‘Student centered approach’ in implementing community based active case finding for tuberculosis in rural, Puducherry – A qualitative evaluation

Abstract

BackgroundAs a part of Competency Based Medical Education (CBME) the competencies related to Communication skills, survey technique, can be improvised by exposing the students in community based Active Case Finding for Tuberculosis which helps in sustaining the activity. MethodsCommunity based house-to-house survey using “Student centered approach” was carried out to identify Presumptive TB cases as per the program definition among fourteen villages covered by Thirubhuvanai, Primary Health Centre. The team comprised of trained MBBS student, medical interns supervised by Post graduates, Medical social workers posted at the Department of Community Medicine, of a medical college, Puducherry. After training Mobile based application (Epicollect5) was used for survey. Feedback from students were obtained to explore their experience from ACF. Free listing and pile sorting was done among interns to explore their experience on Epicollect using Visual Anthropic software. ResultsThe major learning of the medical students from ACF activities were communication skills, rapport building with the community people, Screening for TB and their problem. Free listing identified 14 salient variables depending on the cut-off value of 0.083 (Smith's Salience Score) and subjected to pile sorting. Cognitive map identified their experiences into three categories namely knowledge on TB screening, uses of Epicollect and paper-based questionnaire. Totally 19,134 households were screened, among them 77 presumptive TB cases were identified, three positive pulmonary TB cases were detected and linked to TB care pathway. Conclusion“Student centered approach” proved to be effective strategy in ACF for TB from student's reflection. This rigorous ACF outreach activity shares dual benefits individual and community level benefit and also programme level benefits. Implementing this approach of involving MBBS students in ACF activity was successful and it is feasible to continue every year propounded by National TB Elimination Program (NTEP) guidelines.