Student attitudes: potential barriers to implementing a community medicine field activity.
OBJECTIVE
Clerkship-year medical students may have complex attitudes regarding communities in which they train. Our objective was to assess medical students' attitudes following implementation of a community medicine experience in their clerkship year.


METHODS
We analyzed transcripts of audiotaped medical student group discussions following a community field activity. A multidisciplinary team coded the transcripts using content analysis techniques to identify key features of student narratives regarding students' attitudes and attributions regarding their community medicine experiences.


RESULTS
Students expressed several important perceptions regarding the community in which they conducted their field experience. These included strong insider/outsider themes, resentment that historical legacy shape the doctor-patient relationship, and concerns over personal safety and educational relevance of the activity. Some students noted improvement in understanding of patients within their communities.


CONCLUSIONS
Negative attitudes and attributions expressed by students can act as obstacles in the development of community medicine initiatives, hinder professional development if unaddressed, and have the potential to contribute to health disparities. Further work on how to incorporate community medicine training is needed.
Cronholm
Peter F
PF
Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA 19104-4283, USA. peter.cronholm@uphs.upenn.edu
Margo
Katherine
K
Bazelon
Gillian
G
Bream
Kent
K
Bennett
Ian M
IM
Barg
Frances K
FK
D000328:Adult; D001291:Attitude of Health Personnel; D002982:Clinical Clerkship; D003144:Communication Barriers; D003154:Community Medicine / Q000193:education*; D055812:Community-Based Participatory Research / Q000379:methods; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000458:organization & administration; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D008297:Male; D011369:Professional-Patient Relations; D016730:Program Development / Q000379:methods; D012923:Social Class; D013337:Students, Medical / Q000523:psychology*; D055815:Young Adult