Evaluation of the participatory rural appraisal training-hands-on for medical (PRATHaM) students

Training in conventional community medicine often relies on didactic lectures and limited community engagement, which may not adequately improve understanding of students of contextual sociocultural and health-related problems. Participatory rural appraisal (PRA) is an effective and efficient approach to deliver community-based education. The objective of the present study was to evaluate the Participatory Rural Appraisal Training - Hands-on for Medical (PRATHaM) program for the first-year undergraduate medical students by assessing knowledge acquisition and obtaining feedback from students, faculty members, and community stakeholders.

It was a quasi-experimental study with a one-group pretest-posttest study design conducted among first-year undergraduate medical students in a medical college. The study employed total sampling, in which 250 students were enrolled, and data from 245 completers were analyzed. Study was carried out in two stages, namely training of students in PRA methods in classroom, followed by implementation of the same in the community by the trained students. At each stage, students were asked to provide feedback on different aspects of the training, and feedback was obtained from the community as well. Two tools were used to measure feedback from the community, namely observation of students' interaction in the community and feedback from community about their interactions with medical students. Institutional Ethics Committee approval was obtained prior to the start of the study and students were assured that the study will not have any impact on academics. The statistical analysis was done using descriptive and inferential (paired t-test) statistics and qualitative data from open-ended questions were analyzed using the thematic analysis framework.

A total of 245 students with a mean age of 20 ± 2.3 years were trained in PRA methods (remaining five were absent). Out of a maximum score of 10, there was a significant improvement in the mean score of students in the post-test (8.80 ± 1.01), when compared with the mean scores in the pre-test (3.47 ± 1.06), and this difference was found to be highly statistically significant (t = 56.98, p < 0.001). The community members liked the friendly approach adopted by students and that they shared their personal numbers to get in contact in case of any medical issues. The employment of interactive teaching methods, opportunities to interact with local community and implement PRA methods and practical sessions were identified as the most encouraging factors. However, not being aware of the native language, and limited time to interact with allotted families were recognized as the major barriers.

In conclusion, the training imparted to medical students on selected PRA methods brought about a statistically significant improvement in the knowledge of medical students. The findings suggest that PRA-based training is an effective approach for improving medical students' knowledge and community engagement skills and supports its integration into undergraduate community medicine curriculum to strengthen community-based learning experiences.