanye no-2020-21. embikweni wokugcina, uZhou wahlukaniswa njengokuchazayo, okuhlaziyayo, noma okuzindlayo. Lokhu kuhlukaniswa kusekelwe esitayeleni sokubhala sezemfundo esichazwe yi-University of Reading [17]. Njengoba ezinye izifundo zemfundo zihlole izinga lokuzindla ngendlela efanayo [18], sinqume ukuthi kufanelekile ukusebenzisa lokhu kuhlukaniswa ukuhlola izinga lokuzindla kulo mbiko wocwaningo. Umbiko olandisayo umbiko osebenzisa uhlaka lwe-SDH ukuchaza icala, kodwa lapho kungekho ukuhlanganiswa kwezinto. Umbiko wokuhlaziya umbiko ohlanganisa izici ze-SDH. Imibiko yocansi yokuzindla yimibiko lapho ababhali becabanga khona ngemicabango yabo mayelana ne-SDH. Imibiko engawelanga kwenye yalezi zigaba yahlukaniswa njengengahlolwa. Sisebenzise ukuhlaziywa kokuqukethwe okusekelwe ohlelweni lwe-Solid Facts, inguqulo 2, ukuhlola izici ze-SDH ezichazwe ku imibiko [19]. Okuqukethwe kombiko wokugcina kuhambisana nezinhloso zohlelo. Abafundi bacelwe ukuba bacabange ngokuhlangenwe nakho kwabo ukuze bachaze ukubaluleka kochwepheshe bezempilo ukuqonda i-SDH kanye nendima yabo emphakathini. I-SO ihlaziye izinga lokuzindla elichazwe embikweni. Ngemva kokucabangela izici ze-SDH, i-SO, i-JH, kanye ne-AT baxoxe futhi baqinisekisa izindlela zokukhetha isigaba. I-SO iphinde yahlaziya. I-SO, i-JH, kanye ne-AT baxoxe kabanzi ngokuhlaziywa kwemibiko edinga izinguquko ekuhlukanisweni. Bafinyelele esivumelwaneni sokugcina ngokuhlaziywa kwayo yonke imibiko.
Abafundi abangu-118, 101 kanye no-142 bahlanganyele ohlelweni lwe-SDH eminyakeni yezifundo ka-2018-19, 2019-20 kanye no-2020-21. Kwakukhona abafundi besifazane abangu-35 (29.7%), 34 (33.7%) kanye no-55 (37.9%) ngokulandelana.
Isibalo 2 sibonisa ukusatshalaliswa kwamazinga okuzindla ngonyaka uma kuqhathaniswa nesifundo sethu sangaphambilini, esahlaziya amazinga okuzindla emibikweni ebhalwe ngabafundi ngo-2018-19 [13]. Ngo-2018-2019, imibiko engu-36 (30.5%) yahlukaniswa njengendaba elandiswayo, ngo-2019-2020 - imibiko engu-48 (47.5%), ngo-2020-2021 - imibiko engu-79 (54.5%). Kwakukhona imibiko yokuhlaziya engu-9 (7.6%) ngo-2018-19, imibiko yokuhlaziya engu-24 (23.8%) ngo-2019-20 kanye nengu-52 (35.9%) ngo-2020-21. Kwakukhona imibiko yokuzindla engu-2 (1.7%) ngo-2018-19, engu-6 (5.9%) ngo-2019-20 kanye nengu-7 (4.8%) ngo-2020-21. Imibiko engu-71 (60.2%) yahlukaniswa njengengalinganiswanga ngo-2018-2019, imibiko engu-23 (22.8%) ngo-2019-2020. kanye nemibiko engu-7 (4.8%) ngo-2020-2021. Yahlukaniswa njengengalinganiswanga. Ithebula 1 linikeza imibiko eyisibonelo yezinga ngalinye lokuzindla.
Izinga lokuzindla emibikweni yabafundi yamaphrojekthi e-SDH anikezwa eminyakeni yezifundo ka-2018-19, 2019-20 kanye no-2020-21. U-2018-19 ubhekisela ohlelweni oluqala ngo-Okthoba 2018 kuya kuMeyi 2019, u-2019-20 ubhekisela ohlelweni oluqala ngo-Okthoba 2019 kuya kuMashi 2020, kanti u-2020-21 ubhekisela ohlelweni oluqala ngo-Okthoba 2020 kuya kuJuni 2021. I-SDH: Izici Zempilo Emphakathini
Iphesenti lezici ze-SDH ezichazwe embikweni liboniswe kuMfanekiso 3. Inani elimaphakathi lezici ezichazwe emibikweni lalingu-2.0 ± 1.2 ngo-2018-19, 2.6 ± 1.3 ngo-2019-20. kanye no-3.3 ± 1.4 ngo-2020-21.
