Utilizing the community as a learning resource in the training of undergraduate medical students

Saurabh RamBihariLal Shrivastava; Prateek Saurabh Shrivastava

doi:10.4103/cmi.cmi_125_22

MEDICAL EDUCATION

Year : 2023 | Volume : 21 | Issue : 2 | Page : 123-125

Utilizing the community as a learning resource in the training of undergraduate medical students

Saurabh RamBihariLal Shrivastava¹, Prateek Saurabh Shrivastava²
¹ Deputy Director – Academics, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
² Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission	25-Nov-2022
Date of Decision	13-Dec-2022
Date of Acceptance	14-Dec-2022
Date of Web Publication	07-Apr-2023

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/cmi.cmi_125_22

Abstract

The kind and range of attributes that an undergraduate medical student should acquire by the time of completion of their training are extensive. The exposure of undergraduate medical students to the local community during the training period carries immense significance in the learning curve of the students. The exposure to community as a learning resource satisfies multiple principles of adult learning, as medical students can be actively engaged in the learning process, wherein they have to play a specific role and the learning happens across all the learning domains and does not remain restricted to the cognitive domain alone. In conclusion, the use of community as a learning resource for facilitating the training of medical students has been linked with multiple benefits. However, it is quite essential that potential challenges should be identified and accordingly preparation is done by the concerned departments to ensure the attainment of learning objectives and avoid rejection from the community.

Keywords: Community, Learning resource, Medical education

How to cite this article:
Shrivastava SR, Shrivastava PS. Utilizing the community as a learning resource in the training of undergraduate medical students. Curr Med Issues 2023;21:123-5

How to cite this URL:
Shrivastava SR, Shrivastava PS. Utilizing the community as a learning resource in the training of undergraduate medical students. Curr Med Issues [serial online] 2023 [cited 2023 Jun 4];21:123-5. Available from: https://www.cmijournal.org/text.asp?2023/21/2/123/373755

Introduction

The kind and range of attributes that an undergraduate medical student should acquire by the time of completion of their training are extensive. Moreover, the students should also become competent in those domains that are not structurally covered in the curriculum (viz. those things that are part of the hidden curriculum, such as values, compassion, empathy, and professionalism).^[1] The training of medical graduates in all these domains will essentially require a wide range of learning experiences and opportunities. In this regard, a range of learning resources (viz. digital or nondigital and human or nonhuman) can be employed to not only enhance the effectiveness of teaching–learning activities but even ensure the active engagement of students.^[1]

Community as a Learning Resource

Community refers to a group of people who are residing in a similar geographical location or have some specific attribute that is common to all the residents. The exposure of undergraduate medical students to the local community during the training period carries immense significance in the learning curve of the students.^[2] The students in their exposure get access to a wide range of health information at different levels (viz. individual, family, and community). Moreover, community settings offer unique opportunities for the students to learn and understand health problems in the community, which might be quite different to the kinds of cases that students see in the hospital settings, and thus learning becomes more comprehensive.^[3] Students also get exposed to the different stages of the life cycle, the social, economic, demographic, behavioral, and environmental factors that can affect the health status of the individual.

Such a wide range of exposure can make students aware about the sociocultural practices in the field practice area, identification of the prevailing morbidities, and other health-related conditions in the local region, and thereby play a crucial role in the development of a primary health-care physician. In other words, students not only learn about the clinical manifestations of a disease, but also understand the underlying predisposing or risk factors that are prevalent in a specific family or community, and thus tend to get a wider picture.^{[2],[3],[4],[5],[6]} Exposure to the community plays an instrumental role in the making of a primary health-care physician who is empowered and responsive to the needs of the local population.^[3] In fact, in the long run, the exposure of students to the community will be crucial in motivating them to opt for work in rural settings as a preference and not by compulsion, which is not frequently observed across the world as all doctors prefer to settle in urban areas.^[4]

Essential Considerations To Facilitate Learning In The Community

The learning in the community can happen either through inviting members of the community to the class (viz. use of the standardized patients) or by means of a schedule that has a provision wherein students are delivered to the community for a specific period of time within their curriculum.^[5],[6] Depending on the availability of resources and the local factors in the institution, either a single specialty can be involved in community-based learning or for more comprehensive learning, even two or more specialties can join their hands together and deliver inter-professional education to the students.^[7],[8] The ideal approach to implement community-based learning in any institution is through initiating the exposure of students to the community right from the beginning of their training period and continue the same throughout the period of internship.^[2],[4]

