Document Type : Review
Authors
1 MD, Department of Community Based Education of Health Sciences, School of Medical Education and Learning Technologies, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Medical Education, School of Medical Education and Learning Technologies, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
Background: Community-related medical education has been defined under various terms, such as community-oriented medical education, community-based medical education, social accountability education, and community-engaged medical education. These terms have similar definitions and can be used interchangeably. The graduation of physicians who are familiar with the problems of the community is considered a necessity in modern medical education. As a result, numerous activities have been carried out worldwide, each given a different name.
Objectives: This study intended to provide a more comprehensive classification of community-related medical education by examining the maximum number of educational programs and activities worldwide. The classification helps create a scientific and systematic view of this category and serves as a guide in planning and implementing such education.
Methods: The present study is conducted using Carnwell and Daly's critical review method. The review was performed in different stages, including defining the review scope, identifying sources, reviewing, and constructing the texts. By reviewing documents and examining their similarities and differences, previous classifications are complete and updated.
Results: Community-related medical schools are divided into socially responsible, socially responsive, and socially accountable schools, with medical curricula that are community-oriented, community-based, and community-engaged, respectively. All schools are subdivided into education, research, and service-oriented programs.
Conclusion: Community-related educational programs can be designed and implemented at different levels according to the context.
Keywords
Background
At the World Conference on Medical Education in 1988, 12 strategies were adopted for applying fundamental changes in the medical curriculum. One strategy was related to the development of areas where education takes place, including all community resources other than hospitals (1). Additionally, the World Health Organization (WHO) has recommended a social accountability approach for medical universities to align their curricula according to the population’s needs and illness prevention principles. This recommendation is especially crucial for colleges in disadvantaged areas suffering from health inequality (2, 3).
Literature affirms that more than 90% of healthcare services are provided in a community. However, the curriculum remains unchanged, with a significant focus on clinical expertise (4, 5). At the same time, community-related medical education can increase students' knowledge and attitudes toward practical medicine in rural areas (6).
In several medical schools, public health education is conducted by epidemiologists, researchers, and academics. However, if general practitioners with practical experience in the field could perform this training, community health would find its way toward improvement alongside individual health and wellbeing (7). In fact, one important strategy to tackle health inequality is to promote active community academic involvement and develop this as the fourth mission of universities, in addition to education, research, and service delivery (8, 9). In the 1960s and 1970s, medical education was described as community-oriented medical education, and its development to community-based medical education began in 1980. Community-engaged medical education was the third wave that emerged in the first decade of the 20th century with an emphasis on the concept of mutual dependence and cooperation between the university and the community. This educational model is consistent with the socially accountable model proposed by the WHO (10).
In Iran, medical education has undergone a turbulent path in responding to the real needs of society. The reason may be obstacles such as lack of active engagement among clinical groups, insufficient budget, lack of suitable physical resources and required facilities, or even legal issues. Achieving success in social accountability depends mainly on the precise priority setting and the rational allocation of available resources. Therefore, it is necessary to pay closer attention to medical education and its objectives in a wide-ranging and profound manner (11). The results of a study conducted at Kerman University of Medical Sciences revealed that socially accountable education was assessed to be in a weakness-threat position (12). Although Iranian universities focus on community-based medical education, there is still a long way to go before reaching a satisfactory and desirable condition. Considering the existing gap, placing physicians at the core of society can have a significant impact on the compliance of these critical healthcare service providers with the actual needs of society (13).
In the last century, community-related medical education has been defined under various terms that have similar definitions and can be used interchangeably. In 2000, a complete classification of community-based medical education was created (14). With the creation of broader and more complex concepts of community-related medical education, some of these terms were excluded from the classification. In 2008, Roger Strauss classified three categories, including community-oriented medical education, community-based medical education, and community-engaged medical education, in a hierarchical manner (15). The latest classification dates back to 2015 when community-related medical education was divided into four categories. Community service medical education is the fourth category added to the previous classification. However, it seems that an even better classification can be provided, enabling us to implement these concepts and respond to the population’s needs more effectively (16).
Objectives
This study aimed to present a more comprehensive classification of community-related medical education by reviewing existing educational programs related to community needs worldwide, with the objective of determining their relevance to different social spectrums.
