Paramedicals' clinical accuracy in 102 cases referred to a provincial hospital

Ronald E Pust, J. M. Burrell

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Papua New Guinea has excellent manuals of standard therapies for common clincial diagnoses, supported by a well-designed health department pharmaceutical list. However, standard treatments are only as effective as competent diagnosis. Therefore, a new emphasis on problem-based diagnosis and competency-based curricula, both for paramedicals and for physicians, may be in order. A random sample of 102 cases referred in 1983 by paramedicals to the Southern Highlands Provincial Hospital, Papua New Guinea, was analyzed for agreement with the final hospital diagnosis and with standardized primary care therapies. Health center diagnosis was judged accurate in 45% of the cases; inaccuracies in a further 17% had no projected health consequences. However, resulting serious sequelae could be projected in 1/2 of the incorrect diagnoses. There were serious diagnostic inaccuracies in 38% of all referral cases; this study suggests a need for problem-based paramedical education in diagnosis, especially in non-surgical problems. Doctors should become partners with paramedics in the defining and refining of diagnostic skills. When doctors visit health centers, they should reinforce problem based diagnostic learning on their rounds and begin such prospective studies. Clinical teaching of paramedicals in a key role for all tropical doctors. On going local evaluation of that teaching through the clinical outcome of patients managed by paramedicals should be part of the process.

Original languageEnglish (US)
Pages (from-to)38-43
Number of pages6
JournalTropical Doctor
Volume16
Issue number1
StatePublished - 1986

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Papua New Guinea
Health
Teaching
Musculoskeletal Manipulations
Allied Health Personnel
Problem-Based Learning
Curriculum
Primary Health Care
Referral and Consultation
Prospective Studies
Physicians
Education
Therapeutics
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

Cite this

Paramedicals' clinical accuracy in 102 cases referred to a provincial hospital. / Pust, Ronald E; Burrell, J. M.

In: Tropical Doctor, Vol. 16, No. 1, 1986, p. 38-43.

Research output: Contribution to journalArticle

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