Helping tomorrow's doctors to gain a population health perspective - good news for community stakeholders.
BACKGROUND
The modernising agenda of the NHS and recommendations of professional bodies demand that all doctors achieve a basic understanding of a population health perspective. The principle of integrated learning and the logistics of provision make it inappropriate for such learning to be delivered solely by public health specialists, and community-based learning has been promoted as the best setting in which to assist this objective. However, there is little evidence from practice as to whether non-specialist staff are willing or able to play a role in orienting tomorrow's doctors to the needs of communities.


METHODS
Semi-structured interviews, questionnaires and focus groups iterated the opinion of key stakeholders on their preferred contributions to community-oriented undergraduate medical education. Framework analysis was used to elicit key outcomes and process factors.


RESULTS
There was consensus that community-based learning should be a core element of the medical curriculum as it can demonstrate the socioenvironmental context of care and the doctor's role in interagency working and preventive care. Effective academic/NHS partnerships were called for, with higher education leading the agenda on aims and objectives, creating collaborative structures, and reallocating resources to support new learning. Community-based stakeholders would offer the translation of theory into practice by demonstrating clinical and social diversity, models of teamworking, and a context for the application of prior learning. They also promoted recurrent contact with communities, and suggested an enhanced role in mentoring students through longer term relationships.


CONCLUSIONS
Community-based personnel and NHS users are an under-used resource for medical education. Their proposed contributions strongly accord with the agenda for a population health perspective in basic training. Curriculum planners need to make long-term partnerships with community-based agencies, rather than using them as an intermittent provider of limited learning sessions with narrowly defined objectives.
Howe
Amanda
A
University of East Anglia, Norwich, UK. Amanda.howe@uea.ac.uk
Billingham
Kate
K
Walters
Christina
C
D003153:Community Health Services / Q000592:standards; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004739:England; D005194:Family Practice / Q000193:education; D006801:Humans; D011361:Professional Competence; D011634:Public Health / Q000193:education; D011795:Surveys and Questionnaires