Social determinants of health (SDOH) ndi zolumikizana kwambiri ndi zinthu zingapo zachikhalidwe komanso zachuma.Kusinkhasinkha ndikofunikira kuti muphunzire SDH.Komabe, ndi malipoti ochepa okha omwe amasanthula mapulogalamu a SDH;ambiri ndi maphunziro osiyanasiyana.Tidayesetsa kuwunika kwa nthawi yayitali pulogalamu ya SDH mu maphunziro a zaumoyo wa anthu ammudzi (CBME) omwe adakhazikitsidwa mu 2018 potengera kuchuluka ndi zomwe ophunzira amawonetsa pa SDH.
Kapangidwe ka kafukufuku: Njira yodziwikiratu pakusanthula kwa data.Pulogalamu Yophunzitsa: Maphunziro okakamiza a masabata 4 pazamankhwala wamba komanso chisamaliro chambiri pa University of Tsukuba School of Medicine, Japan, amaperekedwa kwa ophunzira onse azachipatala a chaka chachisanu ndi chachisanu ndi chimodzi.Ophunzirawo anakhala akugwira ntchito kwa milungu itatu m’zipatala ndi m’zipatala za m’tauni ndi kumidzi ya Ibaraki Prefecture.Pambuyo pa tsiku loyamba la maphunziro a SDH, ophunzira adafunsidwa kukonzekera malipoti amilandu okhazikika malinga ndi zomwe adakumana nazo pamaphunzirowo.Patsiku lomaliza, ophunzira adagawana zomwe adakumana nazo pamisonkhano yamagulu ndikupereka pepala pa SDH.Pulogalamuyi ikupitiliza kuwongolera ndikupereka chitukuko cha aphunzitsi.Ophunzira omwe adaphunzira nawo: ophunzira omwe anamaliza pulogalamuyi pakati pa October 2018 ndi June 2021. Kusanthula: Mlingo wowunikira umagawidwa ngati wowunikira, wowunikira kapena wofotokozera.Zomwe zili mkati zimawunikidwa pogwiritsa ntchito nsanja ya Solid Facts.
Tidasanthula malipoti 118 a 2018-19, malipoti 101 a 2019-20 ndi malipoti 142 a 2020-21.Panali malipoti a 2 (1.7%), 6 (5.9%) ndi 7 (4.8%) owonetsa, 9 (7.6%), 24 (23.8%) ndi 52 (35.9%) malipoti owunikira, 36 (30.5%) motsatira, 48 (47.5%) ndi 79 (54.5%) ofotokoza malipoti.Sindiyankhapo pazotsalazo.Chiwerengero cha mapulojekiti a Solid Facts mu lipotili ndi 2.0 ± 1.2, 2.6 ± 1.3, ndi 3.3 ± 1.4, motsatira.
Pamene mapulojekiti a SDH mu maphunziro a CBME akukonzedwa, kumvetsetsa kwa ophunzira za SDH kukukulirakulira.Mwina izi zinathandizidwa ndi chitukuko cha aphunzitsi.Kumvetsetsa bwino kwa SDH kungafunike kupititsa patsogolo luso komanso maphunziro ophatikizika mu sayansi ndi zamankhwala.
Zomwe zimapangitsa kuti anthu azikhala ndi thanzi labwino (SDH) ndizinthu zomwe si zachipatala zomwe zimakhudza thanzi, kuphatikizapo malo omwe anthu amabadwira, kukula, ntchito, moyo ndi zaka [1].SDH imakhudza kwambiri thanzi la anthu, ndipo chithandizo chamankhwala chokha sichingasinthe zotsatira za SDH [1,2,3].Othandizira zaumoyo ayenera kudziwa za SDH [4, 5] ndikuthandizira anthu monga othandizira zaumoyo [6] kuchepetsa zotsatira zoipa za SDH [4,5,6].
