Objective: 1) To pilot test the integration of evidence seeking with rural
community health clerkship rotation by 4th year undergraduate medical students
in a medical college.
2) To explore the category of evidence gathered by the students during the
two month clerkship.
Methods: The students of 4th year medical college was involved in a
new skill where we pilot tested the integration of evidence seeking with rural
community health clerkship using our innovative SPICE model (Integrating
Evidence Seeking with Primary care & Community Health). The clerkship was
supervised by the faculty of Community health sciences of the medical college in
collaboration with primary health care physicians of the rural health centre. The
students were provided a format for exploring queries related to the patients that
were assigned to them. The students were given library time in the afternoon
to look for answers to their queries from the resource list provided to them. The
students presented their findings in the bi-weekly morning meeting in the rural
community clinic. The meeting was attended by the four supervisors, primary
care physicians and other students involved in the clerkship.
Results: There were 105 queries made by the students during their 2
months community health clerkship with an average of 5 queries per student.
70% of the queries were related to General Medicine, followed by Gynecology/
Obstetrics, Psychiatry and pediatrics. Surgery related queries accounted for
only 2% of the queries. Classification of queries in to various categories showed
that prevention related queries were the highest (40%), followed by curative
(37%). Epidemiological queries (Association, causation, incidence/prevalence)
together accounted for about 17% of the queries.
Conclusion: Integration of evidence seeking with rural community health
clerkship rotation by 4th year undergraduate medical students in a medical
college was successfully pilot tested, developing the SPICE model, and found
to be objectively designed, practically feasible, learner centered and liked
by the students and the faculty members involved in the study. The pilot test
results are highly supportive of adopting this model in the training curriculum of
undergraduate medical education throughout the country.