Zinthu zomwe zimayambitsa thanzi la anthu (SDOH) zimagwirizana kwambiri ndi zinthu zambiri zachikhalidwe ndi zachuma. Kuganizira mozama ndikofunikira kwambiri pophunzira SDH. Komabe, malipoti ochepa okha ndi omwe amafufuza mapulogalamu a SDH; ambiri ndi maphunziro osiyanasiyana. Tinayesetsa kuchita kuwunika kwa nthawi yayitali kwa pulogalamu ya SDH mu maphunziro a zaumoyo ammudzi (CBME) omwe adayambitsidwa mu 2018 kutengera mulingo ndi zomwe ophunzira adafotokoza za SDH.
Kapangidwe ka kafukufuku: Njira yodziwitsira deta yokhudza khalidwe. Pulogalamu Yophunzitsa: Ophunzira onse azachipatala a chaka chachisanu ndi chachisanu ndi chimodzi omwe ali ndi maphunziro ofunikira a masabata anayi mu zamankhwala ndi chisamaliro chachikulu ku University of Tsukuba School of Medicine, Japan, amaperekedwa kwa ophunzira onse azachipatala a chaka chachisanu ndi chachisanu ndi chimodzi. Ophunzirawo adakhala milungu itatu akugwira ntchito kuzipatala ndi zipatala za anthu ammudzi m'madera akumidzi ndi akumidzi ku Ibaraki Prefecture. Pambuyo pa tsiku loyamba la maphunziro a SDH, ophunzira adapemphedwa kuti akonze malipoti okonzedwa bwino kutengera zomwe adakumana nazo panthawi ya maphunzirowo. Pa tsiku lomaliza, ophunzira adagawana zomwe adakumana nazo m'magulu ndipo adapereka pepala lonena za SDH. Pulogalamuyi ikupitilizabe kukonza ndikupereka chitukuko cha aphunzitsi. Ophunzira omwe adaphunzira: ophunzira omwe adamaliza pulogalamuyi pakati pa Okutobala 2018 ndi Juni 2021. Kusanthula: Mlingo wa kusinkhasinkha umagawidwa ngati kusinkhasinkha, kusanthula kapena kufotokoza. Zomwe zili mkati zimasanthulidwa pogwiritsa ntchito nsanja ya Solid Facts.
Tinasanthula malipoti 118 a 2018-19, malipoti 101 a 2019-20 ndi malipoti 142 a 2020-21. Panali malipoti awiri (1.7%), 6 (5.9%) ndi 7 (4.8%) owunikira, 9 (7.6%), 24 (23.8%) ndi 52 (35.9%) owunikira, 36 (30.5%) motsatana, 48 (47.5%) ndi 79 (54.5%) ofotokozera. Sindinenapo kanthu pa zina zonse. Chiwerengero cha mapulojekiti a Solid Facts mu lipotilo ndi 2.0 ± 1.2, 2.6 ± 1.3, ndi 3.3 ± 1.4, motsatana.
Pamene mapulojekiti a SDH mu maphunziro a CBME akukonzedwanso, kumvetsetsa kwa ophunzira za SDH kukupitirirabe kukula. Mwina izi zidathandizidwa ndi chitukuko cha aphunzitsi. Kumvetsetsa bwino za SDH kungafunike kupititsa patsogolo aphunzitsi ndi maphunziro ophatikizana mu sayansi ya chikhalidwe cha anthu ndi zamankhwala.
Zinthu zomwe zimayambitsa thanzi la anthu (SDH) sizinthu zachipatala zomwe zimakhudza thanzi la anthu, kuphatikizapo malo omwe anthu amabadwira, kukula, kugwira ntchito, kukhala ndi moyo komanso kukalamba [1]. SDH imakhudza kwambiri thanzi la anthu, ndipo chithandizo chamankhwala chokha sichingasinthe zotsatira za SDH pa thanzi lawo [1,2,3]. Opereka chithandizo chamankhwala ayenera kudziwa za SDH [4, 5] ndikuthandizira anthu monga olimbikitsa zaumoyo [6] kuti achepetse zotsatira zoyipa za SDH [4,5,6].