Kufunika kophunzitsa SDH mu maphunziro a zachipatala omaliza maphunziro kumazindikirika kwambiri [4,5,7], koma palinso zovuta zambiri zokhudzana ndi maphunziro a SDH.Kwa ophunzira azachipatala, kufunikira kwakukulu kogwirizanitsa SDH ku njira za matenda a tizilombo [8] kungakhale kodziwika bwino, koma kugwirizana pakati pa maphunziro a SDH ndi maphunziro a zachipatala kungakhalebe kochepa.Malinga ndi bungwe la American Medical Association Alliance for Accelerating Change in Medical Education, maphunziro ambiri a SDH amaperekedwa m'zaka zoyambirira ndi zachiwiri za maphunziro a zachipatala omwe ali ndi maphunziro apamwamba kuposa zaka zachitatu kapena zinayi [7].Sikuti masukulu onse azachipatala ku United States amaphunzitsa SDH pachipatala [9], kutalika kwa maphunziro kumasiyana [10], ndipo maphunziro nthawi zambiri amakhala osankhidwa [5, 10].Chifukwa chosowa mgwirizano pa luso la SDH, njira zowunikira ophunzira ndi mapulogalamu zimasiyana [9].Kupititsa patsogolo maphunziro a SDH mkati mwa maphunziro a zachipatala omwe ali ndi maphunziro apamwamba, m'pofunika kukhazikitsa mapulojekiti a SDH m'zaka zomaliza za maphunziro a zachipatala omaliza maphunziro ndi kuwunika moyenera ntchitozo [7, 8].Japan yazindikiranso kufunika kwa maphunziro a SDH pamaphunziro azachipatala.Mu 2017, maphunziro a SDH adaphatikizidwa m'maphunziro oyambira owonetsa maphunziro azachipatala, kufotokozera zolinga zomwe ziyenera kukwaniritsidwa mukamaliza maphunziro awo kusukulu yachipatala [11].Izi zikugogomezedwanso mu kukonzanso kwa 2022 [12].Komabe, njira zophunzitsira ndi kuyesa SDH sizinakhazikitsidwebe ku Japan.
M'kafukufuku wathu wam'mbuyomu, tidawunika kuchuluka kwa malingaliro amalipoti a ophunzira apamwamba azachipatala komanso njira zawo powunika kuwunika kwa projekiti ya SDH mu maphunziro a zachipatala ammudzi (CBME) [13] payunivesite yaku Japan.Kumvetsetsa SDH [14].Kumvetsetsa SDH kumafuna kuphunzira kosintha [10].Kafukufuku, kuphatikiza wathu, ayang'ana kwambiri malingaliro a ophunzira pakuwunika ntchito za SDH [10, 13].M'maphunziro oyambirira omwe tinkapereka, ophunzira ankawoneka kuti amamvetsa zinthu zina za SDH bwino kuposa ena, ndipo maganizo awo okhudza SDH anali otsika kwambiri [13].Ophunzira adakulitsa kumvetsetsa kwawo kwa SDH kudzera muzochitika za anthu ammudzi ndikusintha malingaliro awo pazachipatala kukhala chitsanzo cha moyo [14].Zotsatirazi ndizofunika pamene miyezo ya maphunziro a maphunziro a SDH ndi kuwunika ndi kuwunika kwawo sikunakhazikitsidwe kwathunthu [7].Komabe, kuwunika kwakanthawi kwamapulogalamu omaliza a SDH sikunenedwa kawirikawiri.Ngati tingathe kusonyeza nthawi zonse ndondomeko yowongola ndikuwunika mapulogalamu a SDH, idzakhala chitsanzo chokonzekera bwino ndikuwunika mapulogalamu a SDH, zomwe zingathandize kukhazikitsa miyezo ndi mwayi wa maphunziro a SDH.
Cholinga cha phunziroli chinali kusonyeza njira yopititsira patsogolo maphunziro a SDH kwa ophunzira azachipatala komanso kuyesa kwautali kwa pulogalamu ya maphunziro ya SDH mu maphunziro a CBME poyesa mlingo wa kulingalira m'malipoti a ophunzira.
