Abstract:

The approach in teaching at The Andrija Stampar School of Public Health of the Zagreb University Medical School, that physicians have to work mostly in patients’ natural environment instead of surgeries and clinics, resulted in Community Health Course held in rural area 200 km far from Zagreb.
The aim of this paper is to compare student’s evaluation done immediately after completing the course in 8th semester of study of medicine with that of the evaluation of the same course two years later in 12th semester.
Investigation covered 225 students of the 2007/08 generation and vas repeated with same students when they were at the sixth year of the study. Out of 225 students at the entry, 192 repeated the interview two years later (response rate 85.3%). Preparatory seminars, final seminar, organization of the field activities, the content of the course, field research which they performed, practical work with family practitioner and field visiting nurse, their own performance in health education session in elementary school and environmental control of water supplies were rated by students with grades 1 (very bad) to 5 (excellent).
Introductory seminars were graded with 4-5 by 98% of students at entry compared with 64% of the same students two years later. Same grades for final seminars were 97% and 78% respectively. The content was very good and excellent for 89% at entry and 86% two years later. Figures for other categories were also very high: 90% and 82% for organization, 98% and 63% for engagement in field research, 94% and 92% for work with home visiting nurse, 93% and 92% for work with family practitioner, 93% and 94% for their engagement in health education as well as 7% and 49% for environmental control of water supplies.
Free comments were very emotional as for instance: “….. the work in patient’s homes in very poor area changed my life. Every physician has to experience this real life.”
Evaluation suggests that students recognize the value of our community oriented course and keep it in memory as one of the most valuable experiences during their studies. Living for a wile in population and taking part in activities of the local health services gives them the opportunity to understand social, organizational and epidemiological determinants of health as well as the knowledge and skills necessary to improve it.