Zvinhu zvinokonzera hutano munharaunda (SDOH) zvakabatana zvakanyanya nezvinhu zvakawanda zvemagariro evanhu nehupfumi. Kufungisisa kwakakosha pakudzidza SDH. Zvisinei, mishumo mishoma chete ndiyo inoongorora mapurogiramu eSDH; mazhinji acho ari zvidzidzo zvakasiyana-siyana. Takatsvaga kuita ongororo yenguva refu yechirongwa cheSDH mukosi yedzidzo yehutano yenharaunda (CBME) yakatangwa muna 2018 zvichibva padanho uye zviri mukati mekufungisisa kwakataurwa nevadzidzi nezveSDH.
Kugadzira tsvakurudzo: Nzira yakajairika yekuongorora data remhando yepamusoro. Chirongwa Chedzidzo: Kudzidzira kwemavhiki mana mukurapa kwakajairika uye kurapwa kwekutanga paYunivhesiti yeTsukuba School of Medicine, Japan, kunopihwa kune vese vadzidzi vekurapa vegore rechishanu nerechitanhatu. Vadzidzi vakapedza mavhiki matatu vari pabasa kumakiriniki emunharaunda nezvipatara munzvimbo dziri kumaruwa nekumaruwa eIbaraki Prefecture. Mushure mezuva rekutanga rezvidzidzo zveSDH, vadzidzi vakakumbirwa kugadzirira mishumo yenyaya yakarongeka zvichibva pamamiriro ezvinhu akasangana nawo panguva yekosi. Pazuva rekupedzisira, vadzidzi vakagovana zvavakasangana nazvo mumisangano yeboka uye vakapa bepa pamusoro peSDH. Chirongwa ichi chinoramba chichivandudza uye chichipa kufambira mberi kwevadzidzisi. Vatori vechikamu muchidzidzo: vadzidzi vakapedza chirongwa ichi pakati paGumiguru 2018 naChikumi 2021. Kuongorora: Hunhu hwekufungisisa hunorongwa sekufungisisa, kuongorora kana kutsanangura. Zviri mukati zvinoongororwa uchishandisa puratifomu yeSolid Facts.
Takaongorora mishumo 118 ye2018-19, mishumo 101 ye2019-20 uye mishumo 142 ye2020-21. Paiva nemishumo miviri (1.7%), 6 (5.9%) uye 7 (4.8%) yekufungisisa, mishumo 9 (7.6%), 24 (23.8%) uye 52 (35.9%) yekuongorora, 36 (30.5%) zvichiteerana, 48 (47.5%) uye 79 (54.5%) yetsanangudzo. Handizotaure nezvezvimwe zvese. Huwandu hwemapurojekiti eSolid Facts mumushumo i2.0 ± 1.2, 2.6 ± 1.3, uye 3.3 ± 1.4, zvichiteerana.
Sezvo mapurojekiti eSDH mumakosi eCBME achivandudzwa, kunzwisisa kwevadzidzi nezveSDH kuri kuramba kuchikura. Pamwe izvi zvakafambiswa nekuvandudzwa kwevadzidzisi. Kunzwisisa kwakadzama kweSDH kungada kuvandudzwa kwevadzidzisi uye dzidzo yakabatana mune zvesainzi yemagariro evanhu nemishonga.
Zvinhu zvinokonzeresa hutano munharaunda (SDH) zvinhu zvisiri zvekurapa zvinokanganisa hutano, kusanganisira nharaunda inozvarirwa vanhu, inokura, inoshanda, inorarama uye inokura [1]. SDH ine simba guru pahutano hwevanhu, uye kupindira kwezvekurapa chete hakugone kuchinja migumisiro yehutano yeSDH [1,2,3]. Vanopa hutano vanofanirwa kuziva nezveSDH [4, 5] uye kubatsira munharaunda sevanotsigira hutano [6] kuderedza migumisiro yakaipa yeSDH [4,5,6].
