1. The Community Health Outreach and Family Study Programme Dr.Joan Rawlins Senior Lecturer/Outreach Coordinator Public Health and Primary Care Unit Dept of Paraclinical Sciences FMS, UWI. St Augustine

2. Rationale Evidence from recent research in medical education indicates that students should be trained early in their education programmes in aspects of; critical thinking reflection and empathy, by allowing them the opportunity of going through an experience and thinking carefully about the outcomes.

3. Rationale cont’d This enables them not only to narrate what has happened, but to: – encourage an analysis of the events and – identify how these events have contributed to the outcomes –and how this experience can be applied to solve similar problems in the other situations. –The Community Health Outreach and Family study proposes to achieve this type of analysis

4. Family Study The Family Study is an educational experience that has been successfully applied in a number of medical schools, one being The Faculty of Medicine, University of New Castle on Tyne, UK.

5. The Family Study Through this process the student should learn about the socio-cultural effects of childbirth in the family and how these interactions can affect the child. The student will also have the opportunity to study at first hand the various biological and developmental events that occur during pregnancy and early childhood.

6. Learning Outcomes (Summarized) By the end of the project, the students should have studied at first hand over a period of time, social, biological and health events related to childbirth in a small group of families in a real-life situation studied the psychosocial impact on the family on having a baby and the possible effects of these on the baby.

7. Learning Outcomes Summarized (Cont’d) experienced group interactions by working with a number of his/hercolleagues; practised some of the communication skills introduced and discussed during the preclinical courses been involved in some ethical considerations relevant to the type of data he/she collects during the study

8. Programme Students attend 6 hours of Lectures (over a two (2) week period) as they prepare for the Health Centre and ( Family Study) Exercise.

9. Lectures Introduction to the Outreach and Family Study Introduction to Community Health Services Caribbean Family –Health and Social Concerns Family Dynamics HIV and the community Gender and Health: The public Health Perspective

10. Health Centre visits Thereafter students are rotated in groups of four (4) through the Health Centres (Arima, Arouca and Maloney) Each week 28 students (7 groups) attend the Health Centres for their Family Study Visit Each group of four students interviews and studies two (2) antenatal clients

11. Deliverables in semester one Students complete a questionnaire in relation to the health and family situation of the two (2) mothers interviewed at the (HC) and They write a reflection page about their experience of that first visit The reflection page aims at developing critical thinking attitude by analyzing, discussing and reflecting on this experience in this Programme

12. Semester 2 Students again attend 3 hours of lectures at the beginning of the semester. The lectures include issues of: Domestic Violence Introduction to The Cancer Registry Breast Feeeding Sexual and Reproductive Health The Rape Crisis Society Introduction to the older person in the family

13. Health Centre Visit Thereafter the students are rotated again in groups of (4 ) through the Health Centres. During this visit they interview the antenatal mother (one mother this time) and examine the baby. A schedule pertaining to Early Child Development is completed. N.B. (A power point presentation of work sheet A is available and is shown and discussed with the students before they go to the community)

14. Reflection page Students again complete a reflection page based on their expectations and the outcome of their meeting with the mother and new baby.

15. Assessment of Students’ Performance The reflection pages are graded. Previously the Family study was included and represented a significant part of the grading.