Introduction of a Social Determinants of Health Education Program into Clinical Clerkship at the University of Tsukuba / 医学教育

The University of Tsukuba School of Medicine introduced an education program on the social determinants of health (SDH). It consists of lectures during the 3rd year and a 4-week family practice and community medicine clerkship between 5th and 6th years. In the clinical clerkship, students receive lectures on the first day, are instructed to consider the SDH in a patient they met during the course, give group presentations and hand in written reports on the last day. Most students were able to analyze patients beyond the biomedical model, but only a few students were able to consider the social background and timeline of each patient. Our future challenge is to enhance students' understanding of SDH through educational programs for faculty members.

Portfolio-based students learning about family and community in their community medicine clerkship: qualitative change in student learning resulting from use of a reflection sheet / 日本プライマリ・ケア連合学会誌

Introduction: Although community medicine clerkship has been introduced in many medical universities, no study of students’ learning during the clerkship has been conducted. Also, no evaluation of students’ learning about family and community has been carried out. <br>Methods: Sapporo Medical University fifth-grade students in the fiscal year 2006 to 2007 experienced two-week community medicine clerkships. They were obliged to record their clerkship experiences on a daily reflection sheet. We analyzed all the reflection sheets to understand what the students learned during their clerkships. We extracted all points considered to be examples of learning from the students’ descriptions, and classified these by content, and we also extracted examples of learning about family and community. <br>Results: The total number of points with learning content that were extracted was 2243 in 2006, and it was 3193 in 2007. Learning content about family and community averaged 5.2% and 3.7%, respectively, in 2006, and 10.7% and 7.9% in 2007. The total number of points of learning about family and community in 2007 increased significantly in comparison with the number in 2006. <br>Conclusion: By changing the viewpoint of learning by the introduction of a reflection sheet regarding family and community, even if the experience in community medicine clerkship was the same, students’ learning may have changed substantially. It was considered that the establishment of the framework of reflection was an important step.

What do medical students learn from their community-medicine clerkships? / 医学教育

Many medical universities have developed community-medicine clerkships. However, few studies have examined what medical students have actually learned from these clerkships. <br>1) In 2006 students participated in a 2-week community-medicine clerkship, during which they were required to write about their experiences on a daily reflection sheet.<br>2) All reflection sheets were collected and analyzed. What students had learned from their clerkships was abstracted from the descriptions on their sheets, and the contents of students' learning were categorized.<br>3) The total number of abstracted learned items was 2243. The numbers of learned items for the areas of medical knowledge, communication, medical skills, clinical reasoning, clinical management, and patient management were 334, 232, 214, 111, 106, and 102, respectively. Learned items in these areas accounted for 49.0% of the total.<br>4) The numbers of learned items concerning the community and families were 84 (3.7%) and 117(5.2%), respectively, and were lower than the numbers for other categories.<br>5) A new strategy must be developed to enhance students' learning about the community and families.

Exploring students' impressions of community medicine clerkship experience by means of significant event analysis / 医学教育

Community medicine clerkships are said to be an important element of current undergraduate medical education. However, little is known about what medical students actually learn from them.Therefore, we performed a study by means of significant event analysis to examine what medical students had learned from 2-week community medicine clerkships.<BR>1) Students in 2006 took part in 2-week community medicine clerkships and then in sessions at the end of their clerkships to review their experiences.<BR>2) The review sessions were recorded, and the students'impressions were extracted and categorized.<BR>3) The depth of their impressions was categorized into 4 depth levels (describing, commenting, generalizing, and planning).<BR>4) Students gave their impressions of the medical system, the role of physicians, patient-centered care, role models, and clinical ethics, and the impressions of most students were at the levels of commenting and generalizing.<BR>5) Medical students learned system-based practice and medical professionalism during their community medicine clerkships, and significant event analysis was a valuable tool for understanding their experiences.