Evaluation of a distance learning academic support program for medical graduates during rural hospital service in India.

BACKGROUND: Christian Medical College (CMC), Vellore, India, a tertiary care hospital, designed a year-long Fellowship in Secondary Hospital Medicine (FSHM) for CMC graduates, with the aim to support them during rural service and be motivated to consider practicing in these hospitals. The FSHM was a blend of 15 paper-based distance learning modules, 3 contact sessions, community project work, and networking. This paper reports on the evaluation of the FSHM program. METHODS: The curriculum development process for the FSHM reflected the six-step approach including problem identification, needs assessment, formulating objectives, selecting educational strategies, implementation, and evaluation. Telephone interviews with students were conducted to determine if the program motivated them to consider working in smaller hospitals. RESULTS: Qualitative data analysis showed that the program motivated the FSHM students to consider practicing in secondary hospitals by creating awareness of challenging opportunities and instilling confidence to provide good quality clinical care with limited resources. DISCUSSION: We propose rural service for MBBS graduates, supported by a blend of on-site and distance education as a model for medical education.

Integration of academic learning and service development through guided projects for rural practitioners in India.

BACKGROUND: Christian Medical College Vellore (CMC) aspired through its Fellowship in Secondary Hospital Medicine (FSHM), a 1-year distance-learning program, to integrate academic learning and service development through guided projects for junior doctors working in small rural hospitals. AIM: The purpose of this article is to report the evaluation of the effectiveness of the project work in the FSHM program. METHOD: Mixed method evaluation was done using focus group discussion with students, written surveys for students and faculty, and telephone interviews with students and medical superintendents. Evidence for validity was gathered for the written survey. Criteria for trustworthiness were applied for the qualitative data analysis. RESULTS: The major strengths of the project work identified were that students became aware of local health problems and how to deal with them, learned to work as a team, and had a sense of doing something useful. Recommendations for improvement were to have more interactions between guides and students. The benefits of projects to the hospital were providing improved clinical care, improved health systems, cost effective care management and benefits to the community. CONCLUSIONS: Service learning through guided project work should be incorporated into distance-learning educational programs for junior doctors working in rural hospitals.