Kufunika kophunzitsa SDH mu maphunziro azachipatala a digiri yoyamba kumazindikirika kwambiri [4,5,7], komanso pali zovuta zambiri zokhudzana ndi maphunziro a SDH. Kwa ophunzira azachipatala, kufunika kogwirizanitsa SDH ndi njira za matenda achilengedwe [8] kungakhale kodziwika bwino, koma kulumikizana pakati pa maphunziro a SDH ndi maphunziro azachipatala kungakhale kochepa. Malinga ndi American Medical Association Alliance for Accelerating Change in Medical Education, maphunziro ambiri a SDH amaperekedwa m'chaka choyamba ndi chachiwiri cha maphunziro azachipatala a digiri yoyamba kuposa m'chaka chachitatu kapena chachinayi [7]. Si masukulu onse azachipatala ku United States omwe amaphunzitsa SDH pamlingo wazachipatala [9], kutalika kwa maphunziro kumasiyana [10], ndipo maphunziro nthawi zambiri amakhala osankhidwa [5, 10]. Chifukwa cha kusowa kwa mgwirizano pa luso la SDH, njira zowunikira ophunzira ndi mapulogalamu zimasiyana [9]. Kuti tilimbikitse maphunziro a SDH mkati mwa maphunziro azachipatala a digiri yoyamba, ndikofunikira kukhazikitsa mapulojekiti a SDH m'zaka zomaliza za maphunziro azachipatala a digiri yoyamba ndikuchita kuwunika koyenera kwa mapulojekitiwo [7, 8]. Japan yazindikiranso kufunika kwa maphunziro a SDH mu maphunziro azachipatala. Mu 2017, maphunziro a SDH adaphatikizidwa mu maphunziro ofunikira a maphunziro azachipatala, kufotokoza zolinga zomwe ziyenera kukwaniritsidwa akamaliza maphunziro awo ku sukulu ya zamankhwala [11]. Izi zikugogomezedwanso mu ndondomeko ya 2022 [12]. Komabe, njira zophunzitsira ndikuwunika SDH sizinakhazikitsidwe ku Japan.
Mu kafukufuku wathu wakale, tinayesa kuchuluka kwa kusinkhasinkha m'malipoti a ophunzira azachipatala apamwamba komanso njira zawo poyesa kuwunika kwa pulojekiti ya SDH mu maphunziro azachipatala ophunzirira anthu ammudzi (CBME) [13] ku yunivesite yaku Japan. Kumvetsetsa SDH [14]. Kumvetsetsa SDH kumafuna kuphunzira kosintha [10]. Kafukufuku, kuphatikizapo wathu, wayang'ana kwambiri pamalingaliro a ophunzira pakuwunika mapulojekiti a SDH [10, 13]. M'maphunziro oyamba omwe tidapereka, ophunzira amawoneka kuti akumvetsa bwino zinthu zina za SDH kuposa ena, ndipo kuchuluka kwawo kwa kuganiza za SDH kunali kochepa [13]. Ophunzira adakulitsa kumvetsetsa kwawo kwa SDH kudzera muzochitika za anthu ammudzi ndipo adasintha malingaliro awo a chitsanzo chachipatala kukhala chitsanzo cha moyo [14]. Zotsatirazi ndizofunika kwambiri pamene miyezo ya maphunziro a SDH ndi kuwunika kwawo ndi kuwunika kwawo sizinakhazikike mokwanira [7]. Komabe, kuwunika kwa nthawi yayitali kwa mapulogalamu a SDH a digiri yoyamba sikunenedwa kawirikawiri. Ngati tingathe kuwonetsa njira yowongolera ndikuwunika mapulogalamu a SDH, idzakhala chitsanzo cha kapangidwe kabwino ndi kuwunika mapulogalamu a SDH, zomwe zingathandize kupanga miyezo ndi mwayi wa SDH ya digiri yoyamba.
Cholinga cha kafukufukuyu chinali kuwonetsa njira yopitirizira kukonzanso pulogalamu yophunzitsa ya SDH kwa ophunzira azachipatala komanso kuchita kuwunika kwa nthawi yayitali pulogalamu yophunzitsa ya SDH mu maphunziro a CBME poyesa kuchuluka kwa kuwunikira mu malipoti a ophunzira.
