8-4
The place and level (hospital, health center, or home)
The term ‘clinical practice’, as we use it, does not mean only activity in a clinic or
health center. It includes visiting sick persons in their homes.
Many programs have found that health workers do not need a special, separate
‘health post’. They can work well in their own homes, or by visiting the homes of
the sick. The home is a more relaxed place for a consultation and puts the health
worker and the sick person on more equal terms. It provides a more appropriate
setting for talking about preventive measures. And it helps to ‘demystify’ or take
the magic out of medical care.
There is, however, one big advantage to having students gain at least part of
their clinical experience in a community clinic or health center. It gives them a
chance to see a wider variety of health problems and to gain repeated experience
in handling the more common problems.
But there are also some disadvantages to clinical practice in a large clinic or
hospital:
• The staffs of large centers or hospitals tend to be less flexible, less able to
arrange active, appropriate learning for health workers.
• Care tends to be less personal and more hurried. Staff may not have time to
treat either patients or health workers as persons. Health workers may learn
more bossy, less friendly attitudes and habits.
• Often costly equipment is used that will not be available in health posts.
• Students may take part in difficult diagnoses or treatments of problems
that they would normally need to refer to a health center. This can lead to
confusion and temptation to go beyond their limits.
LESS APPROPRIATE
MORE APPROPRIATE
As much as possible, health workers should gain clinical experience
in a situation similar to that in their own communities.