Abstract
BackgroundCommunity-based education (CBE) is strategically important to provide contextual learning for medical students. CBE is a priority for countries striving for better primary health care. However, the CBE literature provides little curriculum guidance to enhance undergraduate medical education with the primary health care context. We aim to develop a CBE framework for undergraduate medical education (from macro, meso, and micro curriculum levels) to engage students and teachers with better, more meaningful learning, within primary health care settings.MethodsWe used a grounded theory methodology by interviewing eight medical educationalists and ten CBE teachers, followed with the coding process by sensitizing the concepts of ‘medical education’ and ‘primary care’, to explore any new concepts. The primary data originated from a developing country where the paradigm of high-quality primary health care is mostly unfamiliar. Three senior researchers from international associations of general practices from different countries provided validation to the results.ResultsWe identified a new framework for a community-based educational program. The micro-curriculum should offer opportunities for small group activities, ranging from simple to complex learning, emphasizing clinical skills, leadership, and teamwork to improve self-directed and collaborative practice. Sufficient role models and constructive feedback within primary care contexts are robust facilitators. For the meso-curriculum, comprehensive coordination on teacher-training and CBE program is needed. To ensure the sustainability of the program, faculty leaders and managers should include the macro-curriculum with a national postgraduate general practice curriculum and provide strong commitment.ConclusionsWe designed a ‘CBE-tree’ model for the undergraduate medical curriculum. By using the CBE framework developed in this study, students and teachers may better comprehend the essential of primary health care.
Highlights
Community-based education (CBE) is strategically important to provide contextual learning for medical students
Contextualized learning in primary health care for medical education Studies show that contextual learning or more meaningful learning for medical students can be enhanced by early exposure to community settings [1, 2]
We interview the subjects in this study and inductively coded the data by sensitizing the concepts of ‘student-centered learning’ [1,2,3,4], ‘curriculum levels’ [21], ‘experiential learning’ [29], as well as principles of ‘primary health care’ and ‘general practice’ or ‘family medicine’ [9, 20], until saturation
Summary
Community-based education (CBE) is strategically important to provide contextual learning for medical students. The CBE literature provides little curriculum guidance to enhance undergraduate medical education with the primary health care context. We aim to develop a CBE framework for undergraduate medical education (from macro, meso, and micro curriculum levels) to engage students and teachers with better, more meaningful learning, within primary health care settings. A recent study in the United Kingdom defined the topics taught in primary care medicine in undergraduate medical education as consulting and communication skills, leading and working in teams, and developing yourself; including novel topics such as learning disability, genetics, and multi-morbidity [8]. Some literature argues that engaging with general practices and family medicine specialists may lead to more profound reflections of learning for undergraduate medical students during intensive exposure to the community health problems [9]. Not every country has a graduate general practice specialist program [9]
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