Kafukufukuyu adagwiritsa ntchito njira yodziwitsira anthu onse ndipo adachita kusanthula deta ya polojekitiyi chaka chilichonse kwa zaka zitatu. Amawunika malipoti a SDH a ophunzira azachipatala omwe adalembetsa mu mapulogalamu a SDH mkati mwa maphunziro a CBME. Kuyambitsa maphunziro ndi njira yokhazikika yowunikira deta yaukadaulo momwe kusanthulako kungatsogoleredwe ndi zolinga zenizeni zowunikira. Cholinga chake ndikulola kuti zofufuza zituluke kuchokera ku mitu yodziwika bwino, yofunikira, kapena yofunika kwambiri yomwe ili mu deta yosaphika m'malo mofotokozedwa kale ndi njira yokonzedwa [15].
Ophunzira omwe adatenga nawo mbali mu kafukufukuyu anali ophunzira azachipatala a chaka chachisanu ndi chachisanu ndi chimodzi ku University of Tsukuba School of Medicine omwe adamaliza maphunziro okakamiza a masabata anayi mu maphunziro a CBME pakati pa Seputembala 2018 ndi Meyi 2019 (2018-19). Marichi 2020 (2019-20) kapena Okutobala 2020 ndi Julayi 2021 (2020-21).
Kapangidwe ka maphunziro a CBME a masabata anayi kanafanana ndi maphunziro athu am'mbuyomu [13, 14]. Ophunzira amatenga CBME m'chaka chawo chachisanu kapena chachisanu ndi chimodzi ngati gawo la maphunziro oyamba a zachipatala, omwe adapangidwa kuti aphunzitse akatswiri azaumoyo chidziwitso choyambira, kuphatikiza kulimbikitsa thanzi, ukatswiri, komanso mgwirizano pakati pa akatswiri. Zolinga za maphunziro a CBME ndikudziwitsa ophunzira zomwe madokotala a mabanja amakumana nazo omwe amapereka chisamaliro choyenera m'malo osiyanasiyana azachipatala; kufotokoza nkhawa zaumoyo kwa nzika, odwala, ndi mabanja m'dongosolo lazaumoyo lakumaloko; ndikukulitsa luso loganiza bwino. . Masabata anayi aliwonse, ophunzira 15-17 amatenga maphunzirowa. Kusinthana kumaphatikizapo sabata imodzi m'malo ammudzi, sabata imodzi kapena ziwiri m'chipatala cha anthu ammudzi kapena chipatala chaching'ono, mpaka sabata imodzi m'chipatala cha anthu ammudzi, ndi sabata imodzi m'dipatimenti yamankhwala am'banja m'chipatala cha yunivesite. Pa tsiku loyamba ndi lomaliza, ophunzira amasonkhana ku yunivesite kuti akapezeke pamisonkhano ndi zokambirana zamagulu. Pa tsiku loyamba, aphunzitsi adafotokozera ophunzira zolinga za maphunzirowo. Ophunzira ayenera kupereka lipoti lomaliza lokhudzana ndi zolinga za maphunzirowo. Aphunzitsi atatu akuluakulu (AT, SO, ndi JH) amakonza maphunziro ambiri a CBME ndi mapulojekiti a SDH. Pulogalamuyi imaperekedwa ndi aphunzitsi akuluakulu ndi aphunzitsi ena 10-12 omwe amagwira ntchito yophunzitsa digiri yoyamba ku yunivesite pomwe akupereka mapulogalamu a CBME ngati madokotala a mabanja kapena aphunzitsi azachipatala omwe si madokotala omwe amadziwa bwino CBME.
