In our modern society, despite technological and biomedical advancements, deep-rooted problems such as social inequality and racism still prevail. The medical professional of the future should therefore be trained to work in a diverse setting and foster inclusiveness as a core attitude. This is especially important and perhaps challenging, as the current population of medical students is a substantially homogenous group comprising students from a higher socioeconomic status and with minimal representation of students from ethnic minority groups. Early exposure of students to society is desirable if not indispensable to ensure proper patient care.  

Background information

The vocation of any medical professional includes serving society. Society, however, is diverse in all ways possible: ethnicities and belief systems, socio-economic classes, genders and educational levels. Academia is historically seen as an epicentre of knowledge, a role of great value. However, this epicentre of knowledge must be aligned to the needs of society. Research has shown that the current medical students are usually from a higher socio-economic class, with many having parents from the health professions, and are socio-culturally rather homogeneous with an under-representation of ethnic minorities. It is worrisome that our future medical doctors will be working within the community in various roles, but themselves have minimal exposure to the whole spectrum of diversity within that community.

Aims

By introducing this course, we want to raise awareness in students about the diversity in our society and foster a sense of belonging within the community

Project description

In the current course we want to use community service as a tool to involve students in various community–based programs, where they learn about the diversity in patient populations and their backgrounds. Students will participate in various community projects working with vulnerable populations. The course will be designed to help students be aware of their own bias and to find a balance between staying true to their own beliefs while understanding and respecting those of others. Next to this, students would receive theoretical lessons and exercises on a range of topics such as multiculturalism, public health, social pharmacology and communication. This will help students to understand how the social context of individuals dictate their health status and accessibility to healthcare.  This course is unique for students as it will include both the community (1 day/ week) and academia as learning spaces. It will be based on the idea of co-creation with involvement of students, teachers and the community. Students and the community will benefit from each other’s involvement. 

Results

This course aims to develop skills in students which will enable them to understand themselves, their biases and their “future” patients, better. It aims to promote the understanding that factors such as socio-economic context, belief systems and/or level of education, play an important role when treating patients. Additionally, this course will provide a much-needed bridge between theory and practice within the bachelor curriculum. It will enable students to work with and learn from ‘real life’ examples. Using examples from the community, students can gain first-hand understanding on the application of subjects like public-health, pharmacology or communication. Furthermore, the multidisciplinary learning approach will help develop collaboration skills. The course will provide ample opportunity for patient participation by having patients from different communities contribute to the course. Finally, it will offer opportunities for authentic learning, because students have to apply their medical knowledge and skills in a real-world setting with a high fidelity to their future work environment. 

References

1. Arebalos MR, Botor FL, Simanton E, Young J. Required Longitudinal Service-Learning and Its Effects on Medical Students’ Attitudes Toward the Underserved. Med Sci Educ. 2021 Jun 18;31(5):1639-1643. doi: 10.1007/s40670-021-01350-7. PMID: 34603835; PMCID: PMC8446116. 
2. Brahmaputra Marjadi, Jeff Scobie, Kerrie Doyle, Stephen Tobin, Gilbert Whitton, Nathan Rollinson, Shafiul Haque, Grace Fava, Mitchell Smith, Jennifer Spannenberg & Sowbhagya Micheal (2021): Twelve tips for engaging students and community partners in medical education, Medical Teacher, DOI: 10.1080/0142159X.2021.1986625 
3. Herrington, J., Reeves, T. C., & Oliver, R. (2014). Authentic learning environments. Handbook of research on educational communications and technology, 401-412. 
4. Hunt JB, Bonham C, Jones L. Understanding the goals of service learning and community-based medical education: a systematic review. Acad Med. 2011 Feb;86(2):246-51. doi: 10.1097/ACM.0b013e3182046481. PMID: 21169780. 
5. Lianne Mulder, Anouk Wouters, Jos W. R. Twisk, Andries S. Koster, Eddymurphy U. Ak iwu, Jan H. Ravesloot, Gerda Croiset & Rashmi A. Kusurkar (2022) Selection for health professions education leads to increased inequality of opportunity and decreased student  diversity in The Netherlands, but lottery is no solution: A retrospective multi-cohort study , Medical Teacher, 44:7, 790-799, DOI: 10.1080/0142159X.2022.2041189