Developing teaching opportunities in a day surgery unit

Using rural and remote settings in the undergraduate medical curriculum: AMEE Guide No. 47

The goal of global equity in health care requires that the training of health-care professionals be better tuned to meet the needs of the communities they serve. In fact medical education is being driven into isolated communities by factors including workforce undersupply, education pedagogy, medical practice and research needs. Rural and remote medical education (RRME) happens in rural hospitals and rural general practices, singly or in combination, generally for periods of 4 to 40 weeks. An effective RRME programme matches the context of the local health service and community. Its implementation reflects the local capacity for providing learning opportunities, facilitates collaboration of all participants and capitalises on local creativity in teaching. Implementation barriers stem from change management, professional culture and resource allocation. Blending learning approaches as much as technology and local culture allow is central to achieving student learning outcomes and professional development of local medical teachers. RRME harnesses the rich learning environment of communities such that students rapidly achieve competence and confidence in a primary care/generalist setting. Longer programmes with an integrated (generalist) approach based in the immersion learning paradigm appear successful in returning graduates to rural practice and a career track with a quality lifestyle.

Design, implementation and evaluation of a medical education programme using the ambulatory diagnostic and treatment centre

BACKGROUND

In the UK a central government initiative is seeking to transfer aspects of specialist NHS care to community settings using ambulatory diagnostic and treatment centres (ADTCs).

AIMS

Following the redevelopment of a district general hospital as an ADTC, we were interested in the feasibility of using this new facility to deliver a structured programme for undergraduate medical students.

METHOD

Twenty self-selected fifth year medical students at the University of Dundee, together with teaching and administration staff in the ADTC, took part in the study during the academic year 2005-2006.

RESULTS

One hundred percent of students and 73% of staff responded to a questionnaire pitched at the level of reaction to the course. The key findings were that the students found the teaching venues useful, the general environment conducive to learning, and the content appropriate to their needs. Staff felt that patients were not unhappy or disturbed by having students present and did not think the presence of students inhibited their clinical work. They appreciated the new opportunity to teach.

CONCLUSIONS

An ADTC is a viable setting for structured teaching of undergraduate medical students. It provides a context for medical student leaning away from the main teaching hospital.