Kafukufukuyu adagwiritsa ntchito njira yophunzitsira komanso kusanthula koyenera kwa deta ya polojekiti pachaka kwa zaka zitatu.Imawunika malipoti a SDH a ophunzira azachipatala omwe adalembetsa nawo mapulogalamu a SDH mkati mwa maphunziro a CBME.General induction ndi njira yowunikira bwino momwe kusanthula kungawongoleredwe ndi zolinga zenizeni zowunikira.Cholinga chake ndi kulola kuti zomwe zapeza pa kafukufuku zituluke pamitu yokhazikika, yotsogola, kapena yofunika yomwe imapezeka muzolemba zosawerengeka m'malo mongofotokozedwa mokhazikika [15].
Ophunzirawo anali ophunzira azachipatala a chaka chachisanu ndi chachisanu ndi chimodzi ku University of Tsukuba School of Medicine omwe anamaliza maphunziro ovomerezeka a masabata 4 mu maphunziro a CBME pakati pa September 2018 ndi May 2019 (2018-19).Marichi 2020 (2019-20) kapena Okutobala 2020 ndi Julayi 2021 (2020-21).
Mapangidwe a maphunziro a CBME a masabata anayi anali ofanana ndi maphunziro athu am'mbuyomu [13, 14].Ophunzira amatenga CBME m'chaka chawo chachisanu kapena chachisanu ndi chimodzi monga gawo la Maphunziro Oyambilira a Zamankhwala, omwe adapangidwa kuti aziphunzitsa chidziwitso choyambira kwa akatswiri azaumoyo, kuphatikiza kulimbikitsa thanzi, ukatswiri, komanso mgwirizano pakati pa akatswiri.Zolinga za maphunziro a CBME ndikuwonetsa ophunzira ku zochitika za madotolo apabanja omwe amapereka chisamaliro choyenera m'malo osiyanasiyana azachipatala;nenani zaumoyo kwa nzika, odwala, ndi mabanja omwe ali m'chipatala chapafupi;ndikukulitsa luso loganiza bwino zachipatala..Masabata anayi aliwonse, ophunzira 15-17 amatenga maphunzirowo.Kusinthasintha kumaphatikizapo sabata la 1 kumalo ammudzi, masabata a 1-2 ku chipatala cha anthu kapena chipatala chaching'ono, mpaka sabata limodzi kuchipatala cha anthu, ndi sabata limodzi mu dipatimenti yachipatala ya banja ku chipatala cha yunivesite.Pa tsiku loyamba ndi lomaliza, ophunzira amasonkhana ku yunivesite kuti akakhale nawo pa maphunziro ndi zokambirana zamagulu.Pa tsiku loyamba, aphunzitsiwo anafotokoza zolinga za maphunzirowo kwa ophunzirawo.Ophunzira ayenera kupereka lipoti lomaliza lokhudzana ndi zolinga za maphunziro.Maofesi atatu oyambira (AT, SO, ndi JH) amakonza maphunziro ambiri a CBME ndi mapulojekiti a SDH.Pulogalamuyi imaperekedwa ndi aphunzitsi apakati ndi 10-12 adjunct faculty omwe amatenga nawo gawo pazophunzitsa zamaphunziro apamwamba kuyunivesite pomwe akupereka mapulogalamu a CBME ngati madotolo am'banja kapena gulu losakhala la udokotala lomwe limadziwika ndi CBME.
