Plessas Anastasios, Paisi Martha, Ahmed Nilufar, Brookes Zoe, Burns Lorna, Witton Robert
Peninsula Dental School, Faculty of Health, University of Plymouth, Plymouth, UK.
Bristol Dental School, University of Bristol, Bristol, UK.
BMC Med Educ. 2024 Dec 18;24(1):1490. doi: 10.1186/s12909-024-06367-1.
Many non-communicable diseases are rooted in social factors that determine health outcomes. Complex topics such as the social determinants of health are difficult to teach through traditional didactic methods. Since the introduction of the social accountability of medical schools' framework in 1995 by the World Health Organisation, healthcare education institutions are encouraged to shift their traditional education models towards a socially accountable approach. Community engagement can facilitate a deeper understanding of health inequity, barriers to health care, and the social determinants of health whilst enabling institutions to meet their obligation to the communities they serve. This systematic review aimed to answer the following question: ''What is the impact of community engaged healthcare education on undergraduate healthcare students' empathy and their views towards social accountability?''.
This is a mixed-methods systematic review. The protocol was registered with PROSPERO (CRD42022306181). The following databases were searched: Scopus, MEDLINE, Embase, CINAHL, ERIC, BEI for primary research studies published from 1995 to September 2024. Grey literature was also searched via EThOS and Google. Studies recruiting undergraduate students of regulated healthcare professions in countries of very high development were included. A convergent integrated approach to synthesis was followed.
Out of the 19,590 papers yielded from the literature search, 76 met the inclusion criteria and were included in the review. The following subthemes were generated under three overarching themes: Social accountability (advocacy for action; giving back to the community; bigger picture-identifying social determinants of health and barriers to healthcare; barriers to social accountability), Empathy (humanise community members-everybody has a story; overcome bias and challenge attitudes, assumptions and stereotypes; cultural competence and sensitivity; empathetic communication and interpersonal skills; feeling sympathy and sadness), and Shaping the future workforce (future professional demeanour; professional interests; interprofessional education and collaboration).
Community engaged education can help students better understand community needs, social determinants of health, improve empathy and cultural sensitivity, and build advocacy for social justice and change.
许多非传染性疾病都源于决定健康结果的社会因素。诸如健康的社会决定因素等复杂主题很难通过传统的讲授方法进行教学。自1995年世界卫生组织引入医学院校社会问责框架以来，鼓励医疗教育机构将其传统教育模式转向社会问责制方法。社区参与有助于更深入地理解健康不平等、医疗保健障碍以及健康的社会决定因素，同时使机构能够履行其对所服务社区的义务。本系统评价旨在回答以下问题：“社区参与式医疗教育对本科医学生的同理心及其对社会问责的看法有何影响？”。
这是一项混合方法的系统评价。该方案已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42022306181）注册。检索了以下数据库：Scopus、MEDLINE、Embase、护理学与健康领域数据库（CINAHL）、教育资源信息中心（ERIC）、英国教育索引（BEI），以查找1995年至2024年9月发表的原发性研究。还通过英国国家论文数据库（EThOS）和谷歌搜索了灰色文献。纳入在高度发达国家招募受监管医疗专业本科生的研究。采用了一种收敛性综合方法进行综合分析。
在文献检索得到的19590篇论文中，76篇符合纳入标准并被纳入本评价。在三个总体主题下产生了以下子主题：社会问责（倡导行动；回馈社区；从宏观角度识别健康的社会决定因素和医疗保健障碍；社会问责的障碍）、同理心（使社区成员人性化——每个人都有故事；克服偏见并挑战态度、假设和刻板印象；文化能力和敏感性；同理心沟通和人际交往技巧；感到同情和悲伤）以及塑造未来劳动力（未来的职业行为；职业兴趣；跨专业教育与合作）。
社区参与式教育可以帮助学生更好地理解社区需求、健康的社会决定因素，提高同理心和文化敏感性，并培养对社会正义和变革的倡导能力。