In fact, we must define the learning objectives in each phase of curriculum training and augment them gradually by keeping them relevant to the level of learners. Subsequently, students should be briefed about what they need to do when they are interacting with the community.^[2],[9] The entire learning process should be supervised by teachers depending on the level of learners while they are communicating with members of the community. The teachers must give feedback to students about their performance, and it will be really good if feedback can be obtained from other stakeholders as well (viz. multisource feedback – other students and community).^[9],[10]

Different Modes of Learning in the Community

The conventional teaching–learning methods are not very much effective in facilitating the learning process among medical students. In contrast, the exposure to community as a learning resource satisfies multiple principles of adult learning, as medical students can be actively engaged in the learning process, wherein they have to play a specific role and the learning happens across all the learning domains, and not remain restricted to cognitive domain alone.^[11] Further, students tend to become self-directed in the learning process and they also learn depending on the problem in the area, which is not only meaningful but also gives a platform for the students to apply their gained knowledge for the resolution of the problem.^[2]

Learning in community settings is student-centered, contextual, and collaborative in nature, as students learn along with their other colleagues and members of the community.^[12] As already mentioned above, it is a wonderful opportunity for students if they are exposed to the community right from their first professional year, as it supports early clinical exposure, which has multiple benefits and provides practical relevance to the students.^{[9],[10],[13]} Moreover, as students learn by doing, exposure to the community also promotes experiential learning, which is extremely beneficial for them in their professional careers. Further, students get an opportunity to reflect upon their experiences and actions and thus the learning becomes deep and long-term.^{[12],[13],[14]}

Potential Merits: Community as a Learning Resource

The utilization of the community as a learning resource is beneficial for both students and the community. From the students' perspective, learning occurs beyond the cognitive domain and also covers the social and emotional aspects. In addition, it augments the experience, confidence, and competence levels of students as a whole.^[15],[16] Further, it plays an important role in making students understand the health-care delivery system and also motivates them to opt for rural settings as their future practice area upon completion of their training.^[16],[17] Moreover, we cannot undermine the fact that the learning which occurs in community settings is experiential, authentic, competence/outcome-driven, problem-based, contextual, collaborative (team-based/peer learning/cooperative), self-directed, and reflection-driven. All these aspects are extremely crucial in the making of a competent medical graduate and the acquisition of core competencies.^[15],[18] From the community perspective, the members can become more aware about their health and social problems, understand the myths and misconceptions, and learn the way to stay healthy. In addition, people can also become aware about the national health programs and welfare schemes for the benefit of different sections of the community. In the long run, these attributes will play a defining role in the empowerment of the community.^{[16],[17],[18],[19]}

Potential Challenges: Community as a Learning Resource

The basic concerns of using the community as a learning resource are that it is generally restricted to community health alone and will not be much more effective in cases of emergency situations. Moreover, the challenges can be curriculum-related, such as defining the competencies, specifying learning objectives, selection of appropriate teaching–learning methods, and selection of appropriate assessment methods.^[2] Further, the challenges can be identified with reference to different stakeholders, such as teachers, students, the community, and administrators. From the teachers' perspective, parameters, such as the competence level of teachers to effectively utilize the community as a learning resource, ability to develop rapport with community leaders and members of the community, and employment of those teaching–learning strategies that can ensure active engagement of students, can be identified as important determinants.^[2],[17]

The student-related factors (viz. willingness to learn, awareness about learning objectives and expected outcomes, engagement levels) and community-related (like readiness of the members to contribute to student learning and some previous bad experiences with doctors or health-care sector) factors can prove to be the significant ones.^{[16],[17],[18]} Finally, we cannot ignore the administration-related factors, which can range from the provision of appropriate facilities (viz. facility to stay, food, and Internet) in the community settings, other infrastructure support, and ensuring availability of other learning resources can also define the overall effectiveness of community as a learning resource.^[20],[21] It is quite essential that all these factors should be given due consideration before we initiate the use of the community as a learning resource in the medical curriculum to ensure benefit to students and attainment of learning objectives.^[2],[21]

Conclusion

The use of the community as a learning resource for facilitating the training of medical students has been linked with multiple benefits. However, it is quite essential that potential challenges should be identified and accordingly preparation is done by the concerned departments to ensure the attainment of learning objectives and avoid rejection from the community.

Acknowledgment

This work has been done as a part of the Master in Medical and Health Professions Education offered by the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.

Special mention and regards for Dr. Ide Pustaka Setiawan, M.Sc, Sp.OG, Medical Education and Bioethics Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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