Mapangidwe a polojekiti ya SDH mu maphunziro a CBME amatsatira ndondomeko ya maphunziro athu akale [13, 14] ndipo amasinthidwa nthawi zonse (mkuyu 1).Patsiku loyamba, ophunzira adapezeka pamisonkhano ya SDH ndikumaliza ntchito za SDH pakusinthana kwa milungu 4.Ophunzira adafunsidwa kuti asankhe munthu kapena banja lomwe adakumana nalo panthawi ya maphunziro awo ndikusonkhanitsa zambiri kuti aganizire zomwe zingakhudze thanzi lawo.Bungwe la World Health Organization limapereka Zolemba Zolimba Chachiwiri [15], mapepala a SDH, ndi mapepala omaliza omaliza ngati zolembera.Patsiku lomaliza, ophunzira adapereka milandu yawo ya SDH m'magulu ang'onoang'ono, gulu lililonse lokhala ndi ophunzira 4-5 ndi mphunzitsi m'modzi.Pambuyo pofotokoza, ophunzira adapatsidwa ntchito yopereka lipoti lomaliza la maphunziro a CBME.Iwo adafunsidwa kuti afotokoze ndikugwirizanitsa ndi zomwe adakumana nazo panthawi ya kuzungulira kwa masabata a 4;adafunsidwa kuti afotokoze 1) kufunika kwa akatswiri a zaumoyo kumvetsetsa SDH ndi 2) udindo wawo pothandizira ntchito yaumoyo ya anthu yomwe iyenera kuchitidwa.Ophunzira adapatsidwa malangizo oti alembe lipotilo komanso zambiri za momwe angawunikire lipotilo (zowonjezera).Pakuwunika kwa ophunzira, pafupifupi mamembala a faculty 15 (kuphatikiza mamembala apakati) adawunika malipoti molingana ndi njira zowunika.
Kuwunikira mwachidule pulogalamu ya SDH mu maphunziro a CBME a University of Tsukuba Faculty of Medicine m'chaka cha maphunziro cha 2018-19, komanso njira yopititsira patsogolo pulogalamu ya SDH ndi chitukuko chaukadaulo mzaka zamaphunziro za 2019-20 ndi 2020-21.2018-19 imanena za pulani kuyambira Okutobala 2018 mpaka Meyi 2019, 2019-20 imanena za mapulani kuyambira Okutobala 2019 mpaka Marichi 2020, ndipo 2020-21 ikutanthauza dongosolo kuyambira Okutobala 2020 mpaka Juni 2021. SDH: Zosankha Zaumoyo Zaumoyo, COVID-19: Matenda a Coronavirus 2019
Kuyambira pomwe idakhazikitsidwa mu 2018, takhala tikusintha pulogalamu ya SDH ndikupereka chitukuko chaukadaulo.Ntchitoyi itayamba mu 2018, aphunzitsi akuluakulu omwe adayipanga adapereka maphunziro a zachitukuko kwa aphunzitsi ena omwe angachite nawo ntchito ya SDH.Phunziro loyamba lachitukuko cha luso linayang'ana pa SDH ndi malingaliro a chikhalidwe cha anthu pazochitika zachipatala.
Ntchitoyi itamalizidwa mchaka cha sukulu cha 2018-19, tidakhala ndi msonkhano wachitukuko cha aphunzitsi kuti tikambirane ndikutsimikizira zolinga za polojekitiyi ndikusintha momwe polojekitiyi ikuyendera.Pa pulogalamu ya chaka cha sukulu ya 2019-20, yomwe inayamba mu Seputembara 2019 mpaka Marichi 2020, tidapereka Maupangiri Otsogolera, Mafomu Owunika, ndi Njira Zothandizira Ogwirizanitsa Maofesi a Gulu Lofotokozera za SDH pa tsiku lomaliza.Pambuyo pokamba za gulu lililonse, tinkafunsana ndi wotsogolera aphunzitsi kuti tiganizire za pulogalamuyo.
M'chaka chachitatu cha pulogalamuyi, kuyambira Seputembala 2020 mpaka Juni 2021, tidakhala ndi misonkhano yachitukuko kuti tikambirane zolinga za pulogalamu yamaphunziro ya SDH pogwiritsa ntchito lipoti lomaliza.Tinapanga zosintha zazing'ono pamagawo omaliza opereka lipoti ndi njira zowunika (zowonjezera).Tasinthanso mawonekedwe ndi masiku omaliza olembera mafomu ndi dzanja ndi kusungitsa tsiku lomaliza lisanafike kuti lizilemba ndikulemba pakompyuta mkati mwa masiku atatu mlanduwo.