Kukosha kwekudzidzisa SDH mudzidzo yezvekurapa yepasi pegiredhi kunozivikanwa zvakanyanya [4,5,7], asi kunewo matambudziko akawanda ane chekuita nedzidzo yeSDH. Kune vadzidzi vezvekurapa, kukosha kwakakosha kwekubatanidza SDH nenzira dzezvirwere zvebhayoloji [8] kungave kwakajairika, asi hukama huripo pakati pedzidzo yeSDH nekudzidziswa kwekiriniki hunogona kunge huchiri hushoma. Sekureva kweAmerican Medical Association Alliance for Accelerating Change in Medical Education, dzidzo yakawanda yeSDH inopiwa mugore rekutanga nerechipiri redzidzo yezvekurapa yepasi pegiredhi kupfuura mugore rechitatu kana rechina [7]. Hazvisi zvikoro zvese zvekurapa muUnited States zvinodzidzisa SDH padanho rekiriniki [9], kureba kwezvidzidzo kunosiyana [10], uye makosi anowanzo kuve ekusarudza [5, 10]. Nekuda kwekushaikwa kwekubvumirana pahunyanzvi hweSDH, nzira dzekuongorora dzevadzidzi nemapurogiramu dzinosiyana [9]. Kukurudzira dzidzo yeSDH mukati medzidzo yezvekurapa yepasi pegiredhi, zvakakosha kuita mapurojekiti eSDH mumakore ekupedzisira edzidzo yezvekurapa yepasi pegiredhi uye kuita ongororo yakakodzera yemapurojekiti [7, 8]. Japan yakaonawo kukosha kwedzidzo yeSDH mudzidzo yezvekurapa. Muna 2017, dzidzo yeSDH yakabatanidzwa muchirongwa chikuru chedzidzo yekurapa yekuratidzira, zvichijekesa zvinangwa zvinofanirwa kuzadzikiswa pakupedza chikoro chekurapa [11]. Izvi zvinosimbiswazve mushanduro ya2022 [12]. Zvisinei, nzira dzekudzidzisa nekuongorora SDH hadzisati dzatangwa muJapan.
Muchidzidzo chedu chekare, takaongorora mwero wekufungisisa mumishumo yevadzidzi vekurapa vepamusoro pamwe chete nemaitiro avo nekuongorora kuongororwa kwepurojekiti yeSDH mukosi yedzidzo yezvekurapa yakavakirwa munharaunda (CBME) [13] payunivhesiti yekuJapan. Kunzwisisa SDH [14]. Kunzwisisa SDH kunoda kudzidza kunochinja [10]. Tsvagiridzo, kusanganisira yedu, yakatarisana nekufungisisa kwevadzidzi pakuongorora mapurojekiti eSDH [10, 13]. Mumakosi ekutanga atakapa, vadzidzi vaiita sevanonzwisisa zvimwe zvinhu zveSDH zviri nani pane zvimwe, uye mwero wekufunga kwavo nezveSDH waive wakaderera [13]. Vadzidzi vakadzamisa kunzwisisa kwavo kweSDH kuburikidza nezviitiko zvenharaunda uye vakashandura maonero avo emuenzaniso wezvekurapa kuita muenzaniso wehupenyu [14]. Mhedzisiro iyi inokosha kana zviyero zvedzidzo yeSDH uye kuongororwa kwavo nekuongororwa zvisati zvanyatsosimbiswa [7]. Zvisinei, kuongororwa kwenguva refu kwezvirongwa zveSDH zvevadzidzi vepasi pekutanga hazviwanzo kutaurwa. Kana tikakwanisa kuratidza maitiro ekuvandudza nekuongorora mapurogiramu eSDH, zvichashanda semuenzaniso wekugadzira nekuongororwa kuri nani kwezvirongwa zveSDH, izvo zvichabatsira kugadzira mwero nemikana yeSDH yevadzidzi vepasi pekutanga.
Chinangwa chechidzidzo ichi chaive chekuratidza maitiro ekuvandudza chirongwa chedzidzo cheSDH kune vadzidzi vekurapa uye kuita ongororo yenguva refu yechirongwa chedzidzo cheSDH mukosi yeCBME nekutarisa mwero wekufungisisa mumishumo yevadzidzi.
