[Co-responsibility and social participation]. / Corresponsabilidad y participación social.

Social participation in health is the main issue of this paper. In the first part the role of the state and the necessary elements to guarantee political stability are discussed. In the second part the various forms of social participation are described. Finally, two possible scenarios regarding participation of the society in health activities in Mexico are analyzed.

First contact, simplified technology, or risk anticipation? Defining primary health care.

PIP: Elements important to defining primary health care (PHC) are discussed, with examples from Latin American countries. Topics are identified as follows: the origins and dilemmas of PHC, conflicting PHC values and practices, organizational changes and PHC, health care reforms and examples from Latin America, and the implications for medical education. The new paradigm for medical education and practice is in the classic Kuhn tradition. A paradigm for health care is an ideological model about the form, content, and organization of health care. There are rules that prescribe in a normative way how resources should be combined to produce health services. The current dominant paradigm is that of curative medicine, and the PHC paradigm assumes that a diversified health care team uses modern technology and resources to actively anticipate health damage and promote well being. The key word is anticipatory. As a consequence secondary care also needs to be redefined as actually treating the illness or damage itself. Organizations must be changed to establish this model. Contrasting primary, anticipatory health care with technical, curative medicine has been discussed over at least the past 150 years. An important development was the new model for developing countries which was a result of a Makerere, Kenya symposium on the Medicine of Poverty. The Western model of physicians acting independently and in a highly specialized fashion to address each patient's complaints was considered inappropriate. The concern must be for training and supervising auxiliaries, designing cost-effective systems, and a practice mode limited to what can actually be provided to the population. How to adapt this to existing medical systems was left undetermined. In 1978 with the WHO drive for health for all, there emerged different conceptions and models of PHC. Conceptually, PHC is realized when services are directed to identifying and modifying risk factors at the collective level, where the health team anticipates and prevents problems through active programming and community participation, and in secondary care, the doctors wait for the ill patient. Level of care and type of contact are subordinate to PHC. 1st contact and 1st level facilities are responsible for PHC, although secondary interventions (prenatal care) are handled. The best technology should be evaluated in terms of the capacity to anticipate severe, irreversible, or fatal damage. Simplified technology is not primitive technology.^ieng

[Mexico: evaluation of medical training based on the results of a national test given to candidates for medical residencies]. / México: evaluación de la formación de médicos con base en los resultados de un examen nacional de aspirantes a residencias médicas.

This study assesses the current status of medical education in Mexico by evaluating the IX National Medical Residency Examination. The results indicate that the personal background of the candidates is related to the probability of their passing the examination: age; marital status; number of times they have presented the examination; length of time between graduation from medical school and the examination; place where social service was performed; and work experience. The authors observe a strong tendency toward specialization in the professional curricula of the medical schools in Mexico, with a consequent neglect of the national health system's present need for primary care. They therefore suggest that the educational institutions give thought to alternatives that would better equip the country's human resources to deal with current needs.

[A program for the preparation of educational materials]. / Programa para la elaboración de materiales educacionales.

The article describes a program for the development of educational materials using PC computers. The program may help a teacher plan a course. The teacher can use it to formulate the general and specific course objectives, analyze the content of the objectives and materials, classify the instructional materials to be learnt and sequence the materials to be used by means of a computer. The program also allows student replies to be recorded and the results of the applications to be revised.

[Evaluation, teaching and learning]. / Evaluación, enseñanza y apprendizaje.

These observations center on the context of development that is the evaluation process. When the approach of education shifts from teaching to learning, the object to be evaluated changes too. Not only the quantity of what has been learned must be measured, but its quality as well. The student's performance must be evaluated, particularly in situations which present problems. Evaluation is a process that begins when the school sets its objectives and shapes the image of the health professional it desires to produce. The evaluation is a culmination of that process. There are evaluation techniques that are essentially observational, reactive, and mixed. The neutrality and objectivity of tests are discussed. Techniques must be used as instruments for learning and not be ends in themselves.

[Basic learning strategies and programming languages]. / Estrategias didácticas básicas y lenguajes de programación.

The article is based on three facts. One is that at the present day the computer is tending to be used in all fields, including that of education. The second is that, when a new teaching device appears, the first tendency is to add it to the stock of existing devices, which fails to extract the full benefit from the new device. The third is that for the educator, the computer is an alien and in many cases an unintelligible instrument, the mastery of which requires time which he does not have at his disposal. The author proposes a number of teaching strategies for initiation of the educator who wishes to use the computer in support of some teaching-learning process, and as a bridge between the educator and the computer programmer. To this end he proposes routine, formative evaluation, simulation and game strategies. The routine strategies, as their name indicates, use the repetition of a central learning practice. The formative evaluation is based on the principle of providing the subject with immediate information on his performance of a task in order to improve his efficiency. Simulation promotes learning by changing the values of one or more variables in a situation and verifying the effects. The game, apart from its intrinsic purpose, results in learning through the immediate manipulation of objects and the immediate circumstances in which it takes place.

[Training and use of dental manpower resources in Mexico]. / Formación y utilización de recursos humanos odontológicos en México.

The introductory section describes the general situation of dental care in Mexico, analyzes the prevailing service model (including the kind of work done by the dental professional and the technology he employs), and briefly reviews the evolution of dentistry in the country. There follows an account of a series of new approaches to service and manpower training in experimental implementation since 1972 in the stomatology curriculum at the Xochimilco campus of the Metropolitan Autonomous University, at the National School of Professional Studies at Zaragoza, in the School of Dentistry of Nuevo León Autonomous University, Monterrey, and in the Dental Services at Ciudad Netzahualcóyotl. In each case, the background, characteristics, and objectives of the programs, and their evolution and prospects are described.