Methods
Despite the growing attention given to community-related medical education in recent years, there still exists a significant knowledge gap that cannot be filled by simply answering a question or presenting a simple description of the existing problem. Thus, in the present study, we chose and applied the critical review methodology offered by Grant and Booth (17). The review was carried out using Carnwell and Daly's critical review method, published in 2001. The review was performed in different stages, including determining the scope of the review, identifying sources, reviewing and criticizing documents, and applying the literature to the proposed study (18).
Defining the Scope of the Review: This review includes theoretical and experimental studies on any type of community-related medical education. Our focus is on the classification and differentiation of concepts related to community-related medical education, such as community-oriented, community-based, and community-engaged medical education and social accountability education.
Identifying and Selecting Sources of Relevant Information: The Pubmed, Google Scholar, Web of Science, SID, ERIC, and Scopus databases were searched using keywords, including community-oriented education, community-based education, community-engaged education, social responsibility, service learning, medical, and taxonomy. The search initially yielded 3010 documents. Table 1 shows the search strategies.
It should be noted that university websites and books were also included in the review. The search was carried out between the years 2000 and 2022, and the searched languages were both English and Persian. Figure 1 shows the study identification process.
Results
After a comprehensive review of all documents
in the study, they were divided into three categories
as follows:
- Defining and classifying any type of community-related medical education
- Providing a social responsibility scale for universities and their relation to community-related medical education programs
- Distinguishing features in educational programs in the community
- Defining and Classifying any Type of Community-related Medical Education
Different classifications of community-based medical education were identified. Three articles presented a relatively complete classification each, while a large number of other articles used these classifications repeatedly. The first document classified community-based medical education into three subcategories: education, research, and service (14). Subsequently, three classifications were determined, including community-oriented medical education, community-based medical education, and community-engaged medical education (15). The latest classification, developed in 2015, divides community-related medical education into four categories: community-oriented medical education, community-based medical education, community-engaged medical education, and community service medical education. During this review, it was revealed that some of the consequences of the community's relationship with universities were not included in the previous classifications. As a result, the reviewers created a fourth classification, which indicated a direct relationship with the community, creating an immediate benefit for community partners (16). Our criticism of this classification is that the fourth classification only deals with service provision in the community. Thus, it can be placed under the service delivery subtype of any community-related medical education. The time to achieve the beneficial effects of service provision and the level of community involvement can be used as criteria for differentiation of the fourth classification. Therefore, there is no need to separate it as a fourth class. We have extended the sub-classes of Magzoub to other classes of curricula related to the community.
- Providing a social responsibility scale for universities and their relation to community-related medical education programs
In our classification, every type of community-related education was adjusted based on social obligation scales. Bolen first proposed this link. In 2016, Bolen considered the response to the population’s social needs in the form of three spectrums called the social obligation scale. At one end of the spectrum is social responsibility, which attempts to identify the needs, issues, and problems of society. Regarding social responsiveness, it is crucial to recognize the population’s needs and problems and determine how to plan effectively for the implementation phase at the community level. At the other end of the spectrum is social accountability, which emphasizes the effectiveness of implemented programs in properly solving shortcomings, in addition to identifying the needs and problems of society and planning for improvement. Therefore, the educational program of each medical school should be aligned with its social obligation scale (19). After reviewing the literature and expanding the model of medical education with an emphasis on community participation, our view was that community-engaged medical education is synonymous with contextualized medical education, as introduced by Bolen. According to the WHO, social accountability is also linked to community-engaged education (2). Until then, and even afterward, these concepts were not properly used because these social obligations and their coordination with the curriculum were not known clearly, as confirmed by six other articles. The review and criticism of these six articles yielded this result (2, 19-23).
- Distinguishing features in educational programs in the community
All relevant community-related medical education definitions were extracted and entered into a table. Then, any relevant examples relating to medical universities and schools worldwide, including different curricula, were added to create a complete, informative table. Next, similarities and differences found in the review process were added as a definite column in the table. After all examples were provided and placed in front of each definition, a re-checked process with a back-and-forth approach was conducted until reaching a comprehensive classification of community-related medical education. Table 2 shows the summary of all included documents.
It should be noted that, for bias control, the searching process and document review were conducted independently by two researchers with expertise and knowledge in community-related medical education.