Amaphesenti abafundi ababike ukuthi bakhulume ngesici ngasinye ku-Solid Facts Framework (uHlelo lwesibili) emibikweni ka-2018-19, 2019-20, kanye no-2020-21. Isikhathi sika-2018-19 sibhekisela ku-Okthoba 2018 kuya kuMeyi 2019, 2019-20 sibhekisela ku-Okthoba 2019 kuya kuMashi 2020 kanye no-2020-21 sibhekisela ku-Okthoba 2020 kuya kuJuni 2021, lezi yizinsuku zohlelo. Ngonyaka wezifundo ka-2018/19 kwakunabafundi abangu-118, ngonyaka wezifundo ka-2019/20 - abafundi abangu-101, ngonyaka wezifundo ka-2020/21 - abafundi abangu-142.
Sethule uhlelo lwemfundo lwe-SDH esifundweni se-CBME esidingekayo kubafundi bezokwelapha abangaphansi kweziqu futhi sethule imiphumela yokuhlolwa kweminyaka emithathu kohlelo sihlola izinga lokuzindla kwe-SDH emibikweni yabafundi. Ngemva kweminyaka emi-3 yokusebenzisa lo msebenzi nokuyithuthukisa njalo, iningi labafundi lakwazi ukuchaza i-SDH nokuchaza ezinye zezici ze-SDH embikweni. Ngakolunye uhlangothi, bambalwa kuphela abafundi abakwazile ukubhala imibiko yokuzindla nge-SDH.
Uma kuqhathaniswa nonyaka wesikole ka-2018-19, iminyaka yesikole ka-2019-20 kanye no-2020-21 ibone ukwanda kancane kancane kwenani lemibiko yokuhlaziya nechazayo, kuyilapho inani lemibiko engahlolwanga lehla kakhulu, okungase kube ngenxa yokuthuthuka kohlelo kanye nokuthuthukiswa kothisha. Ukuthuthukiswa kothisha kubalulekile ezinhlelweni zemfundo ze-SDH [4, 9]. Sihlinzeka ngentuthuko yobungcweti eqhubekayo kothisha abahlanganyela kulolu hlelo. Lapho lolu hlelo luqalwa ngo-2018, i-Japan Primary Care Association, enye yezinhlangano zezemfundo zezokwelapha zomndeni kanye nezempilo yomphakathi zaseJapan, yayisanda kushicilela isitatimende nge-SDH kodokotela bokunakekelwa okuyisisekelo baseJapan. Iningi lothisha alijwayelene negama elithi SDH. Ngokuhlanganyela kumaphrojekthi kanye nokuxhumana nabafundi ngezinkulumo zamacala, othisha bajulisa kancane kancane ukuqonda kwabo nge-SDH. Ngaphezu kwalokho, ukucacisa imigomo yezinhlelo ze-SDH ngokuthuthukiswa kobungcweti kothisha okuqhubekayo kungasiza ekuthuthukiseni iziqu zothisha. Omunye umbono ongaba khona ukuthi lolu hlelo luye lwathuthuka ngokuhamba kwesikhathi. Ukuthuthukiswa okunjalo okuhleliwe kungadinga isikhathi esiningi nomzamo. Ngokuphathelene nohlelo luka-2020-2021, umthelela wobhubhane lwe-COVID-19 empilweni yabafundi kanye nasemfundweni [20, 21, 22, 23] ungabangela abafundi ukuthi babheke i-SDH njengenkinga ethinta izimpilo zabo futhi ibasize bacabange nge-SDH.
Nakuba inani lezici ze-SDH okukhulunywe ngazo embikweni likhuphukile, ukwanda kwezici ezahlukene kuyahlukahluka, okungase kuhlotshaniswe nezici zendawo yokusebenza. Amanani aphezulu okusekelwa komphakathi awamangazi uma kubhekwa ukuxhumana okuvamile neziguli esezivele zithola ukunakekelwa kwezokwelapha. Ezokuthutha nazo zikhulunywe ngazo njalo, okungase kube ngenxa yokuthi izindawo ze-CBME zitholakala ezindaweni zasemadolobheni noma zasemakhaya lapho abafundi empeleni behlangabezana nezimo zokuhamba ezingathandeki futhi benethuba lokuxhumana nabantu ezindaweni ezinjalo. Okunye okukhulunywe ngakho ukucindezeleka, ukuhlukaniswa komphakathi, umsebenzi nokudla, okungenzeka ukuthi abafundi abaningi babhekane nakho emsebenzini. Ngakolunye uhlangothi, umthelela wokungalingani komphakathi kanye nokungasebenzi empilweni kungaba nzima ukukuqonda phakathi nalesi sikhathi esifushane sokufunda. Izici ze-SDH abafundi abahlangabezana nazo emsebenzini zingase zincike ezicini zendawo yokusebenza.