Kapangidwe ka pulojekiti ya SDH mu maphunziro a CBME kamatsatira kapangidwe ka maphunziro athu akale [13, 14] ndipo nthawi zonse kamasinthidwa (Chithunzi 1). Pa tsiku loyamba, ophunzira adapita ku phunziro la SDH lochitidwa mwaluso ndipo adamaliza ntchito za SDH mkati mwa masabata anayi. Ophunzira adapemphedwa kuti asankhe munthu kapena banja lomwe adakumana nalo panthawi ya internship yawo ndikusonkhanitsa zambiri kuti aganizire zinthu zomwe zingakhudze thanzi lawo. Bungwe la World Health Organization limapereka Zoona Zachiwiri [15], mapepala a SDH, ndi mapepala omalizidwa ngati zitsanzo. Pa tsiku lomaliza, ophunzira adapereka milandu yawo ya SDH m'magulu ang'onoang'ono, gulu lililonse limakhala ndi ophunzira 4-5 ndi mphunzitsi m'modzi. Pambuyo pa chiwonetserocho, ophunzira adapatsidwa ntchito yopereka lipoti lomaliza la maphunziro a CBME. Adapemphedwa kuti afotokoze ndikuligwirizanitsa ndi zomwe adakumana nazo mkati mwa masabata anayi; adapemphedwa kuti afotokoze 1) kufunika kwa akatswiri azaumoyo kumvetsetsa SDH ndi 2) udindo wawo pothandizira ntchito yazaumoyo yomwe iyenera kuseweredwa. Ophunzira adapatsidwa malangizo olembera lipotilo ndi zambiri zatsatanetsatane za momwe angayesere lipotilo (zinthu zowonjezera). Pa mayeso a ophunzira, aphunzitsi pafupifupi 15 (kuphatikizapo aphunzitsi akuluakulu) adayesa malipotiwo poyerekeza ndi njira zowunikira.
Chidule cha pulogalamu ya SDH mu maphunziro a CBME a University of Tsukuba Faculty of Medicine m'chaka cha maphunziro cha 2018-19, ndi njira yokonzanso mapulogalamu a SDH ndi chitukuko cha aphunzitsi m'zaka zamaphunziro za 2019-20 ndi 2020-21. 2018-19 ikutanthauza dongosolo kuyambira Okutobala 2018 mpaka Meyi 2019, 2019-20 ikutanthauza dongosolo kuyambira Okutobala 2019 mpaka Marichi 2020, ndipo 2020-21 ikutanthauza dongosolo kuyambira Okutobala 2020 mpaka Juni 2021. SDH: Zomwe Zimayambitsa Thanzi la Anthu, COVID-19: Matenda a Coronavirus 2019
Kuyambira pomwe idakhazikitsidwa mu 2018, takhala tikusintha pulogalamu ya SDH nthawi zonse ndikupereka chitukuko cha aphunzitsi. Pamene polojekitiyi idayamba mu 2018, aphunzitsi akuluakulu omwe adapanga adapereka maphunziro opititsa patsogolo aphunzitsi kwa aphunzitsi ena omwe adatenga nawo gawo mu projekiti ya SDH. Nkhani yoyamba yopititsa patsogolo aphunzitsi idayang'ana kwambiri pa SDH ndi malingaliro a anthu m'malo azachipatala.
Pambuyo poti ntchitoyi yatha m'chaka cha sukulu cha 2018-19, tinachita msonkhano wophunzitsa aphunzitsi kuti tikambirane ndikutsimikizira zolinga za polojekitiyi ndikusintha polojekitiyi moyenera. Pa pulogalamu ya chaka cha sukulu cha 2019-20, yomwe idayamba kuyambira Seputembala 2019 mpaka Marichi 2020, tidapereka Malangizo Otsogolera, Mafomu Owunikira, ndi Zofunikira kwa Ogwirizanitsa Aphunzitsi kuti achite Mafotokozedwe a Gulu la Mutu wa SDH patsiku lomaliza. Pambuyo pa kufotokozera gulu lililonse, tidachita zokambirana zamagulu ndi wogwirizanitsa aphunzitsi kuti tiganizire za pulogalamuyi.