Each community-related medical education was considered a separate educational program, and the differences between their components were determined by reviewing the documents. An effort was made to avoid duplicate characteristics between the different types. Distinguishing features and final classifications are shown in Table 3 and Figure 2. Subcategories of each education program are shown in Figures 3-5.
Applying the Literature to the Proposed Classification
Once the classification was finalized, numerous examples found in the literature review were included to test it, as shown in Table 4. This new classification can include almost every community educational activity.
Discussion
After conducting a critical review of the classifications of community-related medical education, previous classifications were expanded, and some amendments were made. This study differentiated between various classifications by creating definite criteria. Although the developed indicators for the first level seemed cleaner in differentiating various types of community-related medical education, distinctions between different subcategories of education, research, and service provision were less clear-cut.
For instance, a university may take an active part in participatory community-based research and act as community-engaged medical education; however, in service provision, it might be regarded as community-based medical education. Reviewing the literature on community-related medical education worldwide, we distinguished the differences between various types of education. In general, the distinguishing feature of community-engaged medical education is the active participation of community members in all stages of the educational program, including defining needs, goals, and teaching strategies, conducting the students’ evaluation process, and even admitting students. Another differentiating factor is the duration of training that takes place outside the hospital, which, in this study, was suggested to be more than 50%. For example, community participation does not occur in community-oriented education. In such an educational approach, some training sessions might be held in hospitals to convey some information about the social and behavioral factors of a community, or research priorities might be determined by considering the population’s health needs. However, in practice, no intervention is put into action. These activities are usually carried out in the first year of the general practice curriculum by teaching socio-economic determinants of health in theory, and they are not highlighted as clinical aspects of the training course. In some cases, interventions might take the form of providing basic public health services and giving priority to prevention and health promotional strategies. In community service medical education, as a separate classification of Ellaway, although there are some types of active community participation, they do not last long after the end of the program, and the community is not involved in all educational activities of the university. Additionally, the duration of training outside the hospital is less than 50%. On the other hand, in universities with social accountability and a community-engaged medical education curriculum, such as Flinders in Australia, some students voluntarily choose parallel rural educational programs for one year. This means that one university has two spectrums of community-related medical education simultaneously (24), which can be considered in Iran’s medical universities. Therefore, since social accountability and responsibility are two sides of a particular spectrum, the three mentioned types of community-related medical education are placed into the same continuum. Ideally, it is helpful to entirely separate all classifications of community-related medical education. However, this does not usually occur in practice, as it is a time-consuming process and brings many challenges. An example of this is Kendra University of Bangladesh, where the program could not continue to progress toward its social goals as before (2).
Furthermore, many universities in different countries, such as Japan, China, and Germany, which were previously categorized as community-based medical education, are now included in our classification as community-oriented education.
Despite the varying degrees of social responsibility in different universities, they all acknowledge that such educational programs have been effective in changing medical students’ attitudes toward prevention and health promotion, elimination of health inequality, and provision of specialized health personnel in rural and remote areas (16, 24).
Higher education in the community leads to the improvement of health indicators and the return of physicians to deprived areas (86). One practical recommendation for tackling injustice and health inequality, particularly in less privileged communities, is to establish universities with social accountability that promote educational programs with an emphasis on community engagement.
Limitations: Various structural, cultural, and social perspectives in different countries and even in different schools of the same country can cause problems in providing a comprehensive classification. Moreover, we examined the situation of universities based on written documents, which may not accurately reflect reality.
Conclusion
By providing such classifications, confusion resulting from multiple definitions can be claimed to have been largely reduced. This classification helps design and implement community-related educational programs at different levels according to the context.
