title: Assumptions about disease treatment challenged in a family health clerkship: views of first clinical year medical students.
abstract: BACKGROUND
  During a family health clerkship at the University of The West Indies, students are expected to acquire individual and community diagnosis skills and the ability to relate the two, as well as acquire knowledge of other community agencies involved in health care.
  
  
  OBJECTIVE
  To determine the main assumptions related to disease treatment, which students have had to re-think after engaging in this clerkship.
  
  
  METHODS
  End of clerkship assessments were carried out from two successive groups of third year medical students (n=64) at the University of West Indies, Jamaica. Students were asked to "list two assumptions regarding treating disease that have been challenged by your experience". A subsequent content analysis was done.
  
  
  RESULTS
  Fifty-five students (86%) completed the assessment. All assumptions were listed (n=99) and similar issues were linked into emerging themes. Twenty-five groups of assumptions produced seven main themes: "Issues related to compliance" (27.3%),"Patient's treatment is mainly physical" (17.2%), " Superiority of western medicine over alternative" (15.2%), "Patients' health seeking behavior and attitudes" (12.1%), " The extent of the contribution of social factors on health" (12.1%) and "Patients' knowledge and understanding of health" (7.0%).
  
  
  CONCLUSIONS
  The majority of students examined felt challenged on three themes: relating to issues of compliance, treating the "whole" patient not just the physical, and the superiority of western medicine over alternative. The three most popular individual assumptions were; patients have a mindset that favours compliance, medication affordability does not affect compliance and treatment is independent of social and environmental conditions.
authors.affiliation: Department of Community Health and Psychiatry, University of the West Indies, Jamaica, West Indies. anika.mitchell@uwimona.edu.jm
authors.forename: A
authors.initials: A
authors.lastname: Mitchell
authors.forename: T J
authors.initials: TJ
authors.lastname: Paul
authors.forename: J
authors.initials: J
authors.lastname: LaGrenade
authors.forename: A
authors.initials: A
authors.lastname: McCaw-Binns
authors.forename: P
authors.initials: P
authors.lastname: Williams-Green
mesh_terms: D001291:Attitude of Health Personnel; D002982:Clinical Clerkship; D000529:Complementary Therapies; D005194:Family Practice / Q000193:education*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007563:Jamaica; D013337:Students, Medical