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Skip to 0 minutes and 1 secondHello!! Everyone!!

Skip to 0 minutes and 2 secondsWelcome to today's class: Community Engagement for Service Learning.

Skip to 0 minutes and 9 secondsFirst, I would like to introduce you the challenges facing Taiwan's medical professional today. There are global issues, such as, increasing dependence on market forces, rising costs from technology innovations, and also management overrides physicians' autonomy and their traditional commitments to the primacy of patients' interests.

Skip to 0 minutes and 36 secondsThere are local issues. The National Health Insurance peculiar mix of governmental interventionism and the market ideology. It's the major issue. And also, patients lake of risking sharing awareness. It would be another one. And physicians' collective integrity yet to be established in Taiwan. So... There are professional crisis. Fields that are considered high costs and high risks have difficulty recruiting young doctors. Various surveys show physicians' decreasing satisfaction and increasing frustration with their working environment. Their major complaints include stress, long hours, salary, management’s disrespect, lack of trust from the patients and society.

Skip to 1 minute and 45 secondsThese are part of the cultural issues. Lack of an essential concept for modern citizens, which is civic responsibility. In this structure, public affairs only matter when they are perceived as the extension of the private domain.

Skip to 2 minutes and 6 secondsSo... Things that have no immediate relevance are often ignored or sacrificed for personal or family gains. Some medical resources provided by the National Health Insurance are considered entitlement, and the governments is a hesitant to educate citizens on the concepts of "given and take" and "risk-sharing" for fear of the losing popular votes. Government, physicians and citizens should have a equal responsibility, like this figure shows. So... community building is an important national policy in Taiwan. The concept of the "Community Building Act" was proclaimed and national policy in the 1990's. However, so far it is only superficial.

Skip to 3 minutes and 6 secondsIt is needed: to empower people, to deepen our democratic foundations, and to enrich Taiwaneses civil society. But, without professionalism and medical ethics, there is a missing link between citizens and the states.

Skip to 3 minutes and 28 secondsSo... There are important meanings in the concepts of community. It is a basis of the individual memory and life stories. It is commonality of the imagination of identity. And the basic unit for integration of resources. So... Professional is a part of the systemic element, shall play a whole system to empower the community.

Skip to 4 minutes and 2 secondsSo... There are ideals for community health. Based on the Community Building Act, the concept of right to health should be implemented with the community and the populace as the decision makers. The right to participate, the right to organize, and the right to initiate programs in national health system. And the national health system mechanisms at the grassroots level should advance community autonomy and capacity. A new national civic consciousness should be developed on the basis of health autonomy, to achieve integration and coordination of the use of national and community resources.

Skip to 4 minutes and 56 secondsSo... Current shortcomings in environment for community health building programs are evident. The concepts of self-autonomy in personal and community health have not yet been widely disseminated. Dependence on large-scale specialist health institutions remains dominant. Grassroots capacity for health autonomy is insufficient. Generally there is a dearth of civic and community consciousness. And treatments of medical emergencies, rather than long-term prevention and care, and medical services for commercial profit predominante in Taiwan.

Skip to 5 minutes and 44 secondsSo... It's very important for us to design curriculum to engage students with community. The goal is to empower willing students and teachers from different schools, to participate in programs that interact with the communities to achieve and advance their health autonomy. And each participating school and institution, together with the community teams, will constitute a local work platform, with the Taiwan Social Empowerment Association acting as a coordinator and platform for all the programs in medical humanities.

Skip to 6 minutes and 33 secondsSo... The development of the curriculum concept is to extend the achievement of proceeding students programs, such as, making friends with patients and the community oral history, for benefit of presently-participating students and teachers.

Skip to 6 minutes and 55 secondsIntegrated advanced techniques for oral history narrative and community area and the community group development. Transmit discipline knowledge of community health practice, encompassing humanities and social context. Inculcate the approach of the “doctor as mediator in the changing relationship with patients.”

Skip to 7 minutes and 26 secondsSo, there are three dimensions of the empowerment approach to the community building. First, to start from live experience, respect the centrality of the human. And secondary, connect with the historical memory, expand on the experience of community identity. And third, to coalesce the common platform through consensus on integration of rofessional resources.

Community engagement for service learning

Nowadays, aging has become a major issue for many developed countries.

At the same time, the needs of healthcare arise tremendously. In the past, only doctors or healthcare workers can provide medical knowledge and services. However, people has begun to gather more and more health related information through different channels, mainly from internet.

The good thing is that patients nowadays can be more educated and more health-literate. The bad thing is that healthcare providers should pay more attention to teaching patients which is the correct information. In addition, there are still imbalances between cities and rural areas in terms of healthcare resources.

In this video, I would like to give you a hint about the role of community participation in the practice of medical humanities.

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This video is from the free online course:

Medical Humanity: Engaging Patients and Communities in Healthcare

Taipei Medical University