Table 1. Search Strategies Based on Each Database
|
Database |
Syntax |
|
PubMed |
"Community-oriented*"[Title/Abstract] OR "community-based *"[Title/Abstract] OR "community-based*"[Title/Abstract] OR "community-oriented"[Title/Abstract] OR "community-engaged education"[Title/Abstract] OR "service learning"[Title/Abstract] AND "social responsibility"[Title/Abstract] |
|
Scopus |
TITLE-ABS ("Community-oriented" OR " community-based” OR "community-based" OR " community-oriented" OR "community-engaged education" OR "service learning" AND "social responsibility" AND "medical" AND "taxonomy" (LIMIT-TO (PUBYEAR, 2000- 2022) AND (LIMIT-TO (DOCTYPE, "ar”) OR LIMIT-TO (DOCTYPE, “re”)) AND (LIMIT-TO (LANGUAGE, “English”)) |
|
WOS |
(TI= ("community-oriented" OR "community-based" OR "community-based*" OR "community-oriented" OR "community-engaged education" OR "service learning" AND "social responsibility" AND "medical" AND "taxonomy") Document Types: Articles or Proceedings Papers or Review Articles or Data Papers. Languages: English. Timespan: 2000-01-01 to 2022-12-30 (Publication Date) |
|
Google Scholar |
"Community-oriented" OR "community-based" OR "community-based" OR "community-oriented" OR " community-engaged education" OR "service learning" AND "social responsibility" AND "medical " AND "taxonomy” in Title Abstract Keyword - (Word variations have been searched) |
Table 2. Summary of Reviewed Articles
|
No. |
First author |
Year |
Publication |
Country |
Objectives |
Study design |
|
1 |
Magzoub, M. E. (14) |
2000 |
Journal article |
USA |
Taxonomy of community-based medical education |
Reports in the literature |
|
2 |
Paul Worley (24) |
2000 |
Journal article |
Australia |
Aims of the program Parallel Rural Community Curriculum; student selection; practice recruitment; curriculum structure, and academic content, together with lessons learned from the evaluation |
Qualitative study |
|
3 |
Boyle, F. M. (25) |
2002 |
Journal article |
Australia |
Describing a community-based learning program for medical |
Case study |
|
4 |
Nor Mohd Adnan Azila (26) |
2006 |
Journal article |
Malaysia |
Curricular approaches implemented in Malaysian medical schools |
Descriptive |
|
5 |
LUBNA, A. Baig (27) |
2006 |
Journal article |
Pakistan |
Development of the Community-oriented Medical Education Curriculum of Pakistan |
Case report |
|
6 |
AbdelRahman, |
2007 |
Journal article |
Sudan |
Assessing the effects of implementing the basic development |
Quantitative study |
|
7 |
Seifer, S. D. (29) |
2007 |
Book chapter |
USA, Dartmouth Medical School |
Concepts and models for service-learning in medical education |
Non stated |
|
8 |
Daniel Blumenthal (30) |
2007 |
Book chapter |
USA, Morehouse School of Medicine |
Describing the philosophy, development, implementation, |
Non stated |
|
9 |
Franklin R. (31) |
2007 |
Book chapter |
USA, Ohio State University |
A description of two programs at the Ohio State University |
Non stated |
|
10 |
Judy Lewis (32) |
2007 |
Book chapter |
USA, University of Connecticut |
An urban partnership: An analysis of the experience and lessons that may be generalized to programs in other communities |
Non stated |
|
11 |
Bruce Bennard (33) |
2007 |
Book chapter |
USA, Quillen College of Medicine, East Tennessee State University |
Introduced a fifth consecutive cohort of first-year medical students to a three-year multi-professional curriculum emphasizing health professions education within a community-oriented service environment |
Non stated |
|
12 |
Joellen B. (34) |
2007 |
Book chapter |
USA, East Tennessee State University |
Describing the results of an effort by the faculty from the colleges of Medicine, Nursing, and Public Health, together with the WK. Kellogg Foundation's Community Partnership Initiative at East Tennessee State University to create synergy rather than antagonism among these usually conflicting demands on faculty time |
Non stated |
|
13 |
Thomas P. (35) |
2007 |
Book chapter |
USA, University of Pittsburgh |
Community partnership in service to the homeless |
Non stated |
|
14 |
Sharon Dobie (36) |
2007 |
Book chapter |
USA, Washington |
Developing programs that address an identifiable unmet need in a local underserved community |
