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Table 3 The recommended meso-curriculum namely “Supported Learning Activities” within a systematic CBE framework in the ‘CBE-tree’ in this study

From: Community-based educational design for undergraduate medical education: a grounded theory study

“Supportive Learning Activities” in which teachers should coordinate to the micro-content:

Examples of “Supportive Learning Activities”

Basic micro abilities to be enhanced

Topics (Gradual)

1. Small Group work (2 to 5 students)

2. Learning strategy: inductive (starting from exploration and the conclusion or intervention comes later in the later stage)

3. Tasks:

a. To interact with people

b. To do unobtrusive observation

c. To reflect on experiences

• Using log-book or portfolio

• Adequate feedback on listening skills, observation skills, reflection-planning, two-way shared decision making skills

d. Continued tasks – periodic

e. The tasks should match with block-theme

f. Gradual tasks

4. Settings:

a. Field work

b. Gradual clinical settings

c. Gradual focus on individual/ family/ community

5. Proper period of time for learning cycle: field work activities ➔ learning process ➔ feedback ➔ learning plan

6. Assessment:

a. Continuous constructive feedback

b. Observation-based assessment

Year 1

1. Tutorial discussions, mini lectures with cases

2. Survey with guided questions based on block-topics

3. Learning ‘symptom and sign’ in daily settings:

a. Laboratory settings: Role-Play, Simulated Patient

b. Field work of VS at community settings (with log book and feedback session)

4. Individual unobtrusive observation-participation

a. Field work of observation and interaction with common people and their daily activities (farmers, fisherman, executives, micro economic sellers, teachers, etc.)

b. Field work of observation and interaction with specific group of people and their daily activities (disabled, HIV, etc.)

Listening skills

Observation skills

Reflection skills

Individual as unit of care

Year 2

Learning risk factors, social determinants of health, symptom and sign in daily settings:

a. Laboratory settings: Role-Play, Simulated Patient

b. Field work of VS at community settings (with log book and feedback session) to various age group

Listening skills

Observation skills

Reflection skills

Family as unit of care

Year 3

Learning Early Detection of Natural History of Illness, High Risk, Priority Illness, Chronic Illness and Clinical education in various settings (link to community settings):

a. Community based settings: Individual unobtrusive observation-participation: Field work of observation and interaction with specific group of people and their daily activities (disabled, HIV, etc.)

b. Primary health care

c. Hospitals – outpatient clinics, home care, home visits

Listening skills

Observation skills

Reflection skills

Two-way shared decision making skills

Integrated clinical skills in primary health care

Special Age group as unit of care

Clinical years

Learning of :

a. Diagnosis for Individual (Clinical-Sub Clinical-High Risk)

b. Diagnosis for Family health problems

c. Diagnosis for Community health problems

d. Patient education using two-way interaction and shared clinical decision making

e. Community education- to communicate effectively with the community member and/or with key person including on how to consider the sociocultural aspects

Listening skills

Observation skills

Reflection skills

Two-way shared decision making skills

Integrated patient management

Community as unit of care