Kuti tidziwe mitu yofunika komanso yodziwika bwino mu lipotilo, tidawunika momwe mafotokozedwe a SDH adawonekera ndikuchotsa zinthu zotsimikizika zomwe zatchulidwa.Chifukwa ndemanga zam'mbuyomu [10] zawona kusinkhasinkha ngati njira yowunikira maphunziro ndi pulogalamu, tatsimikiza kuti mulingo womwe waperekedwa pakuwunika ungagwiritsidwe ntchito kuyesa mapulogalamu a SDH.Popeza kuti kulingalira kumatanthauzidwa mosiyana m’zochitika zosiyanasiyana, timatengera tanthauzo la kulingalira m’nkhani ya maphunziro a zachipatala monga “njira yosanthula, kufunsa ndi kukonzanso zokumana nazo n’cholinga choziunika pa zolinga za kuphunzira.”/ kapena kusintha machitidwe, "monga momwe Aronson anafotokozera, kutengera tanthauzo la Mezirow la kulingalira mozama [16].Monga m'phunziro lathu lapitalo [13], zaka 4 mu 2018-19, 2019-20 ndi 2020-21.mu lipoti lomaliza, Zhou adasankhidwa kukhala ofotokozera, osanthula, kapena owunikira.Gululi lidatengera kalembedwe kamaphunziro komwe akufotokozedwa ndi University of Reading [17].Popeza kuti maphunziro ena a maphunziro ayesa mlingo wa kulingalira mofananamo [18], tinawona kuti ndi koyenera kugwiritsa ntchito gululi kuti tiwone mlingo wa kulingalira mu lipoti la kafukufukuyu.Lipoti lofotokozera ndi lipoti lomwe limagwiritsa ntchito dongosolo la SDH kuti lifotokoze nkhani, koma momwe mulibe kuphatikiza kwa zinthu.Lipoti la kafukufuku ndi lipoti lomwe limagwirizanitsa zinthu za SDH.Malipoti okhudzana ndi kugonana ndi malipoti momwe olemba amaganiziranso za SDH.Malipoti omwe sanagwere m'gulu limodzi mwa maguluwa adasankhidwa kukhala osawerengeka.Tinagwiritsa ntchito kusanthula kwazinthu zochokera ku Solid Facts system, mtundu wa 2, kuti tiwone zinthu za SDH zomwe zafotokozedwa m'malipoti [19].Zomwe zili mu lipoti lomaliza zikugwirizana ndi zolinga za pulogalamuyi.Ophunzira adafunsidwa kuti aganizire zomwe adakumana nazo kuti afotokoze kufunikira kwa akatswiri azachipatala kumvetsetsa SDH ndi udindo wawo.pagulu.SO idasanthula mulingo wowonetsera womwe wafotokozedwa mu lipotilo.Pambuyo poganizira za SDH, SO, JH, ndi AT adakambirana ndikutsimikizira magawo a gulu.SO anabwereza kusanthula.SO, JH, ndi AT adakambirananso za kusanthula kwa malipoti omwe amafunikira kusintha kwamagulu.Iwo adafika pachigwirizano chomaliza pakuwunika malipoti onse.
Ophunzira 118, 101 ndi 142 adatenga nawo gawo mu pulogalamu ya SDH mzaka zamaphunziro za 2018-19, 2019-20 ndi 2020-21.Panali 35 (29.7%), 34 (33.7%) ndi 55 (37.9%) ophunzira aakazi, motero.