Non stated |
|
15 |
Dongre, |
2008 |
Journal article |
India |
Students' perception of community medicine teaching |
Qualitative study |
|
16 |
Heestand Skinner, D. (38) |
2008 |
Journal article |
Nigeria |
Identifying and describing the CBE programs in accredited Nigerian medical schools and reporting students' assessments of the knowledge and skills gained during their community-based educational experience |
Quantitative study |
|
17 |
Marahatta, |
2009 |
Journal article |
Nepal |
Reviewing the existing community-based medical education in health institutions in Nepal |
Comparative study |
|
18 |
Jay S. Erickson (40) |
2011 |
Journal article |
USA, Washington |
Historical development of the rural medical programs at the University of Washington School of Medicine (UWSOM) and the design of a new rural LICC experience in the existing rural longitudinal medical school curriculum |
Case report |
|
19 |
Stewart, R. (41) |
2011 |
Journal article |
USA, Johns Hopkins |
Examining the rationale, development, and challenges during the implementation of longitudinal ambulatory clerkship |
Case report |
|
20 |
Hunt J. B. (42) |
2011 |
Journal article |
USA |
Understanding the educational goals of projects described as "service learning" or "community-based medical education" and learning the relationships between medical schools and community members |
Systematic review |
|
21 |
Ní Chróinín D. (43) |
2012 |
Journal article |
Dublin |
Developing, implementing, and evaluating a module with a broad community focus based on primary and secondary care |
Quantitative study |
|
22 |
Chastonay, |
2012 |
Journal article |
Switzerland |
Describing the conception, elaboration, and implementation |
Educational program evaluation |
|
23 |
Faris, A. (15) |
2013 |
Journal article |
Malaysia |
Appreciating the structure and functions of a family as an essential Appreciating the family dynamics in facing life events |
University-Family Partnership in Community Wellness Program )PuPUK model) evaluation |
|
24 |
Larkins SL (45) |
2013 |
Journal article |
Australia |
Developing and pilot testing a comprehensive evaluation framework to assess progress toward socially accountable health professions education |
Mixed method |
|
25 |
Chowdhury Z. (46) |
2014 |
Book chapter |
Bangladesh |
Selecting case studies or ‘stories’ from selected schools; |
Case study |
|
26 |
Bollela VR. (47) |
2014 |
Book chapter |
Brazil |
Selecting case studies or ‘stories’ from selected schools; Defining community-based education |
Case study |
|
27 |
El-Metwally D (48) |
2014 |
Book chapter |
Egypt |
Selecting case studies or ‘stories’ from selected schools; |
Case study |
|
28 |
Sketch B. (49) |
2014 |
book chapter |
India |
Selecting case studies or ‘stories’ from selected schools; |
Case study |
|
29 |
Villiers M. (50) |
2014 |
book chapter |
South Africa |
Selecting case studies or ‘stories’ from selected schools; |
Case study |
|
30 |
Kikukawa, Makoto (51) |
2014 |
Journal article |
Japan |
Investigating the outcomes of a community-based education program |
Mixed method |
|
31 |
Lee SWW (52) |
2014 |
Journal article |
UK, England |
Evaluating the current provision and outcome of community-based education (CBE) in UK medical schools |
Systematic review |
|
32 |
Angélica Maria (53) |
2015 |
Book chapter |
Brasilia |
Integrating primary healthcare with teaching-service-axis in the |
Case study |
|
33 |
Renata Maria Zanardo (54) |
2015 |
Book chapter |
Brasilia |
The Medical and Nursing Undergraduate Education in Primary Healthcare: 45 Years of Experience at Botucatu Medical School |
Case study |
|
34 |
Maria Katia Gomes (55) |
2015 |
book chapter |
Brasilia |
The Experience of the Faculty of Medicine at the Federal |
Case study |
|
35 |
Maria Neile Torres de (56) |
2015 |
book chapter |
Brasilia |
The Experience at the Federal University of Ceará Medical School |
Case study |
|
36 |
Oscarina da Silva Damásio (57) |
2015 |
book chapter |
Brasilia |
Blended Learning and Concept Map During a Primary Care Medicine Clerkship at the Medical School of Federal University of Juiz de Fora |
Case study |
|
37 |
Alessandra Vitorino (58) |
2015 |
book chapter |
Brasilia |
