Patient-centred medicine through student-centred teaching: a student perspective on the key impacts of community-based learning in undergraduate medical education

Context The UK General Medical Council has proposed that increased use of c ommunity settings is essential to enhancement of medical education. However , such curriculum developments have been directed by educationalists and cl inical faculty; there is to date little to show whether student perspective s accord with such expectations. Aim To examine student views on whether community-based learning during a U K undergraduate medical education course results in new learning in the are as expected, and to elucidate any process factors which enhance attainment of learning objectives. Method Nominal group technique, to develop consensus on important learning outcomes and process factors, and questionnaire survey, developed from the views of the nominal groups. Results 89 students participated (response rate 70% for the nominal groups, and 88% for questionnaire). Students perceived increased learning in many of the areas expected. In particular, students reported significant learnin g from: witnessing the impact of a longer term and more personal relationsh ip with patients; the visible impact of social environment on health; the i mportance of dealing with people rather than diseases, and the use of the w hole team for care. In addition, they emphasized that tutor, staff and pati ent enthusiasm for student presence and learning greatly enhanced the stude nt learning experience. Conclusions Community settings appear to achieve the expected attitudinal a daptation of students. The role of the committed tutor and team is seen as pivotal to learning. The conclusions support an increased emphasis in conte mporary medical education and related research activity on the key impact o f relationships in the learning environment.