Chithunzi 2 chikuwonetsa kugawidwa kwa milingo yowunikira pachaka poyerekeza ndi kafukufuku wathu wam'mbuyomu, womwe udasanthula milingo yamalingaliro m'malipoti olembedwa ndi ophunzira mu 2018-19 [13].Mu 2018-2019, malipoti 36 (30.5%) adawonetsedwa ngati nkhani, mu 2019-2020 - 48 (47.5%) malipoti, mu 2020-2021 - 79 (54.5%) malipoti.Panali malipoti owunikira 9 (7.6%) mu 2018-19, 24 (23.8%) mu 2019-2020 ndi 52 (35.9%) mu 2020-21.Panali malipoti owonetsera 2 (1.7%) mu 2018-19, 6 (5.9%) mu 2019-20 ndi 7 (4.8%) mu 2020-21.Malipoti 71 (60.2%) adagawidwa ngati osawerengeka mu 2018-2019, 23 (22.8%) malipoti mu 2019-2020.ndi 7 (4.8%) malipoti mu 2020-2021.Zagawidwa ngati zosawerengeka.Gulu 1 limapereka malipoti achitsanzo pamlingo uliwonse wowunikira.
Mlingo wamalingaliro amalipoti a ophunzira a mapulojekiti a SDH omwe aperekedwa m'zaka zamaphunziro za 2018-19, 2019-20 ndi 2020-21.2018-19 imanena za pulani kuyambira Okutobala 2018 mpaka Meyi 2019, 2019-20 imanena za mapulani kuyambira Okutobala 2019 mpaka Marichi 2020, ndipo 2020-21 ikutanthauza dongosolo kuyambira Okutobala 2020 mpaka June 2021. SDH: Zosankha Zaumoyo Zaumoyo.
Kuchuluka kwa zinthu za SDH zomwe zafotokozedwa mu lipotili zikuwonetsedwa mu Chithunzi 3. Chiwerengero cha zinthu zomwe zafotokozedwa m'malipoti zinali 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 adanenanso kuti atchula chinthu chilichonse mu Solid Facts Framework (2nd Edition) mu malipoti a 2018-19, 2019-20, ndi 2020-21.Nthawi ya 2018-19 imanena za Okutobala 2018 mpaka Meyi 2019, 2019-20 akutanthauza Okutobala 2019 mpaka Marichi 2020 ndipo 2020-21 akutanthauza Okutobala 2020 mpaka Juni 2021, awa ndi masiku achiwembu.M’chaka cha maphunziro cha 2018/19 panali ophunzira 118, m’chaka cha maphunziro cha 2019/20 – ophunzira 101, m’chaka cha maphunziro cha 2020/21 – ophunzira 142.
Tinayambitsa pulogalamu ya maphunziro a SDH mu maphunziro ofunikira a CBME kwa ophunzira achipatala omwe ali ndi maphunziro apamwamba ndipo tinapereka zotsatira za kuwunika kwazaka zitatu za pulogalamuyi ndikuwunika momwe SDH ikuwonetsera m'malipoti a ophunzira.Pambuyo pa zaka 3 zogwiritsira ntchito ntchitoyi ndikuwongolera mosalekeza, ophunzira ambiri adatha kufotokoza SDH ndikufotokozera zina mwazinthu za SDH mu lipoti.Kumbali inayi, ophunzira ochepa okha ndi omwe amatha kulemba malipoti owonetsera pa SDH.