Community-based Education: The Experience of the |
case study |
|
38 |
Marlene Rodrigues (59) |
2015 |
book chapter |
Brasilia |
Community-based Education in the Medical School at the Maringá |
Case study |
|
39 |
Rosuita |
2015 |
book chapter |
Brasilia |
Health and Medical Education as Social Commitments at the |
Case study |
|
40 |
Daniela |
2015 |
book chapter |
Brasilia |
The Community-based Education at the University of Fortaleza |
Case study |
|
41 |
Ana Claudia Camargo (62) |
2015 |
book chapter |
Brasilia |
Service-learning-community integration in the Teaching of Primary Healthcare: Lessons and Challenges of the USP School of Medicine |
Case study |
|
42 |
Strasser R. (10) |
2015 |
Journal article |
Canada |
Examples of the Implementation and Implications of Community-engaged Medical Education at Three Medical Schools |
Case report |
|
43 |
Holst, J. (63) |
2015 |
Journal article |
Germany |
Ensuring Rural Medical Care, Including Innovative Teaching Approaches During Undergraduate Training |
Educational program (qualitative designed) |
|
44 |
Bannon A. (64) |
2015 |
Journal article |
UK |
Describing and Evaluating the Initiative, the Personal Development Certificate (PDC): A 12–Week Community Development Program |
Quantitative and |
|
45 |
Hosny, S. (23) |
2015 |
Journal article |
Egypt |
Assessing the compliance of the Faculty of Medicine, Suez Canal University, to social accountability using the ‘‘Conceptualization, Production, Usability’’ (CPU) model |
Qualitative design |
|
46 |
Ellaway, R. (16) |
2016 |
Journal article |
Canada |
Exploring and synthesizing the evidence on medical |
Systematic review |
|
47 |
Charles Boelen (19) |
2016 |
Journal article |
WHO, Geneva, Switzerland |
Recognizing excellence in medical education and social |
Non stated |
|
48 |
Amalba A. (65) |
2016 |
Journal article |
Ghana |
Investigating students’ perceived usefulness of COBES and its potential effect on their choice of career specialty and willingness to work in rural areas |
Mixed-methods design |
|
49 |
Arscott-Mills, |
2016 |
Journal article |
Botswana |
Investigating the impact of rural training on students’ attitudes |
Mixed-methods design |
|
50 |
Kapanda, |
2016 |
Journal article |
Tanzania |
Assessing students’ perceptions and attitudes toward rural |
Quantitative study |
|
51 |
Pokharel, |
2016 |
Journal article |
Nepal |
Describe the teaching district concept and its implementation |
Narrative review |
|
52 |
Strasser, R. (69) |
2016 |
Journal article |
Canada |
Examples from Canadian and Australian education programs that provide the majority of clinical education in remote and rural settings |
Case report |
|
53 |
Siega-Sur J. L. (20) |
2017 |
Journal article |
Philippines |
Describing the impact of socially accountable health professional education on graduates |
Quantitative study |
|
54 |
Cole, C. (70) |
2018 |
Journal article |
Cuba |
Cuban Medical Education: 1959 to 2017 |
Review article |
|
55 |
Woolley, T. (21) |
2018 |
Journal article |
Philippine |
Describing differences between the practice locations of Philippines medical graduates from two 'socially accountable, community-engaged' health professional education programs |
Quantitative study |
|
56 |
Elyasa Elamin S. A. (71) |
2018 |
Journal article |
Gezira |
Evaluating competencies and their interventions toward the |
Quantitative study |
|
57 |
Yoo J. E. (72) |
2018 |
Journal article |
Korea |
Proposing learning objectives and an educational program |
Consensus workshop for curriculum development |
|
58 |
Ohta, R. & Ryu Y. J. (73) |
2019 |
Journal article |
Japan |
Examining students' perceptions of general medicine following community-based medical education in rural Japan |
Mixed methods design |
|
59 |
Ahmed, S. (74) |
2019 |
Journal article |
Bangladesh |
Investigating medical students’ perceptions of community-based learning experiences |
Quantitative study |
|
60 |
Choulagai |
2019 |
Journal article |
Nepal |
Assessing the organization and implementing community-based education in the Institute of Medicine |
Qualitative design |
|
61 |
Adefuye, A. (76) |
2019 |
Journal article |
South Africa |
Investigating student's perceptions of their experience during community-based medical education training at Botshabelo District Hospital |
