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Year : 2001  |  Volume : 14  |  Issue : 3  |  Page : 357-365

Best Practices in Community-Oriented Health Professions Education: International Exemplars

School of Public Health, University of I llinois at Chicago, USA

Correspondence Address:
Ronald W Richards
School of Public Health, University of Illinois at Chicago, 1601 W. Taylor Street, Chicago, IL 60612
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Source of Support: None, Conflict of Interest: None

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Introduction: During 1998 - 2000, an international team of five researchers described nine innovative health professions education programmes as selected by The Network : Community Partnerships for Health through Innovative Education, Service, and Research. Each researcher visited one or two schools. Criteria for selection of these nine schools included commitment to multidisciplinary and community-based education, longitudinal community placements, formal linkages with government entities and a structured approach to community participation. The purpose of these descriptions was to identify key issues in designing and im plementing community-based education. Methodology: Programmes in Chile, Cuba, Egypt, India, the Philippines, South A frica, Sudan, Sweden and the United States were visited. Before site visits were conducted, the researchers as a group agreed upon the elements to be described. Elements included overall institutional characteristics, curriculum, admissions practices, evaluation systems, research, service, community involvement, faculty development, postgraduate programmes and the school's relationship with government entities. Here I describe the common features of each of the nine programmes, their shared dilemmas and how each went about balancing the teaching of clinical competence and population perspectives. Lessons learned: Based upon an analysis of the cases, I present seven "lessons learned'' as well as a discussion of programme development, institutionaliz ation of reform and long-term im plications for health professions education. The seven lessons are:( 1 ) PBL and CBE are not seen as independent curricular reforms; ( 2 ) student activities are determined based upon sensitivity to locale; ( 3 ) health professionals need to work collaboratively; ( 4 ) there is a connection between personal health and population health issues;( 5 ) population health interventions and treatment strategies need to be appropriate to local conditions;( 6 ) graduates need to advocate for patients and the community in the public policy arena; and ( 7 ) organiz ational change tak es a long time. Conclusions: Despite their differences, all nine exemplars are engaged in processes of organiz ational change. Schools are becoming more community-oriented and socially accountable, and all of these programmes have accepted two fundamental tenets: "take public money, give to the public'' and "place matters''.

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