Table 2 The CBE learning design for undergraduate medical curriculum based on the ‘CBE-tree’ in this study
From: Community-based educational design for undergraduate medical education: a grounded theory study
Principles | Illustrations (Shows by Figure 1) | Quotations | |
|---|---|---|---|
Micro-curriculum | Students’ learning strategies: | Root | |
1. Self-directed learning | Root | “Learning in community settings may capture many experiences. We should stimulate students to reflect on their experiences by using written diary of audio-visual records and use them to plan their future learning.” | |
2. Teamwork collaboration | Root | “Students will work together during explorations and discussion sessions with the community. Although students should mastering the abilities individually, in the process, they need each other to get peers feedback, to do complimentary tasks and to learn from other health professionals.” | |
Teachers’ facilitation strategies: | Root | ||
3. Role model | Root | “Role model of the teacher is certainly needed. Teachers should show ‘passion’, so that students can feel it more than via direct feedback. I call this: a leadership by example.” | |
4. Constructive Feedback | Root | “Good feedback would really stimulate students to think and learn by themselves and so the role of the teachers is “Tut Wuri Handayani” or from behind we empower, as stated by the first Minister of Education of Indonesia in early 1950s.” | |
Contents to be facilitated: | Root | ||
5. Medical content (emphasizing of 5 levels of prevention – natural history of illnesses) | Root | “The 5 levels of prevention emphasizing the natural history of illnesses are important to be understood by future doctors. When they meet a patient, besides exploring on patients intention to visit, doctors should also aware of risks detection of priority illnesses on particular age group and how to prevent risks to move further in the levels of prevention.” | |
6. Socio-determinants of health | Root | “The concept of diseases and illness perceptions should be understood by medical students as well as socio-cultural values of our society. To involve the people during learning with them in trying to overcome health problems are the challenge.” | |
Meso-curriculum | Coordination and training of simple to complex levels of learning: | Branches | “An environment of closer knowing and care towards the people should begin since early medical education at community settings and continue throughout their study.” “Medical students may start to learn with the healthy people surrounding them, in the family, neighbourhood, community, and realize that every person has risk-exposures of priority illnesses. In more advances years, students may work in local clinics to start to help manage the patients’ problems when they already have presenting symptoms or maybe diagnosed.” |
7. Supportive learning activities | Fruits | *) More about supportive learning activities are described in Table 3 | |
8. Intensive supervision | Leaves | *) More about intensive supervisions are described in Table 4 | |
Macro-curriculum | Sustainability of the program: | Trunk | |
9. Commitment of the management: National to faculty levels | Trunk | “We need somebody to state the need of early exposure of primary health care at community settings in the national standard of medical doctors’ competencies and we must have a graduate program on primary care medicine, so it will give all faculty of medicines clearer direction.” | |
10. National curriculum towards graduate general practice | Bark | “This primary health care exposures program needs planning, organizing, actuating, monitoring and good evaluation. The management support is crucial. To prioritize this program is highly necessary.” “This kind of learning activities should be created by integrated departments and not a stand-alone program.” | |