EDUCATIONAL HANDBOOK FOR HEALTH

This 1998 updated reprint of the sixth edition in English is being published shortly before the thirtieth anniversary of the Handbook /WHO Offset Publication № 35/. The first edition was prepared in 1969 on the basis of the first educational workshop organized by the WHO Regional Office for Africa in Brazzaville. Initially, the Handbook was widely used in the African Region, and has since served as the main textbook for numerous WHO-sponsored workshops attended by over 4000 participants in different parts of the world. Thanks to the constructive comments of many users, the Handbook has become a collective work and has been translated into 15 languages.

During the past three decades the presentation and content of the Handbook have evolved, but its basic principles have remained the same: community-oriented education, directed at individuals and population groups and taking their health needs into account; learner-centered education, keeping the learners in an active situation and gradually helping them to become the architects of their own learning so that they become and remain competent for their professional role.

The application of these two principles has been particularly reinforced in this updated version. Relevance to the priority health needs of the population has been stressed in the first chapter. Problem-based learning has been described in some detail in the third chapter. Over 55 new pages and several new exercises have been added.

This Handbook is now entering a new phase. I am convinced that the time is ripe for the preparation of adaptations to national and to specific professional situations. The Handbook has hitherto aimed to address the needs of educators for the health professions in any part of the world equally well. But it is clear that health care and the services provided by health professionals of all kinds are strongly influenced by the specific local situation.

3. You will also have strengthened your desire to go on learning and acquiring skills in education and will have mastered an effective way of setting about it.

Figure 1: The educational spiral for health professions /from the English original/.

(i). It can be useless to try to change a program or teaching methods without also changing the system of evaluation /particularly examinations/. Evaluation provides a sound basis for program planning. Therefore, an evaluation mechanism should be set up before proceeding to any reform of the program. This makes it possible to measure the level at the outset and the level at the finish - thus, to determine whether the change has been positive or not. This process can be represented by what is called the educational spiral.

Supplement: There is not much to be added to this translation of a WHO manual. It is the only of it's kind in the bulgarian literature and remains a valuable asset for medical pedagogic in Bulgaria. I would like to make some connotations on the development of the discipline in the country, since, not so much materials exist in the field and particularly in English language.

My sources are rather scanty and I would like to arrange them in a chronological manner. Pedagogical science in Bulgaria has a separate development and this will be subject to another review. There are some books on the history of education in the Bulgarian lands, but they treat the theme globally and no chapter on medical education is included. I intend to find these books and put them in the index. However, let me narrow our view on the present matter.

My research extends, as early as, the 30s of the past century. It concerns the Medico-Pedagogical Journal from SZDB /Soyuz za Zashtita na Detzata v Bulgaria, transliteration is from bulgarian/ and edited by Dr. Vassil Shumanov. I couldn't find his name in the Almanac of Sofia University, therefore, he doesn't seem to be university lecturer from that time and was a private practitioner in his profession. The journal itself is handsomely printed and edited with great precision. Most of the materials follow a pro-German line and this is characteristic of the historical period, when, Bulgaria and Germany were allies in the Triple Alliance. The publishing ends abruptly at the beginning of the Second World War.

After the war pro-Nazism propaganda in the country was banned and this reflected on the development of the discipline, which, couldn't still find it's institutional basis. Separation of medical faculty from Sofia University and formation of Medical Academy were a long process for bulgarian medical science. This institution was twice conglomerated - i.e., in the 50s and in the 70s of the past century. It couldn't establish itself as a functioning one and mainly because of its monstrous dimensions. The organizational work of medical education included some curriculum building and student associations and all of them administrated by the Dean's Office - i.e., from a Secretary of Health Education. For example, major professional concourse were held in the medical discipline and an extramural Faculty of Public Professions was established in the town of Haskovo /1985/. From that time period is the translation of the before mentioned health education manual.

The end of communism and the reorganization of Medical Academy led to new organizational forms in medical education, as well. First division of medical education & medical ethics was established in the growing Department of Social Medicine and Public Health. Efforts were concentrated in the hands of Prof. Tzekomir Vodenicharov and he became a leading figure in the discipline. First textbook in bulgarian was published in 1995. By year 2001 the division has transformed in a Department of Medical Education within frames of a Faculty of Public Health.

Efforts of the newly established Faculty of Public Health were concentrated on two basic surfaces - namely, i./ to establish a disciplinary foundation for Medical Education and simultaneously for a growing second detachment for Medical Ethics; ii./ collateral activities for training of auxiliary personnel in Bulgaria, with training and retraining of cadres on a vocational basis. This has led to an establishment of a Nursing College, which later was integrated within the premises of the Faculty of Public Health.