M'chaka chachitatu cha pulogalamuyi, kuyambira Seputembala 2020 mpaka Juni 2021, tinachita misonkhano yophunzitsa aphunzitsi kuti tikambirane zolinga za pulogalamu yophunzitsa ya SDH pogwiritsa ntchito lipoti lomaliza. Tinasintha pang'ono pa ntchito yomaliza ya lipoti ndi njira zowunikira (zinthu zowonjezera). Tasinthanso mawonekedwe ndi nthawi yomaliza yoperekera mafomu ndi manja ndi kutumiza asanafike tsiku lomaliza kukhala kutumiza ndi kutumiza pakompyuta mkati mwa masiku atatu kuchokera pamene mlanduwu unayamba.
Kuti tipeze mitu yofunika komanso yofanana mu lipotilo, tinayesa momwe mafotokozedwe a SDH adasonyezedwera ndikupeza mfundo zenizeni zomwe zatchulidwa. Chifukwa ndemanga zam'mbuyomu [10] zaganizira za kusinkhasinkha ngati njira yophunzitsira ndi kuwunika mapulogalamu, tinatsimikiza kuti mulingo wodziwika bwino wa kusinkhasinkha ungagwiritsidwe ntchito poyesa mapulogalamu a SDH. Popeza kusinkhasinkha kumatanthauzidwa mosiyana m'malo osiyanasiyana, timagwiritsa ntchito tanthauzo la kusinkhasinkha pankhani ya maphunziro azachipatala ngati "njira yosanthula, kufunsa mafunso ndikumanganso zokumana nazo ndi cholinga choziwunikira kuti ziphunzire." /kapena kuwongolera machitidwe,” monga momwe Aronson adafotokozera, kutengera tanthauzo la Mezirow la kusinkhasinkha kozama [16]. Monga momwe tinaphunzirira kale [13], zaka 4 mu 2018-19, 2019-20 ndi 2020-21. mu lipoti lomaliza, Zhou adasankhidwa kukhala wofotokozera, wosanthula, kapena wowunikira. Kugawa kumeneku kumachokera ku kalembedwe kolemba ka maphunziro komwe kafotokozedwa ndi University of Reading [17]. Popeza maphunziro ena a maphunziro ayesa mulingo wowunikira mwanjira yofanana [18], tidatsimikiza kuti ndikoyenera kugwiritsa ntchito gululi kuti tiwone mulingo wowunikira mu lipoti lofufuzali. Lipoti lofotokoza nkhani ndi lipoti lomwe limagwiritsa ntchito chimango cha SDH pofotokoza mlandu, koma momwe mulibe kuphatikiza kwa zinthu. Lipoti losanthula ndi lipoti lomwe limaphatikiza zinthu za SDH. Malipoti ogonana owunikira ndi malipoti omwe olemba amaganiziranso malingaliro awo okhudza SDH. Malipoti omwe sanagwere m'gulu limodzi mwa maguluwa adagawidwa ngati osayesedwa. Tinagwiritsa ntchito kusanthula zomwe zili kutengera dongosolo la Solid Facts, mtundu wachiwiri, kuti tiwone zinthu za SDH zomwe zafotokozedwa mu malipoti [19]. Zomwe zili mu lipoti lomaliza zikugwirizana ndi zolinga za pulogalamuyi. Ophunzira adapemphedwa kuti aganizire zomwe adakumana nazo kuti afotokoze kufunika kwa akatswiri azaumoyo kumvetsetsa SDH ndi udindo wawo pagulu. SO idasanthula mulingo wowunikira womwe wafotokozedwa mu lipotilo. Ataganizira zinthu za SDH, SO, JH, ndi AT adakambirana ndikutsimikizira zofunikira za gululo. SO adabwereza kusanthulako. SO, JH, ndi AT adakambirananso kusanthula malipoti omwe amafuna kusintha kwa magulu. Adafika pa mgwirizano womaliza pa kusanthula malipoti onse.
Ophunzira onse 118, 101 ndi 142 adatenga nawo gawo mu pulogalamu ya SDH m'zaka zamaphunziro za 2018-19, 2019-20 ndi 2020-21. Panali ophunzira achikazi 35 (29.7%), 34 (33.7%) ndi 55 (37.9%) motsatana.
