Health for all: comparing apprenticeship with traditional classroom learning in community oriented medical education (COME)

Abstract

In the last few decades, a substantial effort has been made globally to mould medical education in accordance with the needs of the local community of a region. The objective of this study was to ascertain whether apprenticeship could substitute the prevalent, traditional classroom learning in order to make the medical education in Pakistan more community oriented. A cross sectional study was conducted for six months. Selection was based on purposive sampling. A total of 300 students were recruited for the study, with the inclusion criteria being enrolled in 4th year MBBS of King Edward Medical University, Pakistan, studying the subject of community during 3rd year MBBS. Informed consent was obtained; data were collected through a pretested questionnaire and analysed through SPSS version 23. Medical apprenticeship was defined as a contract between a senior doctor and a medical student, combining onthe-job training, formal learning and productive work in a clinical/practical setting for a period of 9 months, 12 hours a week. Classroom based learning was defined as one in which the medical students are taught by medicine, and having prior 1-year experience of apprenticeship in the form of ward rotations the delivery of lectures for 12 hours a week for a period of 9 months, within the premises of classroom, accommodating at least 300 students, without demonstrating the practicality of theory on a subject/ patient. The results indicated 90% of the students believed apprenticeship to promote greater knowledge retention, instilling confidence in the students to apply medical knowledge, and to carve their own professional identity (p value<0.05). However, apprenticeship was deemed as more exhausting (69.0%), prone to favouritism (59.3%) and harassment (79.0%). With reference to Community Medicine, 70.0% wanted apprenticeship to be utilized in teaching. As far as the implementation is concerned, only 39.3% students believed that this change would be easy to adopt in the current setup.

Navigating ‘C’ of the SPICES Model in Twin Cities of Pakistan

“…To meet the recommendations of the WFME, Pakistan's regulatory authority has been updating and transforming its standards, particularly concerning social accountability in medical education. A way to achieve social accountability is through community-oriented medical education (COME) in Pakistan (Ullah & Tazeen, 2021), where medical students are trained to provide primary health care to underserved communities (Abbasi, Rubab, & Malik, 2019).…”