Challenges and the new perspectives of the undergraduate medical students education-module “Physician in the Community”

ABSTRACT:
Aim:Medical schools are dominated by disease-centered medicine. Since the 1990s, there has been a clear movement towards the concept of patient-centered medicine. However, physicians tend to show limited ability to achieve patient-centered outcomes, and there is a clear need for modifying medical education for students. We devised the module entitled “Physician in the Community,” with the aim to implement both the concept of patient-centered medicine and community-based learning activity.
Methods: Each student received “his/her patient” from a physician in the Primary Healthcare Center (PHC) and followed the patient in the contacts with health care and social institutions, as well in the family settings. Upon completion of the module, we evaluated the impressions of all participants, i.e., the students, patients, and physicians. We used self-administered questionnaires.
Results: Three hundred fourteen students and the same number of patients were included in the program. The response rates were 77.7 and 51.9%, respectively. The number of physicians included was 52, with a response rate of 69.2%. On a scale of 1-5, students scored their knowledge about social factors which influence patient’s health and quality of life as high (4.29), in comparison to their awareness of overall factors (3.94), and having insight into activities of the local community aimed to improve health (4.05). Students were moderately satisfied with their participation in the module (3.93), while patients’ satisfaction was significantly higher (4.53, Mann-Whitney, Z = -5.887, p = 0.000). Physicians’ opinions about the importance of the module for the future work in the PHC had moderate scores (3.97).
Conclusion: The evaluation demonstrated that enhancing student’s undergraduate education with communicational skills and holistic approach are valuable efforts, especially from the patient’s point of view. Presented educational approach empowers our students to develop future relationship with the patients.