Chidzidzo ichi chakashandisa nzira yekudzidzisa vanhu uye chakaita ongororo yedata remapurojekiti gore rega rega kwemakore matatu. Chinoongorora mishumo yeSDH yevadzidzi vekurapa vakanyoresa muzvirongwa zveSDH mukati mezvidzidzo zveCBME. Kudzidziswa kwevanhu vose inzira yakarongeka yekuongorora data remagadzirirwo umo ongororo inogona kutungamirirwa nezvinangwa zvekuongorora. Chinangwa ndechekubvumira zvakawanikwa pakutsvagisa kuti zvibude kubva muzvinhu zvakajairika, zvinotonga, kana zvakakosha zviri mudata risina kubikwa pane kutsanangurwa nenzira yakarongeka [15].
Vatori vechikamu muchidzidzo ichi vaive vadzidzi vekurapa vegore rechishanu nerechitanhatu paYunivhesiti yeTsukuba School of Medicine avo vakapedza kudzidza kwemavhiki mana muCBME pakati paGunyana 2018 naChivabvu 2019 (2018–19). Kurume 2020 (2019-20) kana Gumiguru 2020 naChikunguru 2021 (2020-21).
Maumbirwo ekosi yeCBME yemavhiki mana akaenzana nezvidzidzo zvedu zvekare [13, 14]. Vadzidzi vanotora CBME mugore ravo rechishanu kana rechitanhatu sechikamu chekosi yeIntroduction to Medicine, iyo yakagadzirirwa kudzidzisa ruzivo rwekutanga kune nyanzvi dzehutano, kusanganisira kusimudzira hutano, hunyanzvi, uye kushandira pamwe kwevashandi. Zvinangwa zvekosi yeCBME ndezvekuratidza vadzidzi ruzivo rwevanachiremba vemhuri vanopa rubatsiro rwakakodzera munzvimbo dzakasiyana-siyana dzekiriniki; kuzivisa matambudziko ehutano kuvagari, varwere, nemhuri dziri muhurongwa hwehutano hwemunharaunda; uye kukudziridza hunyanzvi hwekufunga nezvekiriniki. . Mavhiki mana ega ega, vadzidzi 15-17 vanotora kosi iyi. Kuchinjana kunosanganisira vhiki imwe chete munharaunda, vhiki imwe kusvika mbiri mukiriniki yemunharaunda kana chipatara chidiki, kusvika vhiki imwe chete muchipatara chemunharaunda, uye vhiki imwe chete mudhipatimendi remishonga yemhuri muchipatara cheyunivhesiti. Pamazuva ekutanga neekupedzisira, vadzidzi vanoungana kuyunivhesiti kuti vapinde hurukuro nehurukuro dzemapoka. Pazuva rekutanga, vadzidzisi vakatsanangurira vadzidzi zvinangwa zvekosi iyi. Vadzidzi vanofanirwa kutumira mushumo wekupedzisira une chekuita nezvinangwa zvekosi iyi. Vadzidzisi vatatu vakuru (AT, SO, uye JH) vanoronga makosi mazhinji eCBME nemapurojekiti eSDH. Chirongwa ichi chinoitwa nevadzidzisi vakuru uye vadzidzisi vekuwedzera gumi kusvika gumi nevaviri vari kudzidzisa payunivhesiti uku vachipa mapurogiramu eCBME sevanachiremba vemhuri kana vadzidzisi vezvekurapa vasiri vanachiremba vanoziva nezveCBME.
