Heestand Skinner D E, Onoka C A, Ofoebgu E N
Office of Educational Development, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Educ Health (Abingdon). 2008 Jul;21(2):83. Epub 2008 Sep 5.
Community-based education (CBE) was developed thirty years ago in response to the maldistribution of physicians and subsequent inequity of health care services across geographical areas in developed and developing countries. Several medical schools in Nigeria report adopting CBE. This study seeks to identify and describe the CBE programs in accredited Nigerian medical schools and to report students' assessments of the knowledge and skills gained during their community-based educational experience.
Researchers developed a questionnaire that was distributed to student representatives at 19 of the 20 accredited medical schools. Student representatives distributed the questionnaire to 20 final year medical students and returned the completed questionnaires to the researchers. Quantitative data were entered into SPSS 14.
Most students from CBE schools participated in CBE experiences of 4 to 8 weeks duration during their fifth or sixth year and paid for their food and transportation costs. Medical school personnel supervised the students who were also often assisted by community personnel. Students' rated highest their learning about environmental-related health risks and how to identify community health problems. They rated lowest what they learned about how to train health workers and how to implement and analyze results of community health interventions.
CBE teaches future physicians how to function as health care providers in underserved communities. CBE curricula in Nigeria are addressing most, but not all, of the validated CBE generic objectives. Most notably, the curricula are not providing adequate education in the implementation and analysis of results of a community health intervention.
基于社区的教育（CBE）于三十年前发展起来，以应对发达国家和发展中国家医生分布不均以及随后医疗保健服务在地理区域间的不平等问题。尼日利亚的几所医学院报告称采用了CBE。本研究旨在识别和描述尼日利亚经认证的医学院校中的CBE项目，并报告学生对其在社区教育经历中所获得知识和技能的评估。
研究人员编制了一份问卷，分发给20所经认证医学院校中的19所院校的学生代表。学生代表将问卷分发给20名医学专业最后一年的学生，并将填好的问卷返还给研究人员。定量数据录入SPSS 14。
来自CBE学校的大多数学生在其第五年或第六年期间参加了为期4至8周的CBE经历，并自行承担食品和交通费用。医学院校人员对学生进行监督，学生也经常得到社区人员的协助。学生对他们所学到的与环境相关的健康风险以及如何识别社区健康问题评价最高。他们对所学到的如何培训卫生工作者以及如何实施和分析社区健康干预结果评价最低。
CBE教会未来的医生如何在服务不足的社区中作为医疗保健提供者发挥作用。尼日利亚的CBE课程正在解决大部分但并非所有经过验证的CBE通用目标。最值得注意的是，这些课程在社区健康干预结果的实施和分析方面没有提供足够的教育。
