Medicine in the community: a unique partnership

Many advantages to community-oriented medical education have already been described. Responding to reforms in undergraduate medical education policy, our medical school reconfigured its clinical curriculum to include a module with a broad community focus, based in primary and secondary care. We describe our initial experience developing, implementing and evaluating this module.

The aim of the module was to provide students with an understanding of medicine as practised, and health care as delivered, in the community. The 6-week module is delivered four times annually in the final stage of the medical degree programme, with 40-50 students attending each time. Learning experiences encompass clinical attachments, lectures, workshops, seminars and group presentations, with multifaceted assessment and formal student feedback at the end of the module (Ramsden's Module/Course Experience Questionnaire, and student self-assessment of specified learning objectives, using a five-point Likert scale). RESULTS OF STUDENT FEEDBACK: A total of 104 out of 181 (57.5%) students completed the evaluation. Of these, 69.3 per cent were satisfied with the course (with a mean Likert score of 3.7). More than 75 per cent of the students agreed or strongly agreed that they had attained 12 of 13 specified learning objectives, and 64.6 per cent (95% CI 55.0-74.2%) agreed that they could use common diagnostic/therapeutic equipment. The mean Likert scores for Ramsden questionnaire subscales were: good teaching, 3.5; clarity of goals, 3.1; appropriate assessment, 3.6; appropriate workload, 3.7; and generic skills development, 3.4. The most positive scores were attained for teachers' ability to explain (3.95; 77.5% agreed or strongly agreed) and effort at making subjects interesting (3.83; 73.5% agreed or strongly agreed).

Our experience shows a community-based module with a strong combined primary care and elderly care focus is feasible, and enables the achievement of valuable learning objectives.