Maumbirwo echirongwa cheSDH mukosi yeCBME anotevera maumbirwo ezvidzidzo zvedu zvekare [13, 14] uye anogara achichinjwa (Mufananidzo 1). Pazuva rekutanga, vadzidzi vakapinda hurukuro yeSDH uye vakapedza mabasa eSDH panguva yekutenderera kwemavhiki mana. Vadzidzi vakakumbirwa kusarudza munhu kana mhuri yavakasangana nayo panguva yekudzidzira kwavo uye kuunganidza ruzivo kuti vafunge nezvezvinhu zvinogona kukanganisa hutano hwavo. Sangano reWorld Health Organization rinopa Solid Facts Second Edition [15], mapepa ebasa eSDH, uye mienzaniso yemapepa ebasa akazadzwa sezvinhu zvekutarisa. Pazuva rekupedzisira, vadzidzi vakapa nyaya dzavo dzeSDH mumapoka madiki, boka rega rega riine vadzidzi 4-5 nemudzidzisi 1. Mushure mekuratidzwa, vadzidzi vakapihwa basa rekutumira mushumo wekupedzisira wekosi yeCBME. Vakakumbirwa kuti vatsanangure uye vaubatanidze neruzivo rwavo panguva yekutenderera kwemavhiki mana; vakakumbirwa kutsanangura 1) kukosha kwevashandi vehutano kunzwisisa SDH uye 2) basa ravo mukutsigira basa rehutano hweveruzhinji rinofanira kuitwa. Vadzidzi vakapihwa mirairo yekunyora mushumo uye ruzivo rwakadzama rwekuti vangaongorora sei mushumo (zvinyorwa zvekuwedzera). Pakuongorora vadzidzi, nhengo dzevadzidzisi dzinosvika gumi neshanu (kusanganisira nhengo dzevadzidzisi vakuru) dzakaongorora mishumo yacho dzichienzanisa nezvinodiwa pakuongorora.
Pfupiso yechirongwa cheSDH muchirongwa cheCBME cheYunivhesiti yeTsukuba Faculty of Medicine mugore redzidzo ra2018-19, uye maitiro ekuvandudza chirongwa cheSDH nekuvandudza vadzidzisi mumakore edzidzo a2019-20 na2020-21. 2018-19 zvinoreva chirongwa kubva muna Gumiguru 2018 kusvika Chivabvu 2019, 2019-20 zvinoreva chirongwa kubva muna Gumiguru 2019 kusvika Kurume 2020, uye 2020-21 zvinoreva chirongwa kubva muna Gumiguru 2020 kusvika Chikumi 2021. SDH: Zvinokonzera Hutano Munzanga, COVID-19: Chirwere cheCoronavirus 2019
Kubva payakatanga muna 2018, takaramba tichichinja chirongwa cheSDH uye tichipa kudzidziswa kwevadzidzisi. Pakatanga chirongwa ichi muna 2018, vadzidzisi vakuru vakachigadzira vakapa hurukuro dzekudzidziswa kwevadzidzisi kune vamwe vadzidzisi vaizotora chikamu muchirongwa cheSDH. Hurukuro yekutanga yekudzidziswa kwevadzidzisi yakatarisana neSDH nemaonero ezvemagariro evanhu munzvimbo dzekiriniki.
Mushure mekupedzwa kweprojekiti mugore rechikoro ra2018-19, takaita musangano wekuvandudza vadzidzisi kuti tikurukure nekusimbisa zvinangwa zveprojekiti uye kugadzirisa projekiti zvinoenderana nazvo. Pachirongwa chegore rechikoro ra2019-20, chakatanga kubva munaGunyana 2019 kusvika munaKurume 2020, takapa Magwara Ekutungamira, Mafomu Ekuongorora, uye Maitiro eVatungamiriri veVadzidzisi kuti vaite Mharidzo dzeSDH Topic Group pazuva rekupedzisira. Mushure mekuratidzwa kweboka rega rega, takaita hurukuro dzeboka nemurongi wevadzidzisi kuti tifungisise nezvechirongwa ichi.
Mugore rechitatu rechirongwa ichi, kubva munaGunyana 2020 kusvika munaChikumi 2021, takaita misangano yekuvandudza vadzidzisi kuti tikurukure zvinangwa zvechirongwa chedzidzo cheSDH tichishandisa mushumo wekupedzisira. Takachinja diki pakugoverwa kwemushumo wekupedzisira uye zvinodiwa zvekuongorora (zvinyorwa zvekuwedzera). Takachinjawo mafomati nenguva yekupedzisira yekutumira mafomu nemaoko uye kutumira mafomu zuva rekupedzisira risati rasvika kuita magwaro emagetsi uye kutumira mafomu mukati memazuva matatu kubva pamhosva.
