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CBME: Community Based Medical Education

Medical education most commonly occurs within universities and tertiary teaching hospitals. Evidence is emerging that a community setting may provide students with a better medical education during the clinical years of their training.

The material presented here seeks to analyse the strengths and weaknesses of educating doctors in a community setting. It explores the role of clinical, institutional, social and personal relationships in developing a framework for describing quality in community-based undergraduate medical education.

Social axis Social axis Personal axis Personal axis Institutional axis Institutional axis Clinical axis Clinical axis It describes four key relationships, the four Rs, in which the medical student must be immersed to facilitate high quality learning. These four Rs are the relationships between

  1. clinicians and patients
  2. health service and university research
  3. government and community
  4. personal principles and professional expectations.

This model is proposed as a valid framework for articulating the important principles in CBME, and describes why community-based medical education is such an attractive alternative. Relationships do matter!

These relationships are represented by the four intersecting axes of the diagram:

  • The Clinical axis:
    Clinician - (Student) - Patient
  • The Institutional axis:
    Health Service - (Student) - University Research
  • The Social axis:
    Community - (Student) - Government
  • The Personal axis:
    Personal Principles - (Student) - Professional Practice

These axes are interdependent. The quality of the whole is more than the sum of the parts when they are integrated with integrity.

Click the coloured sections of the diagram to further explore each axis.

This material is based on two papers by Prof Paul Worley which themselves draw on the wisdom and hard work of many other researchers in the field of medical education.

  • Relationships: A New Way to Analyse Community-based Medical Education? (Part 1)
    Education for Health, Vol.15, No. 2, 2002, 117-128 (on-line)
  • Integrity: The Key to Quality in Community-based Medical Education? (Part 2)
    Education for Health, Vol.15, No. 2, 2002, 129-138 (on-line)

 

 

Updated June 13, 2007