Poyerekeza ndi chaka cha sukulu cha 2018-19, zaka za sukulu za 2019-20 ndi 2020-21 zidakwera pang'onopang'ono kuchuluka kwa malipoti owunikira ndi ofotokozera, pomwe gawo la malipoti osawunikidwa lidatsika kwambiri, zomwe zitha kukhala chifukwa chakusintha kwamaphunziro. pulogalamu ndi chitukuko cha aphunzitsi.Kukula kwa aphunzitsi ndikofunikira pamapulogalamu amaphunziro a SDH [4, 9].Timapereka chitukuko chokhazikika cha akatswiri kwa aphunzitsi omwe akuchita nawo pulogalamuyi.Pulogalamuyi itakhazikitsidwa mu 2018, bungwe la Japan Primary Care Association, lomwe ndi amodzi mwa mabungwe azachipatala ku Japan komanso mabungwe azaumoyo, anali atangotulutsa mawu pa SDH kwa asing'anga aku Japan.Aphunzitsi ambiri sadziwa mawu akuti SDH.Pochita nawo ntchito komanso kucheza ndi ophunzira kudzera muzofotokozera, aphunzitsi adakulitsa kumvetsetsa kwawo kwa SDH.Kuphatikiza apo, kumveketsa zolinga zamapulogalamu a SDH kudzera pakupititsa patsogolo luso la aphunzitsi kungathandize kuwongolera ziyeneretso za aphunzitsi.Lingaliro limodzi lotheka ndilakuti pulogalamuyo yasintha pakapita nthawi.Kuwongolera kotereku kungafunike nthawi ndi khama.Pankhani ya pulani ya 2020–2021, zotsatira za mliri wa COVID-19 pamiyoyo ndi maphunziro a ophunzira [20, 21, 22, 23] zingapangitse ophunzira kuona SDH ngati nkhani yomwe ikukhudza miyoyo yawo ndikuwathandiza kuganizira za SDH.
Ngakhale kuchuluka kwa zinthu za SDH zomwe zatchulidwa mu lipotilo zawonjezeka, zochitika za zinthu zosiyanasiyana zimasiyanasiyana, zomwe zingakhale zokhudzana ndi makhalidwe omwe amachitira.Kuchuluka kwa chithandizo chamagulu ndizosadabwitsa chifukwa chokumana pafupipafupi ndi odwala omwe akulandira kale chithandizo chamankhwala.Mayendedwe amatchulidwanso pafupipafupi, zomwe zitha kukhala chifukwa chakuti masamba a CBME ali m'madera akumidzi kapena akumidzi komwe ophunzira amakumana ndi zovuta zamayendedwe ndikukhala ndi mwayi wolumikizana ndi anthu okhala m'malo otere.Zomwe zatchulidwanso zinali kupsinjika, kudzipatula, ntchito ndi chakudya, zomwe ophunzira ambiri amakumana nazo pochita.Kumbali ina, zotsatira za kusagwirizana pakati pa anthu ndi kusowa kwa ntchito pa thanzi zingakhale zovuta kumvetsa panthawi yochepa yophunzirayi.Zinthu za SDH zomwe ophunzira amakumana nazo pochita zingadalirenso mawonekedwe a malo ochitirako.
Phunziro lathu ndi lofunika chifukwa tikuwunika mosalekeza pulogalamu ya SDH mkati mwa pulogalamu ya CBME yomwe timapereka kwa ophunzira omaliza maphunziro azachipatala powunika momwe amawonera malipoti a ophunzira.Ophunzira apamwamba azachipatala omwe aphunzira zamankhwala azachipatala kwa zaka zambiri ali ndi malingaliro azachipatala.Chifukwa chake, ali ndi kuthekera kophunzira pokhudzana ndi sayansi ya chikhalidwe cha anthu omwe amafunikira mapulogalamu a SDH ndi malingaliro awo azachipatala [14].Chifukwa chake, ndikofunikira kwambiri kupereka mapulogalamu a SDH kwa ophunzira awa.Mu phunziro ili, tinatha kuwunika mosalekeza pulogalamuyo poyesa kuchuluka kwa malingaliro amalipoti a ophunzira.Campbell ndi al.Malinga ndi lipotilo, masukulu azachipatala aku US ndi mapulogalamu othandizira madokotala amawunika mapulogalamu a SDH kudzera mu kafukufuku, magulu owunikira, kapena kuwunika kwapakati pamagulu.Njira zoyezera zomwe zimagwiritsidwa ntchito kwambiri poyesa polojekiti ndi kuyankha kwa ophunzira ndi kukhutitsidwa, chidziwitso cha ophunzira, ndi khalidwe la ophunzira [9], koma njira yokhazikika komanso yothandiza yowunikira mapulojekiti a maphunziro a SDH sinakhazikitsidwebe.Kafukufukuyu akuwonetsa kusintha kwanthawi yayitali pakuwunika kwa pulogalamu ndi kuwongolera pulogalamu mosalekeza ndipo athandizira pakupanga ndikuwunika mapulogalamu a SDH m'masukulu ena amaphunziro.
