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Comparison of outcomes of a community-based education programme executed with and without active community
Tri N Kristina1, Gerard D Majoor, Cees P M van der Vleuten
1Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
Objective:
The aim of this study was to evaluate the applicability of a previously designed set of generic objectives for community-based education (CBE) emphasising community involvement.
Methods:
The study was designed as a non-blinded, randomised trial. Experimental and conventional groups of students following CBE programmes either closely or weakly matching the set of generic objectives were compared. Student groups were subjected to passive participatory observation. Students evaluated their programmes through questionnaires. The impact of student interventions was assessed by community compliance. Community perception of the programmes was evaluated through structured interviews with community representatives.
Results:
Students in experimental groups appreciated their programme more than students in conventional groups. High compliance and appreciation were recorded in communities hosting the modified programme. Most students in conventional groups judged their posting negatively, largely because of the high number of households to be visited. Health interventions performed by conventional groups lacked co-operation between students and the community. Communities hosting conventional groups felt their health needs were scarcely discussed and addressed.
Conclusions:
The modification of an existing CBE programme to better match a set of generic CBE objectives emphasising community involvement had a positive effect on programme outcomes and levels of appreciation by both students and hosting communities. However, some confounding variables could not be controlled. Colleagues planning comparable studies may take advantage of the lessons we learned while performing this study.
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