Chithunzi 2 chikuwonetsa kugawa kwa milingo yowunikira chaka chilichonse poyerekeza ndi kafukufuku wathu wakale, womwe unasanthula milingo yowunikira m'malipoti olembedwa ndi ophunzira mu 2018-19 [13]. Mu 2018-2019, malipoti 36 (30.5%) adagawidwa ngati nkhani, mu 2019-2020 - malipoti 48 (47.5%), mu 2020-2021 - malipoti 79 (54.5%). Panali malipoti 9 (7.6%) owunikira mu 2018-19, malipoti 24 (23.8%) owunikira mu 2019-20 ndi 52 (35.9%) mu 2020-21. Panali malipoti 2 (1.7%) owunikira mu 2018-19, 6 (5.9%) mu 2019-20 ndi 7 (4.8%) mu 2020-21. Malipoti 71 (60.2%) adagawidwa m'magulu ngati osayesedwa mu 2018-2019, malipoti 23 (22.8%) mu 2019-2020. ndi malipoti 7 (4.8%) mu 2020-2021. Adagawidwa ngati osayesedwa. Gome 1 limapereka malipoti a zitsanzo pa mulingo uliwonse wowunikira.
Mlingo wa kusinkhasinkha mu malipoti a ophunzira a mapulojekiti a SDH omwe adaperekedwa m'zaka zamaphunziro za 2018-19, 2019-20 ndi 2020-21. 2018-19 ikutanthauza dongosolo kuyambira Okutobala 2018 mpaka Meyi 2019, 2019-20 ikutanthauza dongosolo kuyambira Okutobala 2019 mpaka Marichi 2020, ndipo 2020-21 ikutanthauza dongosolo kuyambira Okutobala 2020 mpaka Juni 2021. SDH: Zomwe Zimayambitsa Thanzi la Anthu
Chiwerengero cha zinthu za SDH zomwe zafotokozedwa mu lipotilo chawonetsedwa mu Chithunzi 3. Chiwerengero cha zinthu zomwe zafotokozedwa mu malipoti chinali 2.0 ± 1.2 mu 2018-19, 2.6 ± 1.3 mu 2019-20. ndi 3.3 ± 1.4 mu 2020-21.
Peresenti ya ophunzira omwe adanena kuti atchula chilichonse mu Solid Facts Framework (Kope Lachiwiri) mu malipoti a 2018-19, 2019-20, ndi 2020-21. Nthawi ya 2018-19 ikuyimira Okutobala 2018 mpaka Meyi 2019, 2019-20 ikuyimira Okutobala 2019 mpaka Marichi 2020 ndipo 2020-21 ikuyimira Okutobala 2020 mpaka Juni 2021, awa ndi masiku a ndondomekoyi. Mu chaka chamaphunziro cha 2018/19 panali ophunzira 118, mu chaka chamaphunziro cha 2019/20 - ophunzira 101, mu chaka chamaphunziro cha 2020/21 - ophunzira 142.
Tinayambitsa pulogalamu yophunzitsa za SDH mu maphunziro a CBME ofunikira kwa ophunzira azachipatala a digiri yoyamba ndipo tinapereka zotsatira za kuwunika kwa zaka zitatu kwa pulogalamuyi poyesa kuchuluka kwa kuwunikira kwa SDH mu malipoti a ophunzira. Patatha zaka zitatu tikukhazikitsa pulojekitiyi ndikuyikonza mosalekeza, ophunzira ambiri adatha kufotokoza za SDH ndikufotokozera zina mwa zinthu za SDH mu lipoti. Kumbali inayi, ophunzira ochepa okha ndi omwe adatha kulemba malipoti owunikira pa SDH.
