Community medicine clerkship amidst COVID-19 pandemic: re-designing, implementation, and evaluation
Abstract
Clerkship on primary care and family medicine is multi-elemental and very challenging in amidst the COVID-19 pandemic. Some medical students have postponed their graduation because the clerkship at the health center cannot be carried out in a pandemic situation. This article aims to describe the community medicine clerkship (CMC) module and how the implementation amidst the COVID-19 pandemic. This module was delivered by online and offline activities from 10th August to 13th September 2020. A total of forty students, twelve faculty mentors, and fifteen PHC preceptors from ten PHCs in Tangerang District, Indonesia were involved. Students could carry out activities and fulfill assignments given in the midst of a pandemic with a re-designing of the CMC module. One-sample t-tests were run to determine whether scores of students participating in CMC module during the COVID-19 pandemic differed from normal and showed that individual and group scores were significantly different from normal. The findings of the study clearly indicate that all clinical clerkship modules must be redesigned to suit the current conditions. Modifications and variations of various learning methods, guidance techniques, monitoring and coordination are factors that should be considered in its implementing.
References
Alsoufi, A., Alsuyihili, A., Msherghi, A., Elhadi, A., Atiyah, H., Ashini, A., Ashwieb, A., Ghula, M., Hasan, H. B., Abudabuos, S., Alameen, H., Abokhdhir, T., Anaiba, T., Shuwayyah, A., Benothman, R., Arrefae, G., Alkhwayildi, A., Zaid, A., & Elhadi, M., (2020) ‘Impact of the COVID-19 pandemic on medical education: Medical students’ knowledge, attitudes, and practices regarding electronic learning’. PLoS ONE, 25, pp. 1–20. https://doi.org/10.1371/journal.pone.0242905
Bansal, P., Supe, A., Sahoo, S., & Vyas, R. (2017) Faculty development for competency based medical education : Global, national and regional perspectives. National Journal of Integrated Research in Medicine. 8(5), pp. 89–95. http://nicpd.ac.in/ojs-/index.php/njirm/article/view/1315
Bennett, F. J. (1979) Community diagnosis and health action. A manual for tropical and rural areas. London: Macmillan Press Ltd.
Bernstein, R., Ruffalo, L. and Bower, D., (2016) A multielement community medicine curriculum for the family medicine clerkship. MedEdPORTAL, 12(1), pp. 1–8. https://doi.org/10.15766/mep_2374-8265.10417
Bjärås, G. (1993) The potential of community diagnosis as a tool in planning an intervention programme aimed at preventing injuries. Accident Analysis and Prevention, 25(1), pp. 3–10. https://doi.org/10.1016/0001-4575(93)90091-A
Bloom, B. S. (1956) ‘Engelhart, M. D, Furst, E. J, Hill, W. H, & Krathwohl, D. R, Taxonomy of educational objectives: The classification of educational goals’, in Handbook I: Cognitive Domain. New York: David Mckay.
Botma, Y., and Labuschagne, M. (2019) Application of the Donabedian quality assurance approach in developing an educational programme. Innovations in Education and Teaching International, 56(3), pp. 363–372. https://doi.org/10.1080/14703297.2017.1378587
Campbell, C., Hendry, P., Delva, D., Danilovich, N., and Kitto, S. (2020) Implementing competency-based medical education in family medicine: A scoping review on residency programs and family practices in Canada and the United States. Family Medicine, 54(4), pp. 246–254. https://doi.org/10.22454/FamMed.2020.594402
Cannon, H. M., and Feinstein, A. H. (2005) Bloom beyond Bloom: Using the revised taxonomy to develop experiential learning strategies. Developments in Business Simulations and Experiential Learning, 32, pp. 348–356. https://absel-ojs-ttu.tdl.org/absel/article/view/624
Deng, A., Wang, J. J., and Tsui, B. H. (2020) Keeping trainees safe in a pandemic: the evolving role of medical simulation training. Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 67, pp. 1292–1293. https://doi.org/10.1007/s12630-020-01662-z
Dory, V., Charlin, B., Vanpee, D., and Gagnon, R. (2014) Multifaceted Assessment in a Family Medicine Clerkship: A Pilot Study. Family Medicine, 46(10), pp. 755–760. https://www.stfm.org/familymedicine/vol46issue10/Dory755
Falchikov, N. (2001) How theory can inform practice. In N. Falchikov Learning Together: Peer tutoring in higher education. (1st ed., pp. 114-127). https://doi.org/10.4324/9780203451496-10
Fernandez, N., Dory, V., Ste-Marie, L-G., Chaput, M., and Charlin, B. (2012) Varying conceptions of competence: an analysis of how health sciences educators define competence. Medical Education, 46(4), pp. 357–365. https://doi.org/10.1111/j.1365-2923.2011.04183.x
Ferrel, M. N., and Ryan, J. J. (2020) The impact of COVID-19 on medical education. Cureus, 12(3), pp. 1–4. https://www.cureus.com/articles/29902-the-impact-of-covid-19-on-medical-education
Franchi, T. (2020) The Impact of the Covid-19 Pandemic on Current Anatomy Education and Future Careers: A Student’s Perspective. Anatomical Sciences Education, 13, pp. 309–312. https://doi.org/10.1002/ase.1966
Haj, H. I. El., Lamrini, M., and Rais, N. (2013) Quality of care between the Donabedian model and the ISO9001V2008 model. International Journal for Quality Research, 7(1), pp. 17–30. http://www.ijqr.net/paper.php?id=24
Harden, R. M. and Crosby, J. (2000) AMEE guide No. 20: The good teacher is more than a lecturer - the twelve roles of the teacher. Medical Teacher, 22(4), pp. 334–347. https://doi.org/10.1080/014215900409429
Harries, A. J., Lee, C., Jones, L., Rodriguez, R. M., Davis, J.A., Boysen-Osborn, M., Kashima, K. L., Krane, N. K., Kman, N., Langsfeld, J. M., & Jurez, M. (2021) Effects of the COVID-19 pandemic on medical students: a multicenter quantitative study. BMC Medical Education, 21(1), pp. 1–8. https://doi.org/10.1186/S12909-020-02462-1
Howe, A. (2003) Twelve tips for developing professional attitudes in training. Medical Teacher, 25(5), pp. 485–487. https://doi.org/10.1080/01421590310001605624
Huggett, K. N. and Jeffries, W. B. (2014) An introduction to medical teaching. Springer Dordrecht. https://doi.org/10.1007/978-94-017-9066-6
Iglar, K., Whitehead, C., and Takahashi, S. G. (2013) Competency-based education in family medicine. Medical Teacher, 35(2), pp. 115–119. https://doi.org/10.3109/0142159X.2012.733837
Indonesia Medical Council (2012) Standar kompetensi dokter Indonesia [Competency standards for Indonesian doctors]. Jakarta: Konsil Kedokteran Indonesia. http://pd.fk.ub.ac.id/wp-content/uploads/2013/08/KKI-SKDI-2012.pdf
Junaidi, A. (2020) Panduan penyusunan kurikulum pendidikan tinggi [Higher education curriculum development guide]. (4th Ed.) Edited by S. S. Kusumawardani. Jakarta: Direktorat Jenderal Pendidikan Tinggi Kementrian Pendidikan dan Kebudayaan.