Kuti tizive dingindira rakakosha uye rakajairika mumushumo wese, takaongorora kuti tsananguro dzeSDH dzakaratidzwa zvakadii uye takatora zvinhu zvakasimba zvakataurwa. Nekuti wongororo dzakapfuura [10] dzakafunga nezvekufungisisa senzira yekuongorora dzidzo nechirongwa, takaona kuti huwandu hwakatarwa hwekufungisisa mukuongorora hunogona kushandiswa kuongorora mapurogiramu eSDH. Tichifunga kuti kufungisisa kunotsanangurwa zvakasiyana mumamiriro akasiyana, tinoshandisa tsananguro yekufungisisa mumamiriro edzidzo yezvekurapa se "maitiro ekuongorora, kubvunza uye kuvakazve zviitiko nechinangwa chekuzviongorora kuti zviitwe pakudzidza." /kana kuvandudza maitiro,” sezvakatsanangurwa naAronson, zvichibva pane tsananguro yaMezirow yekufungisisa zvakadzama [16]. Sezvakaitika mukudzidza kwedu kwakapfuura [13], makore mana muna 2018–19, 2019–20 na2020–21. mumushumo wekupedzisira, Zhou akaiswa muchikamu chekutsanangura, kuongorora, kana kufungisisa. Kupatsanura uku kwakavakirwa pamaitiro ekunyora edzidzo akatsanangurwa neYunivhesiti yeKuverenga [17]. Sezvo zvimwe zvidzidzo zvedzidzo zvakaongorora mwero wekufungisisa nenzira yakafanana [18], takaona kuti zvakakodzera kushandisa kupatsanura uku kuongorora mwero wekufungisisa mumushumo uyu wekutsvagisa. Mushumo wenyaya mushumo unoshandisa hurongwa hweSDH kutsanangura nyaya, asi umo musina kubatanidzwa kwezvinhu. Mushumo wekuongorora mushumo unobatanidza zvinhu zveSDH. Mishumo yepabonde yekufungisisa mishumo umo vanyori vanofungisisa pfungwa dzavo pamusoro peSDH. Mishumo isina kuwira mune imwe yezvikamu izvi yakarongwa seisingakosheswi. Takashandisa ongororo yezviri mukati zvichibva paSolid Facts system, vhezheni 2, kuongorora zvinhu zveSDH zvakatsanangurwa mu mishumo [19]. Zviri mumushumo wekupedzisira zvinoenderana nezvinangwa zvechirongwa. Vadzidzi vakakumbirwa kuti vafungisise nezvezvakaitika kwavari kuti vatsanangure kukosha kwekuti nyanzvi dzehutano dzinzwisise SDH nebasa ravo munharaunda. SO yakaongorora nhanho yekufungisisa yakatsanangurwa mumushumo. Mushure mekufunga nezvezvinhu zveSDH, SO, JH, naAT vakakurukura uye vakasimbisa zvinodiwa zvechikamu. SO vakadzokorora ongororo. SO, JH, naAT vakakurukurazve ongororo yemishumo yaida shanduko mukuisa muzvikamu. Vakasvika pakubvumirana kwekupedzisira pakuongorora mishumo yese.
Vadzidzi vanosvika 118, 101 uye 142 vakapinda muchirongwa cheSDH mumakore ekudzidza a2018-19, 2019-20 uye 2020-21. Paive nevadzidzi vechikadzi 35 (29.7%), 34 (33.7%) uye 55 (37.9%), zvichiteerana.
