title: Development and evaluation of a community immersion program during preclinical medical studies: a 15-year experience at the University of Geneva Medical School.
abstract: BACKGROUND
  Significant changes in medical education have occurred in recent decades because of new challenges in the health sector and new learning theories and practices. This might have contributed to the decision of medical schools throughout the world to adopt community-based learning activities. The community-based learning approach has been promoted and supported by the World Health Organization and has emerged as an efficient learning strategy. The aim of the present paper is to describe the characteristics of a community immersion clerkship for third-year undergraduate medical students, its evolution over 15 years, and an evaluation of its outcomes.
  
  
  METHODS
  A review of the literature and consensus meetings with a multidisciplinary group of health professionals were used to define learning objectives and an educational approach when developing the program. Evaluation of the program addressed students' perception, achievement of learning objectives, interactions between students and the community, and educational innovations over the years.
  
  
  RESULTS
  The program and the main learning objectives were defined by consensus meetings among teaching staff and community health workers, which strengthened the community immersion clerkship. Satisfaction, as monitored by a self-administered questionnaire in successive cohorts of students, showed a mean of 4.4 on a five-point scale. Students also mentioned community immersion clerkship as a unique community experience. The learning objectives were reached by a vast majority of students. Behavior evaluation was not assessed per se, but specific testimonies show that students have been marked by their community experience. The evaluation also assessed outcomes such as educational innovations (eg, students teaching other students), new developments in the curriculum (eg, partnership with the University of Applied Health Sciences), and interaction between students and the community (eg, student development of a website for a community health institution).
  
  
  CONCLUSIONS
  The community immersion clerkship trains future doctors to respond to the health problems of individuals in their complexity, and strengthens their ability to work with the community.
authors.affiliation: Institute of Social and Preventive Medicine, University of Geneva, Faculty of Medicine, Geneva, Switzerland ; Unit of Development and Research in Medical Education, University of Geneva, Faculty of Medicine, Geneva, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Chastonay
authors.forename: V
authors.initials: V
authors.lastname: Zesiger
authors.forename: A
authors.initials: A
authors.lastname: Klohn
authors.forename: L
authors.initials: L
authors.lastname: Soguel
authors.forename: E K
authors.initials: EK
authors.lastname: Mpinga
authors.forename: Nv
authors.initials: N
authors.lastname: Vu
authors.forename: L
authors.initials: L
authors.lastname: Bernheim
keywords: community health; community immersion; community-based learning; medical curriculum
references.citation: Acad Med. 1999 Dec;74(12):1316-9
references.pmid: 10619009
references.citation: World Health Organ Tech Rep Ser. 1987;746:1-89
references.pmid: 3632772
references.citation: Med Educ. 2006 Apr;40(4):301-13
references.pmid: 16573665
references.citation: J Rural Health. 2008 Fall;24(4):353-9
references.pmid: 19007389
references.citation: Acad Med. 2008 Apr;83(4):357-64
references.pmid: 18367896
references.citation: Med Educ. 2004 May;38(5):510-21
references.pmid: 15107085
references.citation: J Gen Intern Med. 2003 May;18(5):370-6
references.pmid: 12795736
references.citation: CMAJ. 1997 Feb 1;156(3):365-7
references.pmid: 9033418
references.citation: Med Educ Online. 2012;17:16741
references.pmid: 22778541
references.citation: BMJ. 2005 Aug 13;331(7513):387-91
references.pmid: 16096306
references.citation: Acad Med. 2007 Dec;82(12):1211-9
references.pmid: 18046131
references.citation: Acad Med. 2001 Oct;76(10):1076-9
references.pmid: 11597854
references.citation: Med Educ. 2007 Sep;41(9):892-6
references.pmid: 17696982
references.citation: Acad Med. 2002 Jul;77(7):747
references.pmid: 12114168
references.citation: Lancet. 2010 Dec 4;376(9756):1923-58
references.pmid: 21112623
references.citation: BMJ. 2004 Oct 9;329(7470):834
references.pmid: 15472265
references.citation: Med Teach. 2004 May;26(3):211-4
references.pmid: 15203496
references.citation: Acad Med. 1997 Dec;72(12):1043-50
references.pmid: 9435709
references.citation: Med Educ. 2001 Mar;35(3):242-9
references.pmid: 11260447
references.citation: Fam Med. 2003 Apr;35(4):273-8
references.pmid: 12729313
references.citation: Acad Med. 1991 May;66(5):259-63
references.pmid: 2025353
references.citation: Fam Med. 1999 Apr;31(4):257-62
references.pmid: 10212767