Calimag, Angela Pauline P., & Calimag, Maria Minerva P. (2017, September). Patient perception of medical student engagement in community-based outreach activities during community health clerkship: A Q-methodology study. Journal for Medicine, University of Santo Tomas, 1(1), 98-108. (doi: 10.1000/2546-1621.017.0056) (Link: http://www.jmust.org/elib/journal/2546-1621/issues/10.1000/001)

Abstract:

Introduction: The essence of the medical profession is providing service not only to individual patients but to the community at large. The patient-physician interaction is essential in the Community Service learning component of the Doctor of Medicine curriculum of the University of Santo Tomas, Faculty of Medicine and Surgery (UST-FMS) students for more than five decades. As the modern view of the patient veers away from paternalism, however, he assumes the roles of ‘member of the health team,’ an ‘evaluator of care,’ and a potential ‘agent of change.’ Evidence-based guidelines on health promotion in adult patients recommend giving them “voice” and involving them in projects. A blank spot exists regarding attitudes and expectations of adult patients about the role of medical students in community-based projects, as these remain unreported. Anchored on the Community-based Program Theory, this paper explores the central question: How do patients perceive the role of medical students in a community-based setting? Methodology:The Q-methodology is the primary design used in this study. It combines the objectivity of quantitative approach with the essence of human experiences as explored in qualitative studies. The participants (P-sample) were 25 subjects gathered by convenience sampling in a community outreach site of the Department of Preventive, Family, and Community Medicine of the UST-FMS, in a comprehensive Philippine University. They were asked to arrange 25 statements (Q-sample), derived from the initial interview, in the Q-sort table based on their degree of agreement, which was then further explicated in the post-sort interviews. The results were then subjected to by-person factor analysis with varimax rotation using the PQ Method version 2.11. Results and Discussion:Four profiles emerged from the by-person factor analysis, i.e., the respondents value the medical students in their various roles in the community as: (1) ‘community engager’ in a curative role; (2) ‘capacity enhancer’ in a promotive role; (3) ‘community enabler’ in a preventive role; and (4) ‘community energizer’ in a rehabilitative role. The discussion focused on similarities and differences among profiles regarding the three principal themes (attention, appreciation, and action) derived from the statements used as the Q-sample. This paper contributes to primary care research, as it 1) applied a mixed-method approach in the study of patient and physician relationship in the Philippine community setting; 2) knowledge and perceptions of Filipino patients were codified and made explicit through this study; and 3) it adds to the worldview of the culture-laden concept of patient-physician relationship, particularly regarding the Filipino patients’ perceptions of the medical student as a primary care physician and the role they play in his/her healthcare.

Maria Minerva P Calimag <mpcalimag@ust.edu.ph> is in the Department of Pharmacology and Clinical Epidemiology, the Department of Anesthesiology, and the Research Centers for Social Science and Education and for the Health Sciences, University of Santo Tomas, Manila, Philippines.

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