Mufananidzo 2 unoratidza kugoverwa kwemazinga ekufungisisa pagore zvichienzaniswa nekudzidza kwedu kwakapfuura, uko kwakaongorora mazinga ekufungisisa mumishumo yakanyorwa nevadzidzi muna 2018-19 [13]. Muna 2018-2019, mishumo 36 (30.5%) yakarongwa senyaya, muna 2019-2020 - mishumo 48 (47.5%), muna 2020-2021 - mishumo 79 (54.5%). Kwaive nemishumo 9 (7.6%) yekuongorora muna 2018-19, mishumo 24 (23.8%) yekuongorora muna 2019-20 uye 52 (35.9%) muna 2020-21. Kwaive nemishumo 2 (1.7%) yekufungisisa muna 2018-19, 6 (5.9%) muna 2019-20 uye 7 (4.8%) muna 2020-21. Mishumo 71 (60.2%) yakarongwa seisina kuongororwa muna 2018-2019, mishumo 23 (22.8%) muna 2019-2020. uye mishumo 7 (4.8%) muna 2020-2021. Yakarongwa seisina kuongororwa. Tafura 1 inopa mienzaniso yemishumo yedanho rega rega rekufungisisa.
Mwero wekufungisisa mumishumo yevadzidzi yemapurojekiti eSDH akapihwa mumakore ekudzidza a2018-19, 2019-20 uye 2020-21. 2018-19 zvinoreva hurongwa kubva muna Gumiguru 2018 kusvika Chivabvu 2019, 2019-20 zvinoreva hurongwa kubva muna Gumiguru 2019 kusvika Kurume 2020, uye 2020-21 zvinoreva hurongwa kubva muna Gumiguru 2020 kusvika Chikumi 2021. SDH: Zvinokonzera Hutano Munzanga
Chikamu chezvinhu zveSDH zvakatsanangurwa mumushumo chinoratidzwa muMufananidzo 3. Avhareji yehuwandu hwezvinhu zvakatsanangurwa mumishumo yaive 2.0 ± 1.2 muna 2018-19, 2.6 ± 1.3 muna 2019-20. uye 3.3 ± 1.4 muna 2020-21.
Chikamu chevadzidzi vakataura nezvechimwe nechimwe chinhu muSolid Facts Framework (2nd Edition) mumishumo ye2018-19, 2019-20, uye 2020-21. Nguva ye2018-19 inoreva Gumiguru 2018 kusvika Chivabvu 2019, 2019-20 inoreva Gumiguru 2019 kusvika Kurume 2020 uye 2020-21 inoreva Gumiguru 2020 kusvika Chikumi 2021, aya ndiwo mazuva echirongwa. Mugore redzidzo ra2018/19 maive nevadzidzi 118, mugore redzidzo ra2019/20 - vadzidzi 101, mugore redzidzo ra2020/21 - vadzidzi 142.
Takaisa chirongwa chedzidzo yeSDH mukosi yeCBME inodiwa yevadzidzi vezvekurapa vepasi pegiredhi uye takaratidza mhedzisiro yeongororo yepurogiramu yemakore matatu tichiongorora huwandu hwekufungisisa kweSDH mumishumo yevadzidzi. Mushure memakore matatu ekushandisa chirongwa ichi uye tichiramba tichichivandudza, vadzidzi vazhinji vakakwanisa kutsanangura SDH uye kutsanangura zvimwe zvezvinhu zveSDH mumushumo. Kune rumwe rutivi, vadzidzi vashoma chete ndivo vakakwanisa kunyora mishumo yekufungisisa pamusoro peSDH.