Ngakhale kuti kusinkhasinkha kwa ophunzira kunakula kwambiri panthawi yonse yophunzira, chiwerengero cha ophunzira omwe amalemba malipoti owonetserako chinakhalabe chochepa.Njira zowonjezera za chikhalidwe cha anthu zingafunikire kupangidwa kuti zipitirire kuwongolera.Ntchito mu pulogalamu ya SDH imafuna ophunzira kuti aphatikize malingaliro a chikhalidwe cha anthu ndi azachipatala, omwe amasiyana mosiyana ndi chitsanzo chachipatala [14].Monga tafotokozera pamwambapa, ndikofunikira kupereka maphunziro a SDH kwa ophunzira aku sekondale, koma kukonza ndi kukonza mapulogalamu amaphunziro kuyambira atangoyamba kumene maphunziro azachipatala, kukulitsa malingaliro azamakhalidwe ndi azachipatala, ndikuphatikizana nawo kungakhale kothandiza kupititsa patsogolo kupita patsogolo kwa ophunzira.'kukula.Kumvetsetsa SDH.Kuwonjezeka kowonjezereka kwa malingaliro a aphunzitsi a chikhalidwe cha anthu kungathandizenso kuonjezera kulingalira kwa ophunzira.
Maphunzirowa ali ndi malire angapo.Choyamba, malo ophunzirira anali ochepa kusukulu imodzi yachipatala ku Japan, ndipo malo a CBME anali ochepa kudera limodzi lakumidzi kapena kumidzi ya Japan, monga momwe tinaphunzirira kale [13, 14].Tafotokoza mbiri ya kafukufukuyu komanso maphunziro am'mbuyomu mwatsatanetsatane.Ngakhale zili zolepheretsa izi, ndikofunikira kudziwa kuti tawonetsa zotsatira kuchokera ku mapulojekiti a SDH mu mapulojekiti a CBME pazaka zambiri.Chachiwiri, kutengera phunziroli lokha, ndizovuta kudziwa kuthekera kokhazikitsa maphunziro owunikira kunja kwa mapulogalamu a SDH.Kafukufuku wowonjezera akufunika kuti alimbikitse kuphunzira kowoneka bwino kwa SDH mumaphunziro azachipatala omaliza.Chachitatu, funso loti ngati chitukuko cha aphunzitsi chimathandizira kuti pulogalamuyo ipite patsogolo ndi yopitirira malire a kafukufukuyu.Kuchita bwino kwa ntchito yomanga gulu la aphunzitsi kumafunikira kuphunzira ndi kuyezetsa.
Tidawunika kwanthawi yayitali pulogalamu yophunzitsa ya SDH ya ophunzira apamwamba azachipatala mkati mwa maphunziro a CBME.Tikuwonetsa kuti kumvetsetsa kwa ophunzira za SDH kukukulirakulira pamene pulogalamuyo ikukula.Kuwongolera mapulogalamu a SDH kungafunike nthawi ndi khama, koma chitukuko cha aphunzitsi chomwe cholinga chake ndi kukulitsa kumvetsetsa kwa SDH kwa aphunzitsi kungakhale kothandiza.Kuti apititse patsogolo kumvetsetsa kwa ophunzira za SDH, maphunziro omwe ali ophatikizidwa mu sayansi ya chikhalidwe cha anthu ndi zamankhwala angafunikire kupangidwa.
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Nthawi yotumiza: Oct-28-2023