Biomedical subjects

T N Kristina

Publications and source records attributed to T N Kristina.

4 recordsLinked to original sources

PubMed2006

Does Community-Based Education come close to what it should be? A case study from the developing world: students' opinions.

CONTEXT: There has been an increase in the number of medical schools implementing community-based educational (CBE) programmes. However, there are doubts whether CBE programmes are appropriately implemented. As a case study, the CBE programme of the Medical Faculty of Diponegoro University (MFDU) in Semarang, Indonesia was evaluated. OBJECTIVES: To acquire MFDU's students' opinions on their CBE programme as part of a comprehensive evaluation of that programme, and to generate recommendations for improvement of MFDU's CBE programme. METHODS: Coles and Grant's model for curriculum evaluation was applied. This model recommends triangulation of data generated from comparison of the programme as designed "on paper", as implemented "in action" by the faculty, and "as experienced" by the students. To assess the curriculum as experienced by the students, direct participatory observation was performed and focus group discussions were conducted to collect students' opinions. RESULTS: Students specifically signalled: (1) frequent overlap of lectures given during the CBE clerkship and in the previous part of the curriculum, (2) mismatch between their activities in the community and the community's felt health needs, (3) greater benefits of the CBE programme for Primary Health Care (PHC) centres and students than for target communities, and (4) incidental defective co-operation between students and health providers or community health workers. CONCLUSION: Students' opinions yielded more in-depth information on the CBE programme evaluated and facilitated formulation of recommendations for improvement of that CBE programme.

Community Medicine↗

PubMed2006

A survey validation of generic objectives for community-based education in undergraduate medical training.

INTRODUCTION: A framework for the definition of generic objectives for community-based education (CBE) was developed for undergraduate medical programmes, particularly for developing countries. To probe the validity of the set of CBE objectives generated by this approach, opinions from a wider audience were sought. METHOD: Questionnaires were sent to 72 medical schools in 36 developing countries. Half of the addressees were randomly drawn from the list of institutional members of The Network: Toward Unity For Health (TUFH) and stratified according to developing countries. Another 36 medical schools were randomly drawn from non-Network: TUFH schools from the same country where the selected Network: TUFH addressee was located, or from a neighbouring country. RESULTS: A total of 43 medical schools responded to the questionnaire (60% response rate), 31 out of the 36 addressed Network: TUFH members (86%) and 12 out of 36 addressed non-Network: TUFH schools (33%). Out of all 43 respondents 39 (91%) had implemented CBE in their curricula. Opinions of Network: TUFH and non-Network: TUFH schools on the framework and the generic objectives were not significantly different. Out of the 21 proposed objectives, 17 were scored as relevant by 75% or over of all responders and one out of the four objectives considered to be less relevant by the responders was deleted. CONCLUSION: A framework to develop generic CBE objectives and a derived set of 21 objectives were modified based on input by 43 medical schools residing in developing countries distributed all over the globe. The outcome is a validated set of 20 generic objectives for CBE programmes in developing countries.

Chi-Square Distribution↗

PubMed2005

Does CBE come close to what it should be? A case study from the developing world. Evaluating a programme in action against objectives on paper.

CONTEXT: A growing number of health professions schools have implemented programmes for community-based education (CBE) for their students. There are indications, however, that particularly in developing countries, CBE programmes are not always optimally implemented or sustained. OBJECTIVE: To test the suitability of an established method for curriculum evaluation, combined with a set of generic objectives for CBE programmes, for evaluation of CBE programmes. METHODS: As a case study, Coles and Grant's model for curriculum evaluation was applied to the CBE programme of the Medical Faculty of Diponegoro University (MFDU) in Semarang, Indonesia. Document analysis yielded information on the programme on paper; participatory observation and staff interviews on the programme in action. In addition, MFDU's CBE programme was evaluated against a set of generic objectives for CBE programmes recently designed by us. RESULTS: MFDU has created great opportunities for its CBE programme in which, however, also significant weaknesses were revealed. (1) In the community, much time was spent on formal teaching; (2) Students' work in the community was not jointly identified with community members regarding the community's felt health needs; (3) There was rarely continuity, and evaluation or follow-up of the students' work in the community; and (4) No systematic programme evaluations are carried out. DISCUSSION: This evaluation study showed shortcomings in the implementation of MFDU's CBE programme. The major weaknesses identified point at an underutilization of the opportunities and potential jeopardization of the facilities in the community. On the other hand, more time is needed in the CBE programme to establish the health needs to be addressed jointly with the community and to assess the impact of activities undertaken. A thorough review of the CBE programme, perhaps taking the outcomes of this study into account, could turn MFDU's CBE programme into a fine example for other medical schools in Indonesia and beyond. CONCLUSION: Coles and Grant's method for curriculum evaluation proved suitable for evaluation of a CBE programme in a developing country. After additional comparison with a reference list of objectives for CBE programmes, reasoned suggestions for programme can be made.

Community Health Services↗

PubMed2004

Defining generic objectives for community-based education in undergraduate medical programmes.

RATIONALE: The availability of a framework for the definition of generic objectives for community-based education (CBE) programmes may assist in the rational design of objectives for specific CBE programmes. STRATEGY: Factors impacting on community health from the perspective of a developing country were collected. Potential assistance from medical students to communities to improve their health status was determined. Competencies required in students to execute tasks in the community were defined and eventually educational objectives to develop these competencies in the students were established. METHODS: Factors impacting on community health and activities of medical students in CBE programmes were identified by review of literature and Internet resources. Competencies desired for execution of tasks by students and educational objectives to develop these competencies were defined by us and checked against pertinent literature. A draft table representing the 4 elements of the framework was discussed by an international group of experts for external validation. MAIN OUTCOMES: A total of 26 factors impacting on community health were identified and clustered in 5 domains. Twenty-one generic objectives for CBE programmes were defined to develop the required competencies in students. Analogues of each of these 21 objectives were found in at least 1 publication specifying objectives for specific CBE programmes but none of these publications stated any objective not covered by our list of generic objectives. CONCLUSION: It proved possible to develop a framework to define generic objectives for CBE programmes. An example was elaborated from the perspective of a medical school in a developing country.

Clinical Competence↗