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Learning about pesticides in Thai medical
schools: a community-oriented,
problem-based approach
Robert Chase
Community Medicine Residency Program, Department of
Clinical Epidemiology and Biostatistics, McMaster University,
Hamilton, Ontario, Canada
A package of teaching and reference materials concerned with the humanhealth
aspects of pesticide use is described in this paper. It was designed
for use in Thai medical schools, which employ tutorial-based learning
methods. The problem-oriented format of the package encourages medical
students to develop critical thinking and decision-making skills. The
package addresses the broader community context of this serious health
issue in Thailand and provides the opportunity to consider areas of public
health often neglected by traditional physician training and hos pita!based
activities. The package uses nationally derived health data. Problem
scenarios depict the realities of pesticide use and poisoning in Thailand to
generate discussion and achieve learning objectives. The need to reorient
medical curriculums and training in developing countries to sensitize
physicians to national health priorities is discussed, because it is necessary
to educate physicians about the role they can serve in the multidisciplinary
activities of health and safety promotion in their communities.
Community-oriented medical education and
problem-based learning
Medical educators in developing countries, as elsewhere, are faced with the
challenge of how to direct their physicians-to-be to the common health problems
facing society. Traditionally, training has been modeled on the textbooks,
technology and programs used in industrial countries. In Thailand, expansion
of the health-care system over recent decades has favoured specialization (in
1988, about 50% of physicians were specialists) and has led to a proliferation
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