Zvichienzaniswa negore rechikoro ra2018-19, makore echikoro a2019-20 na2020-21 akaona kuwedzera zvishoma nezvishoma kwehuwandu hwemishumo yekuongorora uye yekutsanangura, nepo huwandu hwemishumo isina kuongororwa hwakaderera zvakanyanya, izvo zvinogona kunge zvichikonzerwa nekuvandudzwa kwepurogiramu nekukura kwevadzidzisi. Kukura kwevadzidzisi kwakakosha kumapurogiramu edzidzo eSDH [4, 9]. Isu tinopa kukura kwehunyanzvi kuri kuramba kuchienderera mberi kuvadzidzisi vari kutora chikamu muchirongwa ichi. Pakatangwa chirongwa ichi muna 2018, Japan Primary Care Association, imwe yemasangano edzidzo yemhuri nehutano hwevanhu muJapan, yakanga ichangobva kuburitsa chirevo pamusoro peSDH yevanachiremba vekutanga vekuJapan. Vadzidzisi vazhinji havazivi izwi rekuti SDH. Nekutora chikamu mumapurojekiti uye kutaurirana nevadzidzi kuburikidza nekupa mienzaniso yezviitiko, vadzidzisi vakawedzera zvishoma nezvishoma kunzwisisa kwavo kweSDH. Pamusoro pezvo, kujekesa zvinangwa zvezvirongwa zveSDH kuburikidza nekukura kwehunyanzvi hwevadzidzisi kuri kuramba kuchienderera mberi kunogona kubatsira kuvandudza zvikwaniriso zvevadzidzisi. Imwe fungidziro inogona kunge iri yekuti chirongwa ichi chakavandudzika nekufamba kwenguva. Kuvandudzwa kwakadaro kwakarongwa kunogona kuda nguva yakawanda nesimba. Nezvechirongwa che2020–2021, kukanganisa kwedenda reCOVID-19 pahupenyu hwevadzidzi nedzidzo [20, 21, 22, 23] kunogona kukonzera vadzidzi kuti vaone SDH sedambudziko rinokanganisa hupenyu hwavo uye kuvabatsira kufunga nezve SDH.
Kunyangwe huwandu hwezvinhu zveSDH zvataurwa mumushumo hwakawedzera, kuwanda kwezvinhu zvakasiyana-siyana kunosiyana, izvo zvingave zvine chekuita nehunhu hwenzvimbo yekurapa. Mwero wepamusoro werutsigiro rwevanhu haushamisi tichifunga nezvekusangana kakawanda nevarwere vatove kugamuchira kurapwa. Kutakurwa kwataurwawo kakawanda, izvo zvinogona kunge zvichikonzerwa nekuti nzvimbo dzeCBME dziri munzvimbo dziri kumaruwa kana kumaruwa uko vadzidzi vanowana mamiriro ekufambisa asina kunaka uye vane mukana wekutaurirana nevanhu munzvimbo dzakadaro. Zvakataurwawo kushushikana, kuzviparadzanisa nevamwe, basa nechikafu, izvo vadzidzi vakawanda vangangosangana nazvo mukuita. Kune rumwe rutivi, kukanganisa kwekusarongeka kwevanhu uye kushaya mabasa pahutano zvingave zvakaoma kunzwisisa munguva pfupi iyi yekudzidza. Zvinhu zveSDH zvinosangana nevadzidzi mukuita zvinogonawo kutsamira pahunhu hwenzvimbo yekurapa.
Chidzidzo chedu chinokosha nekuti tiri kuramba tichiongorora chirongwa cheSDH mukati mechirongwa cheCBME chatinopa kuvadzidzi vezvekurapa vepasi pegiredhi nekuongorora mwero wekufungisisa mumishumo yevadzidzi. Vadzidzi vezvekurapa vepamusoro vakadzidza zvekurapa kwemakore mazhinji vane maonero ekurapa. Saka, vane mukana wekudzidza nekubatanidza sainzi yemagariro inodiwa kumapurogiramu eSDH nemaonero avo ekurapa [14]. Nokudaro, zvakakosha zvikuru kupa mapurogiramu eSDH kuvadzidzi ava. Muchidzidzo ichi, takakwanisa kuita ongororo inoenderera mberi yechirongwa nekuongorora mwero wekufungisisa mumishumo yevadzidzi. Campbell et al. Sekureva kwemushumo, zvikoro zvekurapa zveUS uye mapurogiramu ekubatsira vanachiremba vanoongorora mapurogiramu eSDH kuburikidza neongororo, mapoka ekutarisa, kana data rekuongorora repakati peboka. Zvinonyanya kushandiswa pakuyera mukuongorora mapurojekiti imhinduro yevadzidzi nekugutsikana, ruzivo rwevadzidzi, uye maitiro evadzidzi [9], asi nzira yakajairika uye inoshanda yekuongorora mapurojekiti edzidzo eSDH haisati yagadzwa. Chidzidzo ichi chinoratidza shanduko refu mukuongorora mapurogiramu nekuvandudzwa kwechirongwa nguva dzose uye chichabatsira mukuvandudzwa nekuongorora mapurogiramu eSDH kune dzimwe nzvimbo dzedzidzo.
