Community-oriented medical education in Glasgow: developing a community diagnosis exercise

Recent NHS changes have included an increasing emphasis on primary care settings, and hence community needs assessment. This has led to suggestions that medical education should become more community-oriented if today's medical students are to become effective medical practitioners. Recent curriculum reforms in a number of medical schools frequently involve a more student-centred approach, which encourages students to learn by intellectual discovery and critical thinking. We describe one such exercise in community diagnosis that has been developed in Glasgow's new undergraduate medical curriculum.

The exercise has been developed as three teaching sessions, each with specific learning objectives. The first session explores the strengths and weaknesses of routine statistics, and reveals the lack of information regarding individual's and community's health and health care needs. The second session is a community-based rapid participatory appraisal arranged by general practitioners. Students interview patients, carers, and local key informants and health care professionals about their perceptions of health and health needs. In the final campus-based session, students combine and present their findings. Development included two pilot exercises involving detailed evaluation.

University of Glasgow.

Medical students.

Students valued the contrasting perspectives and information provided by different sources. After completing the three sessions, most students and tutors considered it an interesting, enjoyable and educational experience.

This innovative community-oriented teaching programme gave students some insight into how health, morbidity and mortality are measured, why these might vary between different communities, and how different community members' perspectives might differ regarding perceived health and social needs.