Qualitative design |
|
62 |
Lindsey Pope, (4) |
2020 |
Journal article |
UK |
Evaluating sociocultural factors impeding the expansion of undergraduate medical education in general practice |
Non stated |
|
63 |
Massé, J. (9) |
2020 |
Journal article |
Canada |
Identifying and understanding what medical trainees gain from |
Qualitative study |
|
64 |
Yahata, S. (77) |
2020 |
Journal article |
Japan |
Investigating the long-term impact of community-based clinical training (CBCT) in Japan on current community healthcare (CH) practice |
Quantitative study |
|
65 |
Houbby N. (78) |
2020 |
Journal article |
UK |
Reflecting on students’ experiences after taking part in the community action product during their third year at medical schools |
Case study |
|
66 |
Marjadi B. (79) |
2020 |
Journal article |
Australia |
Describing the Western Sydney University School of Medicine (WSUSoM) diversity education program, medicine in context |
Descriptive report (Curriculum design) |
|
67 |
Amalba, A. (80) |
2020 |
Journal article |
Africa |
The Role of Community-Based Education and Service (COBES) |
Systematic review |
|
68 |
Ohta, R. (6) |
2021 |
Journal article |
Japan |
Synthesizing the impact of the involvement of communities on the learning of medical trainees in community-based medical education |
Systematic review |
|
69 |
Alberti, P. (8) |
2021 |
Journal article |
USA |
Why Academic Medicine Must Embrace Community |
Non stated |
|
70 |
Mann-Jackson, |
2021 |
Journal article |
USA |
Addressing STI/HIV disparities and social determinants of health among young and transgender women of color in North Carolina, USA |
Community-based participatory research |
|
71 |
Guignona, |
2021 |
Journal article |
Philippines |
Describing the qualitative evidence of ADZU-SOM students |
Case study |
|
72 |
Deepa Shah (7) |
2022 |
Journal article |
UK |
Evaluating the Community Diagnosis Project |
Quantitative and qualitative |
|
73 |
O'Brien |
2022 |
Journal article |
USA |
Identifying and evaluating system-level outcomes of pre-clerkship medical students’ engagement in health system improvement efforts |
Case study |
|
74 |
Northern Ontario School of Medicine (83) |
|
Medical school cite |
Canada |
Reviewing the medical education curriculum |
Non stated |
|
75 |
Taibah University, College of Medicine (84) |
- |
Medical school cite |
Saudi Arabia |
The MBBS Program Student Guide (Reviewing the |
Non stated |
|
76 |
Medical University of Khartoum (85) |
- |
Medical school cite |
Sudan |
Khartum Community Medicine Department Curriculum |
Non stated |
Table 3. Distinctive Types of Community-related Medical Education
|
Community-related medical education |
Presence percentage in the field of primary healthcare centers |
Mission/Objective |
Student’s admission |
Educational strategy |
Student’s assessment |
Community involvement |
|
Community-oriented medical education |
Lower than 20% |
Social responsibility |
- |
A combination of different methods/ strategies |
No involvement of community members |
No involvement of community (community sensitization) |
|
Community-based |
20% to 50% |
Social responsiveness |
A percentage of students from indigenous members |
A combination of different methods/ strategies |
Limited activity of community members |
Inactive and limited involvement |
|
Community-engaged medical education |
More than 50% |
Social accountability |
Direct role of community in the selection of indigenous members |
Student-oriented, such as problem-solving, longitudinal, and spiral |
Active role of community members |
Active and wide-ranging involvement |
Table 4. Examples of Community-related Medical Education
|
Community-oriented medical education |
|||||
|
Education focused |
Research-oriented |
Service-oriented |
|||
|
Community visit |
Education in the field of hospital or primary healthcare centers |
Research in the field of hospitals or primary healthcare centers |
Limited health education interventions in hospitals |
||
|
Taibah University in Saudi Arabia (early contact) (84) |
Unnan and Shimane, University in Japan (6) |
- |
Kowbe University in Japan (77) |
||
|
Malaya University in Malaysia (before 2005) (26) |