Kunyangwe huwandu hwevadzidzi hwekufungisisa hwakakwira zvakanyanya munguva yekudzidza, huwandu hwevadzidzi vanonyora mishumo yekufungisisa hwakaramba hwakaderera. Dzimwe nzira dzezvemagariro evanhu dzingangoda kugadzirwa kuti dziwedzere kuvandudzwa. Mabasa ari muchirongwa cheSDH anoda kuti vadzidzi vabatanidze maonero ezvemagariro evanhu neezvekurapa, ayo akasiyana mukuoma kana tichienzanisa nemuenzaniso wezvekurapa [14]. Sezvatataura pamusoro apa, zvakakosha kupa makosi eSDH kuvadzidzi vechikoro chesekondari, asi kuronga nekuvandudza mapurogiramu edzidzo kutanga pakutanga kwedzidzo yezvekurapa, kugadzira maonero ezvemagariro evanhu neezvekurapa, uye kuabatanidza kunogona kushanda mukusimudzira kufambira mberi kwevadzidzi. 'kukura. Kunzwisisa SDH. Kuwedzera kwemaonero ezvemagariro evanhu evadzidzisi kunogonawo kubatsira kuwedzera kufungisisa kwevadzidzi.
Kudzidziswa uku kune zvipingamupinyi zvakawanda. Chekutanga, nzvimbo yekudzidza iyi yaive yakaganhurirwa kuchikoro chimwe chete chekurapa muJapan, uye nzvimbo yeCBME yaive yakaganhurirwa kunzvimbo imwe chete iri kumaruwa kana kumaruwa muJapan, sezvakaitwa muzvidzidzo zvedu zvekare [13, 14]. Takatsanangura nhoroondo yechidzidzo ichi nezvidzidzo zvekare zvakadzama. Kunyangwe nezvipingamupinyi izvi, zvakakosha kuziva kuti takaratidza mhedzisiro kubva kumapurojekiti eSDH mumapurojekiti eCBME mumakore apfuura. Chechipiri, zvichibva pachidzidzo ichi chega, zvakaoma kuona kuti zvinoita here kuita kudzidza kwekufungisisa kunze kwezvirongwa zveSDH. Tsvagiridzo yakawedzerwa inodiwa kukurudzira kudzidza kwekufungisisa kweSDH mudzidzo yezvekurapa yepasi pekutanga. Chechitatu, mubvunzo wekuti kuvandudzwa kwevadzidzisi kunobatsira here mukuvandudza chirongwa hausi pamusoro pefungidziro dzechidzidzo ichi. Kubudirira kwekuvaka timu yevadzidzisi kunoda kudzidza kwakawanda uye kuyedzwa.
Takaita ongororo yakareba yechirongwa chedzidzo cheSDH chevadzidzi vekurapa vepamusoro mukati meCBME curriculum. Tinoratidza kuti kunzwisisa kwevadzidzi nezveSDH kunoramba kuchikura sezvo chirongwa ichi chichikura. Kuvandudza mapurogiramu eSDH kungada nguva nesimba, asi kuvandudza vadzidzisi kwakanangana nekuwedzera kunzwisisa kwevadzidzisi nezveSDH kunogona kushanda. Kuti vadzidzi vawedzere kuvandudza kunzwisisa kwavo nezveSDH, makosi akabatanidzwa zvakanyanya mune zvesainzi yemagariro evanhu nemishonga angangoda kugadzirwa.
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Nguva yekutumira: Gumiguru-28-2023