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      Early community-based teaching of medical undergraduates for achieving better working skills in the community

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          Abstract

          INTRODUCTION:

          It has been perceived that there is a lack of community exposure and active learning in the community for the first-year undergraduates in Community Medicine. This study is designed to evaluate an early community exposure given to the students to help overcome these lacunae.

          METHODOLOGY:

          In this study, the first-year students ( n = 44) were provided an early community exposure and evaluated to understand their perceptions by a prevalidated, pre- and post exposure questionnaire. The community exposure was given to the students by allocating them families in community with designated tasks A core group of mentors monitored the students and scored the students on every visit. Attendance of students, scores marked by the mentors, and pre- and postexposure responses were used to evaluate the impact of community exposure.

          RESULTS:

          A total of 44 students were evaluated in this study. A total of 22 h (36.6%) were dedicated to community-based learning in the 1 st year. A positive response was observed in the postexposure responses with regard to the understanding of the subject and interest in the subject in comparison to preexposure responses ( P < 0.05). A statistically significant difference was observed in the first and final visit scores by the mentors with respect to communication skills, elicitation of history, team spirit, and attitude toward community ( P < 0.00001).

          CONCLUSIONS:

          Students were exposed to the concept of community service and inculcated an interest in public health. Early community exposure of medical undergraduate students is important in developing better working skills in the community.

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          Most cited references13

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          Using service-learning to teach community health: the Morehouse School of Medicine Community Health Course.

          Medical education is evolving to include more community-based training opportunities. Most frequently, third- and fourth-year medical students have access to these opportunities. However, introducing community-based learning to medical students earlier in their training may provide a more formative experience that guides their perspectives as they enter clinical clerkships. Few known courses of this type exist for first-year medical students. Since 1998, the Morehouse School of Medicine (MSM) has required first-year students to take a yearlong Community Health Course (CHC) that entails conducting a community health needs assessment and developing, implementing, and evaluating a community health promotion intervention. In teams, students conduct health needs assessments in the fall, and in the spring they develop interventions in response to the problems they identified through the needs assessments. At the end of each semester, students present their findings, outcomes, and policy recommendations at a session attended by other students, course faculty, and community stakeholders.The authors describe the course and offer data from the course's past 11 years. Data include the types of collaborating community sites, the community health issues addressed, and the interventions implemented and evaluated. The MSM CHC has provided students with an opportunity to obtain hands-on experience in collaborating with diverse communities to address community health. Students gain insight into how health promotion interventions and community partnerships can improve health disparities. The MSM CHC is a model that other medical schools across the country can use to train students.
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            Attitude of medical students towards Early Clinical Exposure in learning endocrine physiology

            Background Different teaching-learning methods have been used in teaching endocrine physiology for the medical students, so as to increase their interest and enhance their learning. This paper describes the pros and cons of the various approaches used to reinforce didactic instruction in endocrine physiology and goes on to describe the value of adding an Early Clinical Exposure program (ECE) to didactic instruction in endocrine physiology, as well as student reactions to it as an alternative approach. Discussion Various methods have been used to reinforce didactic instruction in endocrine physiology such as case-stimulated learning, problem-based learning, patient-centred learning and multiple-format sessions. We devised a teaching-learning intervention in endocrine physiology, which comprised of traditional didactic lectures, supplemented with an ECE program consisting of case based lectures and a hospital visit to see patients. A focus group discussion was conducted with the medical students and, based on the themes that emerged from it, a questionnaire was developed and administered to further enquire into the attitude of all the students towards ECE in learning endocrine physiology. The students in their feedback commented that ECE increased their interest for the subject and motivated them to read more. They also felt that ECE enhanced their understanding of endocrine physiology, enabled them to remember the subject better, contributed to their knowledge of the subject and also helped them to integrate their knowledge. Many students said that ECE increased their sensitivity toward patient problems and needs. They expressed a desire and a need for ECE to be continued in teaching endocrine physiology for future groups of students and also be extended for teaching other systems as well. The majority of the students (96.4%) in their feedback gave an overall rating of the program as good to excellent on a 5 point Likert scale. Summary The ECE program was introduced as an alternative approach to reinforce didactic instruction in endocrine physiology for the first year medical students. The study demonstrated that students clearly enjoyed the experience and perceived that it was valuable. This method could potentially be used for other basic science topics as well.
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              Skill Learning Through Early Clinical Exposure: An Experience of Indian Medical School.

              Indian Medical curriculum being discipline based, there is a line of demarcation between preclinical and clinical subjects. The challenges in medical education include the methods that would enhance the clinical education quality; one such method been Early Clinical Exposure (ECE). ECE can help to instill the skill component of medical education in the first year students helping to minimize the line of demarcation. Hence this study was undertaken to assess the skill learning of students through early clinical exposure and to collate the perception of them.
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                Author and article information

                Journal
                J Educ Health Promot
                J Educ Health Promot
                JEHP
                Journal of Education and Health Promotion
                Medknow Publications & Media Pvt Ltd (India )
                2277-9531
                2319-6440
                2018
                28 December 2018
                : 7
                : 161
                Affiliations
                [1] Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
                Author notes
                Address for correspondence: Dr. Star Pala, Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong - 793 018, Meghalaya, India. E-mail: starpala@ 123456gmail.com
                Article
                JEHP-7-161
                10.4103/jehp.jehp_153_18
                6332666
                30693298
                cac4b2b3-cd32-481c-ab2b-b2410ed48b15
                Copyright: © 2018 Journal of Education and Health Promotion

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 30 May 2018
                : 22 September 2018
                Categories
                Original Article

                community,skills,undergraduates
                community, skills, undergraduates

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