In a recent blog post, Dr. Dianne Delva discussed some of the challenges and a couple of benefits of delivering medical education in a distributed program. In this post, I would would like to suggest that there are three main goals or reasons why we pursue Distributed Medical Education; which are:
- Better Learning Experiences for Students
- Enhanced Physician Retention
- Social Accountability
#1 Better Learning Experiences
Dalhousie Medical School has adopted the long-term vision to have the “Best undergraduate medial education in North America” (2010 Dalhousie Medical School Strategic Plan), therefore the ways distributed medical education enhances student learning are of primary interest. Published reports suggest distributed medical education is beneficial for providing learner experiences with a wider variety of patients, an improved ability to practice clinical skills, as well as a greater awareness of psychosocial issues, patient autonomy, and communication skills (Mennin and Petroni-Mennin 2006).
#2 Enchanced Physician Retention
Those interested with increasing rural medical professionals in underserviced areas have found links between rural origin and rural spouse, as predictors of rural practice (Stagg, Greenhill, and Worley 2009). Stagg et al (2009) also found that student experience with rural practice and small hospital experience contributed to those of urban origin who chose to practice in rural settings. However, the evidence is not conclusive, and more research certainly needs to be done. While the Australian program did identify some positive affects of a rural placement, a Canadian Rural Family Physician Residency program was not able to demonstrate positive retention results (Lu, Hakes, Tolhurst, Dickinson 2008).
The majority of evidence points to Distributed Medical Education having a positive affect on graduate retention, and this remains an important political motivator that is a important goal, and useful for providing justification for the first goal of Better Learning Experiences.
#3 Social Accountability
The purposeful choice to deliver medical education in a distributed method also servers the social accountability role of the medical education programs. Locating learners within communities ensures a broad experience of the complexities and nuances involved in medical care. The number of sites that Dalhousie Medical School uses for our medical programs serves to ensure our programs are accountable to and include the communities within the design and delivery of the educational experiences. Medical students visibly located within smaller communities also provide positive role models for youth in these areas, which is likely to increase the diversity of applicants to the medical education programs.
Delivery of community-based medical education does pose challenges and include additional complexities compared to a single site (urban) education system; however, when we can keep the primary goals in mind, we can ensure our efforts are justified and suitably focused.
Is there a fourth goal of Community Based Education?
Do you have thoughts about Goals 1-3?
Leave a comment below.