Ahmed S M Moslehuddin, Hasan Md Nayeemul, Kabir Russell, Arafat S M Yasir, Rahman Sayeeda, Haque Mainul, Majumder Md Anwarul Azim
Department of Community Medicine, Uttara Adhunik Medical College, Dhaka, Bangladesh
School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, United Kingdom
Rural Remote Health. 2019 Aug;19(3):4614. doi: 10.22605/RRH4614. Epub 2019 Aug 11.
Community orientation in medical education, which prepares medical students to become more effective practitioners, is now a global movement. Many medical schools around the world have adopted the concept as the main curricular framework in order to align learning programs with the needs of the community and the learner. Despite many changes over the past few decades, many improvements are still needed in medical education in Bangladesh. This study investigated medical students' perceptions of the community-based learning experiences incorporated into the Bachelor of Medicine, Bachelor of Surgery (MBBS) degree at Uttara Adhunik Medical College, Dhaka (UAMC), Bangladesh.
A total of 135 students from three undergraduate year levels of the MBBS degree at UAMC, Dhaka, Bangladesh, undertook study tours (community-based teaching, CBT) as a part of a community medicine course and visited a medical college, two rural health centres and a meteorology centre in the Cox's Bazar district, 400 km from Dhaka city. A questionnaire was used to assess the perceptions of students regarding the administration, organisation and learning experiences of the study tours. Students were required to write reports, present their findings and answer questions in their examinations related to the study tours and CBT.
The majority of the students agreed or strongly agreed that the tour was a worthwhile (93%) and enjoyable (95%) learning experience that helped them to understand rural health issues (91%). More than half of the students reported that the study tours increased their awareness about common rural health problems (54%) and provided a wider exposure to medicine (61%). Only 41% of students reported that the study tour increased their interest in undertake training in a rural area. A substantial number of students also expressed their concerns about the planning, length, resources, finance and organisation of the study tours.
Overall, the study tours had a positive effect, enhancing students' awareness and understanding of common rural health problems. As study tours failed to increase the motivation of the students (approximately 60%) to work in rural areas, CBT in the medical curriculum should be reviewed and implemented using effective and evidence-based models to promote interest among medical students to work in rural and underserved or unserved areas.
医学教育中的社区导向旨在让医学生成为更高效的从业者，如今已成为一项全球运动。世界各地的许多医学院校都采用这一理念作为主要课程框架，以使学习项目与社区及学习者的需求相契合。尽管在过去几十年间发生了诸多变化，但孟加拉国的医学教育仍有许多需要改进之处。本研究调查了孟加拉国达卡乌塔拉阿迪尼克医学院（UAMC）医学学士、外科学士（MBBS）学位课程中纳入的基于社区的学习经历在医学生中的认知情况。
孟加拉国达卡UAMC的MBBS学位三个本科年级的135名学生参加了考察旅行（基于社区的教学，CBT），作为社区医学课程的一部分，他们参观了距离达卡市400公里的科克斯巴扎尔区的一所医学院、两个农村健康中心和一个气象中心。通过问卷调查评估学生对考察旅行的管理、组织和学习经历的认知。学生需要撰写报告、展示研究结果并在与考察旅行和CBT相关的考试中回答问题。
大多数学生同意或强烈同意此次考察旅行是一次有价值（93%）且愉快（95%）的学习经历，有助于他们了解农村健康问题（91%）。超过半数的学生表示考察旅行提高了他们对常见农村健康问题的认识（54%），并拓宽了医学知识面（61%）。只有41%的学生称考察旅行增加了他们在农村地区接受培训的兴趣。大量学生还对考察旅行的规划、时长、资源、资金和组织表达了担忧。
总体而言，考察旅行产生了积极影响，增强了学生对常见农村健康问题的认识和理解。由于考察旅行未能提高约60%的学生在农村地区工作的积极性，医学课程中的CBT应进行审查，并采用有效且基于证据的模式来实施，以提高医学生在农村及服务不足或未服务地区工作的兴趣。