Ucwaningo lwethu luwusizo ngoba sihlala sihlola uhlelo lwe-SDH ngaphakathi kohlelo lwe-CBME esilunikeza abafundi bezokwelapha abangaphansi kweziqu ngokuhlola izinga lokuzindla emibikweni yabafundi. Abafundi bezokwelapha abaphezulu asebefunde ubudokotela bezokwelapha iminyaka eminingi banombono wezokwelapha. Ngakho-ke, banamandla okufunda ngokuhlobanisa isayensi yezenhlalo edingekayo ezinhlelweni ze-SDH nemibono yabo yezokwelapha [14]. Ngakho-ke, kubaluleke kakhulu ukuhlinzeka ngezinhlelo ze-SDH kulaba bafundi. Kulesi sifundo, sikwazile ukuqhuba ukuhlolwa okuqhubekayo kohlelo ngokuhlola izinga lokuzindla emibikweni yabafundi. UCampbell et al. Ngokusho kombiko, izikole zezokwelapha zase-US kanye nezinhlelo zosizo lodokotela zihlola izinhlelo ze-SDH ngokusebenzisa izinhlolovo, amaqembu okugxila, noma idatha yokuhlola yeqembu eliphakathi. Izindlela zokulinganisa ezisetshenziswa kakhulu ekuhlolweni kwephrojekthi impendulo nokwaneliseka kwabafundi, ulwazi lwabafundi, kanye nokuziphatha kwabafundi [9], kodwa indlela ejwayelekile nephumelelayo yokuhlola amaphrojekthi ezemfundo e-SDH ayikakasungulwa. Lolu cwaningo luqokomisa izinguquko zesikhathi eside ekuhlolweni kohlelo kanye nokuthuthukiswa kohlelo okuqhubekayo futhi luzofaka isandla ekuthuthukisweni nasekuhlolweni kwezinhlelo ze-SDH kwezinye izikhungo zemfundo.
Nakuba izinga lokuzindla labafundi lilonke landa kakhulu phakathi nesikhathi sokufunda, inani labafundi ababhala imibiko yokuzindla lahlala liphansi. Izindlela ezengeziwe zezenhlalo zingase zidingeke zakhiwe ukuze kuthuthukiswe okwengeziwe. Izabelo ohlelweni lwe-SDH zidinga abafundi ukuthi bahlanganise imibono yezenhlalo neyezokwelapha, ehluke ngobunzima uma kuqhathaniswa nemodeli yezokwelapha [14]. Njengoba sishilo ngenhla, kubalulekile ukuhlinzeka ngezifundo ze-SDH kubafundi besikole samabanga aphezulu, kodwa ukuhlela nokuthuthukisa izinhlelo zemfundo kusukela ekuqaleni kwemfundo yezokwelapha, ukuthuthukisa imibono yezenhlalo neyezokwelapha, nokuyihlanganisa kungaba yimpumelelo ekuqhubekiseleni phambili intuthuko yabafundi. 'thuthukisa. Ukuqonda i-SDH. Ukwandiswa okwengeziwe kwemibono yezenhlalo yothisha kungasiza futhi ekwandiseni ukucabanga kwabafundi.
Lokhu kuqeqeshwa kunemikhawulo eminingana. Okokuqala, indawo yokufunda yayinqunyelwe esikoleni esisodwa sezokwelapha eJapane, kanti indawo ye-CBME yayinqunyelwe endaweni eyodwa emadolobheni noma emaphandleni eJapane, njengasezifundweni zethu zangaphambilini [13, 14]. Sichaze isizinda salolu cwaningo kanye nezifundo zangaphambilini ngokuningiliziwe. Ngisho nalezi mikhawulo, kubalulekile ukuqaphela ukuthi sibonise imiphumela evela kumaphrojekthi e-SDH kumaphrojekthi e-CBME eminyakeni edlule. Okwesibili, ngokusekelwe kulolu cwaningo lodwa, kunzima ukunquma ukuthi kungenzeka yini ukusebenzisa ukufunda okucabangayo ngaphandle kwezinhlelo ze-SDH. Ucwaningo olwengeziwe luyadingeka ukukhuthaza ukufunda okucabangayo kwe-SDH emfundweni yezokwelapha ye-undergraduate. Okwesithathu, umbuzo wokuthi ukuthuthukiswa kothisha kunegalelo yini ekuthuthukiseni uhlelo ungaphezu kwemingcele yalolu cwaningo. Ukusebenza kahle kokwakhiwa kwethimba lothisha kudinga ukutadisha nokuhlolwa okwengeziwe.
Senze ukuhlolwa kwesikhathi eside kohlelo lwemfundo lwe-SDH lwabafundi bezokwelapha abaphezulu ngaphakathi kwekharikhulamu ye-CBME. Sibonisa ukuthi ukuqonda kwabafundi nge-SDH kuyaqhubeka nokujula njengoba uhlelo lukhula. Ukuthuthukisa izinhlelo ze-SDH kungadinga isikhathi nomzamo, kodwa ukuthuthukiswa kothisha okuhlose ukwandisa ukuqonda kothisha nge-SDH kungasebenza kahle. Ukuze kuthuthukiswe ukuqonda kwabafundi nge-SDH, izifundo ezihlanganiswe kakhulu nesayensi yezenhlalo kanye nezokwelapha kungadingeka zithuthukiswe.
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Isikhathi sokuthunyelwe: Okthoba-28-2023