Poyerekeza ndi chaka cha sukulu cha 2018-19, zaka za sukulu za 2019-20 ndi 2020-21 zidawona kuwonjezeka pang'onopang'ono kwa chiwerengero cha malipoti osanthula ndi ofotokozera, pomwe chiwerengero cha malipoti osawunikidwa chidachepa kwambiri, zomwe zitha kukhala chifukwa cha kusintha kwa pulogalamu ndi chitukuko cha aphunzitsi. Kukula kwa aphunzitsi ndikofunikira kwambiri pamapulogalamu ophunzitsira a SDH [4, 9]. Timapereka chitukuko chaukadaulo chopitilira kwa aphunzitsi omwe akutenga nawo mbali mu pulogalamuyi. Pamene pulogalamuyi idayambitsidwa mu 2018, Japan Primary Care Association, imodzi mwa mabungwe azachipatala azachipatala ndi zaumoyo ku Japan, idangofalitsa chikalata chokhudza SDH kwa madokotala azachipatala aku Japan. Aphunzitsi ambiri sadziwa bwino mawu akuti SDH. Mwa kutenga nawo mbali m'mapulojekiti ndikulumikizana ndi ophunzira kudzera muzopereka milandu, aphunzitsi pang'onopang'ono adakulitsa kumvetsetsa kwawo kwa SDH. Kuphatikiza apo, kufotokoza zolinga za mapulogalamu a SDH kudzera mu chitukuko chaukadaulo cha aphunzitsi chopitilira kungathandize kukonza ziyeneretso za aphunzitsi. Lingaliro limodzi lomwe lingakhalepo ndilakuti pulogalamuyi yakhala ikuyenda bwino pakapita nthawi. Kusintha kokonzedwa koteroko kungafunike nthawi ndi khama lalikulu. Ponena za dongosolo la 2020–2021, momwe mliri wa COVID-19 ungakhudzire miyoyo ya ophunzira ndi maphunziro awo [20, 21, 22, 23] zingapangitse ophunzira kuwona SDH ngati vuto lomwe likukhudza miyoyo yawo ndikuwathandiza kuganizira za SDH.
Ngakhale kuti chiwerengero cha zinthu za SDH zomwe zatchulidwa mu lipotilo chawonjezeka, kuchuluka kwa zinthu zosiyanasiyana kumasiyana, zomwe zingagwirizane ndi makhalidwe a malo ochitirako opaleshoni. Kuchuluka kwa chithandizo cha anthu sikudabwitsa chifukwa cha kukhudzana pafupipafupi ndi odwala omwe akulandira kale chithandizo chamankhwala. Mayendedwe adatchulidwanso mobwerezabwereza, zomwe zitha kukhala chifukwa chakuti malo a CBME ali m'madera akumidzi kapena akumidzi komwe ophunzira amakumana ndi zovuta zoyendera ndipo ali ndi mwayi wolumikizana ndi anthu m'malo otere. Zinatchulidwanso ndi nkhawa, kudzipatula, ntchito ndi chakudya, zomwe ophunzira ambiri angakumane nazo pantchito. Kumbali ina, zotsatira za kusalingana pakati pa anthu ndi kusowa ntchito pa thanzi zingakhale zovuta kuzimvetsa panthawi yochepa yophunzirayi. Zinthu za SDH zomwe ophunzira amakumana nazo pantchito zitha kudaliranso makhalidwe a malo ochitirako opaleshoni.
Kafukufuku wathu ndi wofunika chifukwa nthawi zonse timayang'ana pulogalamu ya SDH mkati mwa pulogalamu ya CBME yomwe timapereka kwa ophunzira a digiri yoyamba ya udokotala poyesa kuchuluka kwa kusinkhasinkha m'malipoti a ophunzira. Ophunzira azachipatala apamwamba omwe aphunzira zamankhwala kwa zaka zambiri ali ndi malingaliro azachipatala. Chifukwa chake, ali ndi kuthekera kophunzira pogwirizanitsa sayansi ya chikhalidwe cha anthu yomwe imafunika pamapulogalamu a SDH ndi malingaliro awo azachipatala [14]. Chifukwa chake, ndikofunikira kwambiri kupereka mapulogalamu a SDH kwa ophunzira awa. Mu kafukufukuyu, tidatha kuchita kuwunika kosalekeza kwa pulogalamuyi poyesa kuchuluka kwa kusinkhasinkha m'malipoti a ophunzira. Campbell et al. Malinga ndi lipotilo, masukulu azachipatala aku US ndi mapulogalamu othandizira madokotala amayesa mapulogalamu a SDH kudzera mu kafukufuku, magulu owunikira, kapena deta yowunikira yapakati. Njira zoyezera zomwe zimagwiritsidwa ntchito kwambiri pakuyesa polojekiti ndi mayankho a ophunzira ndi kukhutira, chidziwitso cha ophunzira, ndi khalidwe la ophunzira [9], koma njira yokhazikika komanso yothandiza yowunikira mapulojekiti ophunzirira a SDH sinakhazikitsidwebe. Kafukufukuyu akuwonetsa kusintha kwa nthawi yayitali pakuyesa mapulogalamu ndi kusintha kosalekeza kwa mapulogalamu ndipo adzathandizira pakukula ndikuwunika mapulogalamu a SDH m'mabungwe ena ophunzirira.
