Mixed‐Method Outcome Evaluation of a Community‐Based Education Program for Medical Students

Background: Although community‐based training is included in medical undergraduate education in Japan, little assessment of the outcomes of community‐based education programs has been performed. The aim of this study was to investigate the outcomes of a community‐based education program using a mixed method. Methods: The study design utilized both qualitative and quantitative methods (mixed method). The subjects (n = 278) were fifth‐grade medical students who were involved in the program from 2008 to 2010 inclusive. We collected two types of data: a six‐item pre‐and‐post questionnaire (quantitative) and an open‐ended questionnaire (qualitative) to evaluate the impressions this experience left on the students. Results: Pre‐and‐post questionnaires were completed by 263 (95%) of 278 subjects; on all items, the scores of the post‐ data were significantly higher than that of pre‐ data (P < 0.001). From the responses given by 139 respondents (total 181, 77%) in the open‐ended questionnaire survey, 10 themes were extracted: 1. Inter‐professional cooperation; 2. Role and cooperation among university hospitals, community hospitals, clinics, and welfare facilities; 3. Patient‐centered medicine; 4. Trust‐based relationships; 5. Competency in general medicine; 6. Professionalism; 7. Medical management; 8. Communication; 9. Common diseases; and 10. Long‐term care. Conclusions: We found that medical students gained four major perspectives from their experiences: Inter‐professional cooperation, trust based relationships, roles of community hospitals and clinics, and patient‐centered medicine, respectively. Our findings suggest this program contributed significantly to their understanding of community medicine.