What problems were addressed? Moving clerkship rotations from hospital-based to community-based settings can be challenging, mostly because students are dispersed across many different settings far from the university hospital and are under the supervision of family medicine practitioners or preceptors from municipal services, rather than faculty members. Our medical school runs a 6-year traditional curriculum. This includes 18 months of clerkship rotations, with an 8-week rotation in primary care. Seventeen family health primary care units (PCUs) in the municipality receive a total of 28 students. We decided to improve faculty supervision of these students and to follow up their learning experiences. Although the rotation provided an excellent opportunity for practice, students did not participate in teaching activities oriented by faculty members. What was tried? We planned and implemented an educational activity based on the use of distance learning and conceptual maps. This was intended to support students’ learning and reflection about their practice in the primary care rotation. We conducted 4-hour meetings every 2 weeks with groups of 14 students. During their primary care rotation, each student identified one case per cycle in an area in which they felt they could improve their learning. At the first meeting (time-point 1), students selected one case from among 14 to use in a brainstorming session. In sequence, they discussed and depicted the case and collectively developed a conceptual map; this map revealed their knowledge gaps. At the end of the meeting, students raised questions for learning. During the following 2 weeks, students maintained their practical activities in the PCUs and discussed the learning objectives raised at time-point 1 through participation in forums based on the Moodle (modular object-oriented dynamic learning environment) software platform (time-point 2). Case discussion was conducted using an evidence-based medicine paradigm. Participation was stimulated by a medical faculty member who facilitated discussions, helping students to build individual and collective knowledge. The second face-to-face meeting (timepoint 3) consisted of another 4-hour session used to further discuss questions addressed in the initial meetings and to develop a final conceptual map. A total of 104 students participated, providing attendance rates of 99.6% at time-points 1 and 3, and 96.8% at time-point 2. A questionnaire evaluating the students’ perceptions about this experience was answered by 98 (94.2%) students, who reported that they felt more confident about dealing with real cases after the discussion and believed they had improved their ability to engage in online education, decision making and information seeking. What lessons were learned? These educational activities are helpful for students in settings outside the medical school. The development of group work for students who were unaccustomed to this mode of learning initially presented difficulties for effective participation; hence, it is vital to create a comfortable and safe environment and to establish certain rules before group activities begin. This process should include the delineating of appropriate working groups and the highlighting of teacher responsibility for monitoring the forum and encouraging participation and reflection. Our initial evolution data suggest that our educational strategy is effective in identifying learning gaps and provides a systematic protocol through which to promote learning activities.
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Jul 1, 2013
Ivana Mijatovic + 3
Open Access