Ngakhale kuti ophunzira onse amaganizira kwambiri panthawi yonse yophunzira, chiwerengero cha ophunzira omwe amalemba malipoti oganizira chinakhalabe chochepa. Njira zina zophunzirira zachikhalidwe zingafunike kupangidwa kuti ziwongoleredwe. Ntchito mu pulogalamu ya SDH zimafuna kuti ophunzira aphatikize malingaliro a chikhalidwe ndi azachipatala, omwe amasiyana muzovuta poyerekeza ndi njira yachipatala [14]. Monga tanenera pamwambapa, ndikofunikira kupereka maphunziro a SDH kwa ophunzira aku sekondale, koma kukonza ndikuwongolera mapulogalamu ophunzirira kuyambira koyambirira kwa maphunziro azachipatala, kupanga malingaliro a chikhalidwe ndi azachipatala, ndikuziphatikiza kungakhale kothandiza pakupititsa patsogolo kupita patsogolo kwa ophunzira. 'kukulitsa. Kumvetsetsa SDH. Kukulitsanso malingaliro a chikhalidwe cha aphunzitsi kungathandizenso kuwonjezera kusinkhasinkha kwa ophunzira.
Maphunziro awa ali ndi zoletsa zingapo. Choyamba, malo ophunzirira anali ongopita ku sukulu imodzi ya zamankhwala ku Japan, ndipo malo a CBME anali ongopita kudera limodzi m'mizinda kapena kumidzi ku Japan, monga momwe tinachitira m'maphunziro athu am'mbuyomu [13, 14]. Tafotokoza mbiri ya kafukufukuyu ndi maphunziro am'mbuyomu mwatsatanetsatane. Ngakhale ndi zoletsa izi, ndikofunikira kudziwa kuti tawonetsa zotsatira kuchokera ku mapulojekiti a SDH mu mapulojekiti a CBME kwa zaka zambiri. Chachiwiri, kutengera kafukufukuyu wokha, n'kovuta kudziwa kuthekera kokhazikitsa maphunziro owunikira kunja kwa mapulogalamu a SDH. Kafukufuku wowonjezereka akufunika kuti alimbikitse kuphunzira kowunikira kwa SDH mu maphunziro azachipatala a digiri yoyamba. Chachitatu, funso loti ngati chitukuko cha aphunzitsi chimathandizira kukonza mapulogalamu silikugwirizana ndi malingaliro a kafukufukuyu. Kugwira ntchito bwino kwa gulu la aphunzitsi kumafuna kuphunzira ndi kuyesa kwina.
Tinachita kafukufuku wa nthawi yayitali wa pulogalamu yophunzitsa ya SDH kwa ophunzira a zachipatala okalamba mkati mwa maphunziro a CBME. Tikuwonetsa kuti kumvetsetsa kwa ophunzira za SDH kukupitirirabe kukula pamene pulogalamuyi ikukula. Kukonza mapulogalamu a SDH kungafunike nthawi ndi khama, koma chitukuko cha aphunzitsi chomwe cholinga chake ndi kuwonjezera kumvetsetsa kwa aphunzitsi za SDH chingakhale chothandiza. Kuti ophunzira apititse patsogolo kumvetsetsa kwa SDH, maphunziro omwe ali ogwirizana kwambiri ndi sayansi ya chikhalidwe cha anthu ndi zamankhwala angafunike kupangidwa.
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Nthawi yotumizira: Okutobala-28-2023