Kim, S. M., Park, S. G., Jee, Y. K., and Song, I. H. (2020) Perception and attitudes of medical students on clinical clerkship in the era of the Coronavirus Disease 2019 pandemic. Medical Education Online, 25(1). https://doi.org/10.1080/10872981.2020.1809929
Krathwohl, D. R. (2002) A revision of Bloom’s taxonomy: An overview. Theory into Practice, 41(4), pp. 1–8. https://doi.org/10.1207/s15430421tip4104_2
Liao, K. C., Pu, S-J., L. M-S., Yang, C-W., and Kuo, H-P. (2013) Development and implementation of a mini-clinical evaluation exercise (mini-CEX) program to assess the clinical competencies of internal medicine residents: From faculty development to curriculum evaluation. BMC Medical Education, 13(1), pp. 1–7. https://doi.org/10.1186/1472-6920-13-31
Norcini, J. J., Blank, L. L., Duffy, F. D., and Fortna, G. S. (2003) The Mini-CEX: A Method for Assessing Clinical Skills. Annals of Internal Medicine, 138(6), pp. 476–481. https://doi.org/10.7326/0003-4819-138-6-200303180-00012
Nulkar, A. (2020) Lessons from COVID-19: The perspective of an international medical student back in the United States. International Journal of Medical Students, 8(1), pp. 75-76 https://doi.org/10.5195/ijms.2020.527
Rickman, H. M., Rampling, T., Shaw, K., Martinez-Garcia, G., Hail, L., Coen, P., Shahmanesh, M., Shin, G. Y., Nastouli, E., and Houlihan, C. F. (2020) Nosocomial transmission of coronavirus disease 2019: A retrospective study of 66 hospital-acquired cases in a London teaching hospital. Clinical Infectious Diseases, 72(4) pp. 690-693. https://doi.org/10.1093/cid/ciaa816
Roberts, D. H., Newman, L. R. and Schwartzstein, R. M. (2012) Twelve tips for facilitating Millennials’ learning. Medical Teacher, 34(4), pp. 274–278. https://doi.org/10.3109/0142159X.2011.613498
Rose, S. (2020) Medical Student Education in the Time ofCOVID-19. JAMA, 323, pp. 2131–2132. https://doi.org/10.1001/jama.2020.5227
Schneider, B. N., Biagioli, F. E., Palmer, R., O’Neill, P., Robinson, S. C., and Cantone, R. E. (2019) Design and implementation of a competency-based family medicine clerkship curriculum. Family Medicine, 51(3), pp. 234–240. https://doi.org/10.22454/FamMed.2019.539833
Thammasitboon, S., Mariscalco, M. M., Yudkowsky, R., Hetland, M. D., Noronha, P. A., and Mrtek, R. G. (2008) Exploring individual opinions of potential evaluators in a 360-degree assessment: Four distinct viewpoints of a competent resident. Teaching and Learning in Medicine, 20(4), pp. 314–322. https://doi.org/10.1080/10401330802384680
Van Der Vleuten, C. P. M., and Schuwirth, L. W. T. (2005) Assessing professional competence: From methods to programmes. Medical Education, 39(3), pp. 309–317. https://doi.org/10.1111/j.1365-2929.2005.02094.x
Walsh, A., Koppula, S., Antao, V., Bethune, C., Cameron, S., Cavett, T., Clavet, D., and Dove, M. (2018) Preparing teachers for competency-based medical education: Fundamental teaching activities. Medical Teacher, 40(1), pp. 80–85. https://doi.org/10.1080/0142159X.2017.1394998
Welch, M., and Plaxton-Moore, S. (2017) Faculty development for advancing community engagement in higher education: Current trends and future directions. Journal of Higher Education Outreach and Engagement, 21(2), pp. 131–166. https://openjournals.libs.uga.edu/jheoe/article/view/1324/1321
World Health Organization (2009) Monitoring and evaluation of health systems strengthening 1: An operational framework. Geneva: World Health Organization. Retrieved December 16, 2022, from https://docplayer.net/9337132-Monitoring-and-evaluation-of-health-systems-strengthening-1.html
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