Community Clinical Learning - why it matters to Tomorrows Doctors

Creating great clinicians, who understand people, and the world in which we all live
Looking Ahead: the case for Community Clinical Learning Important Positives
Evidence based: BEME Systematic Review, Dornan et al 2006:

Projected population changes means that

health service needs are changing, but medical education has not changed with them Public expectations that patients will be treated in or near their homes Wider acceptance of importance of lifestyle changes in preventing chronic disease in later life best implemented in patients normal surroundings by multi-professional teams 50% future doctors will need to work in community settings, will need to understand how communities and individuals function and how to work within that context Putting theory into practice engaging with communities in a creative and imaginative way
Mennin & Petroni-Mennin, Community Based Education, Clinical Teacher 2006

Early clinical community learning adds relevance to learning seeing patients holistically from the start Helps them develop professionally More confidence with patients, Develops reflective learning Improves critical appraisal Supports learning in academic subjects including social and psychological aspects of medicine Increases recruitment into underserved areas deprived and rural areas, if students have had positive undergraduate learning experience there. Prepares doctors for leadership roles that will include managing health of the public, deciding how resources will be used, and understanding of the contextual issues underpinning disease and health. Important Negatives Very few RCTs evidence is qualitative rather than quantitative Difficult to implement consistently, time consuming and expensive Change management skills very necessary to alter how we expect our students to learn
Challenges

Achievements

Integrating community clinical learning with main case Support from 3rd sector, Health Boards, NHS, University and GP partners Imaginative sessions, very varied clinical experiences that include patients homes, community clinics and GP surgeries, community teams, 3rd sector seminars and role plays, community social care and Cardiff Prison Implement reflective learning and rapid formative feedback

Change management - developing and communicating the vision Organising transport of 300 students safely to a multiplicity of clinical placements Resources and costs - budgetary management Faculty development and support for new teaching Managing variability in learning experiences across 4 geographical sites

Kamila Hawthorne, Alan Stone, Sue Emerson & Frances Gerrard, with much help from Rob Morris, Elaine Ropke and Tracey Wills (the Community Clinical Learning Team), 4 Health Boards and their Undergraduate Managers and Honorary Senior Lecturers