Abstract:

The course aim is to encourage students to comprehend the importance of communities in the health of individuals and families. The course is based on approach in medical education where main fields of action for physicians are human settlements, not laboratories and consulting rooms. Students have the opportunity to perceive community inside and outside of the health care system, and to study epidemiological and socio-medical determinants of health, throughout activities of health and social care systems. Students work under supervision of local health professionals, physicians and community nurses, in order to facilitate experience, knowledge, skills and attitudes transfer. Course, composed of seminars (18 hours) and practical (30 hours) is performed in local, mostly rural communities, throughout 6 days, from Monday to Saturday. A full day of preparatory seminar, held at the School of Public Health “Andrija Štampar” precedes the field visit. In local setting, students have every evening summing up seminar with reports from morning and afternoon tasks, preparation of health education lectures. The last day is final seminar with course evaluation. Practical work takes place in different health care settings: out-hospital care (community nurses, family medicine, primary paediatrics care, occupational medicine); county public health institute (school medicine, social medicine, epidemiology and environmental health); local general hospital; practical health education in schools, kindergartens, retirement homes; practical with families in their homes and public health field research. Expecting learning outcomes for students considering knowledge are: economic, historic, cultural, ecological, social determinants of community; community development, organisation and health status as a result and determinant of socioeconomic status; influence of moral, cultural, social values on health status of individuals; public health assessment of community needs for health care; efficiency of public health interventions, critical analysis of organization of local health care system; preparation of health educational methods in different settings (lectures, small group work, counselling); health promotion in community nursing, and inter-sectoral collaboration in practice. Considering skills, students are required to develop: communication with people where they live, work and go to school; collaboration with medical professionals and stakeholders in community; working rapport with public health research subjects; taking of water samples; interview techniques; performance of epidemiologic survey; organisation and implementation of vaccination programme; assessment of water supplies; performance of health education through lectures and group work with healthy and chronically ill individuals; participation in community based public health programs (in houses, schools, workplaces), assessment of living and working conditions and performance of local health system regular activities.
The course has been one of the best evaluated courses at School of medicine in Zagreb. The student’s essays are full of very emotional experiences from the practical, where they felt the real sense of working with people far away from clinics and laboratories.

Keywords:

medical education, community health, rural health.