- |
- |
- |
||
|
Kabangsang University in Malaysia (26) |
- |
- |
- |
||
|
Rural health in Magdeburg (Germany) (63) |
Rural Health in Magdeburg (Germany) (63) |
- |
- |
||
|
University of Botswana, South Africa (66) |
Kilimanjaro Christian Medical University College (67) |
- |
- |
||
|
Uttara Adhunik Medical College, |
Uttara Adhunik Medical College, |
- |
Uttara Adhunik Medical College, |
||
|
- |
- |
- |
Imperial College of London (78) |
||
|
Pakistan universities (27) |
Queen Mary University of London (64) |
- |
- |
||
|
Iran University of Medical Education |
Iran University of Medical Education |
Iran University of Medical Education |
Iran University of Medical Education |
||
|
Community-based medical education |
|||||
|
Education focused |
Service-oriented |
Education focused |
|||
|
Community contact |
Education in rural hospitals or primary healthcare centers |
Research in primary |
Research in the community |
Informing or advising the community |
Cross-sectional health interventions |
|
Mahatma Gandhi University of India (37) |
|
- |
Indian Christian College (49) |
Gonoshasthaya Kendra in Bnghladesh (46) |
- |
|
Washington University (40) |
|
- |
Gonoshasthaya Kendra in Bnghladesh (46) |
|
- |
|
Koirala Institute of Health Sciences (43), Tribhuvan University of Nepal, Nepal (75) |
Koirala Institute of Health Sciences (43), Tribhuvan University of Nepal, Nepal (75) |
- |
Koirala Institute of Health Sciences (43), Tribhuvan University of Nepal, Nepal (75) |
Koirala Institute of Health Sciences (43), Tribhuvan University |
- |
|
|
Stellenbach University of South Africa (50) |
- |
|
Stellenbosch University, South Africa (50) |
Kathmandu University, Nepal (39, 68) |
|
Malaya University in Malaysia (after 2005) (26) |
|
|
Malaya University in Malaysia (26) |
Malaya University |
- |
|
University of Sao Paulo, Brazil (47, 54) |
University of Sao Paulo, Brazil (47, 54) |
Aga Khan University |
Aga Khan University of Pakistan (2) |
Aga Khan University |
Aga Khan University of Pakistan (2) |
|
Indian Christian |
Indian Christian |
- |
University of Geneva, Switzerland (44) |
University of Geneva, Switzerland (44) |
University of Geneva, Switzerland (44) |
|
Kandra University of Bangladesh (2) |
Kandra University of Bangladesh (2) |
- |
|
Dartmouth Medical School (29) |
Dartmouth Medical |
|
University of Geneva, Switzerland (44), University of Dayton, Ohio (31) |
University of Geneva, Switzerland (44), University of Dayton, Ohio (31), |
- |
|
University of Dayton, Ohio (31) |
University of Dayton, |
|
Community-based medical education |
|||||
|
Education focused |
Service-oriented |
Education focused |
|||
|
John Hopkins School of America (41) |
John Hopkins School of America (41) |
- |
Morehouse School of Medicine (30) |
Morehouse School of Medicine (30) |
Morehouse School of Medicine (30) |
|
- |
- |
- |
- |
|
University of Sao Paulo, Brazil (47, 54) |
|
Community-engaged medical education |
|||||
|
Education focused |
Research-oriented |
Service-oriented |
|||
|
Community Partnership |
Education in primary healthcare centers and rural hospital |
Participatory research in the community |
Community empowerment |
Longitudinal health interventions |
|
|
Northern Ontario School of Medicine (69, 83) |
Northern Ontario School of Medicine (69, 83) |
|
|
Northern Ontario School of Medicine (69, 83) |
|
|
Ateneo de Zamboanga University School of Medicine (Philippines) (10, 20, 21) |
Ateneo de Zamboanga University School of Medicine (Philippines) (10, 20, 21) |
|
|
Ateneo de Zamboanga University School of Medicine (Philippines) |
|
|
Flinders Australia (10) |
Flinders Australia (10), University of |
University of Gezira (Sudan) (71) |
Flinders Australia (10) |
Flinders Australia (10) |
|
|
Sabah University Malaysia (15) |
Sabah University Malaysia (15) |
North Carolina, |
Sabah University Malaysia (15) |
Sabah University |
|
|
Western Sydney University School |
Western Sydney University School |
|
|
|
|
|
niversity of California, San Francisco School |
University of California, San Francisco, School |
|
University of California, San Francisco, School of Medicine (82) |
University of California, |
|
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