In the first week of November 2015 CISHeW’s Strong Communities, Healthier People (SCHeP) project hosted the first Student Selected Component of the new Curriculum 21 for Cardiff University medical students. The aim of this component was to give second year medical students the opportunity to engage with local communities to get some real hands on understanding of those issues that contribute to health inequalities in some of our poorest communities.
The initiative was held over five days and in this instance was hosted by the 3Gs Development Trust located in North Merthyr Tydfil. The communities of North Merthyr such as Gurnos, Galon Uchaf, Penydarren and Dowlais are some of the most deprived in a deprived area and score very highly under the Welsh Index of Multiple Deprivation. The idea of the scheme is to give students the opportunity to engage with and consult with a local community in relation to particular health issues that people feel impact on them.
The structure of the course involves students being given an introduction to the locality and its history. This is then followed by a very brief introduction to qualitative and and participatory approaches to community consultation and research and their practical ethical considerations. The students are then asked to design a simple approach to consulting with the community in relation to a specific health related topic which in this case was how local people accessed health related information and how that might impact on issues around vaccination.
The students are given guidance and support in relation to methods and techniques for recording and reporting on what they find from talking to people in the community but they are also encouraged to develop their own approach and analysis of what they find.
Following the development of their study the students are supported to put their study into practice with the local community to identify and explore the salient issues in a co-productive partnership approach with local residents. This enables the students to explore with local people what are the issues that impact on them on a daily basis.
Ten second year students took part and they were split in to two groups of five and were able to conduct interviews with a wide section of the community including parent and toddler, working age men and an elderly group. Although the research / consultation exercise was limited and was primarily aimed at introducing the students to the techniques and methodology of community consultation the students highlighted a number of key challenges in the provision of healthcare in the area and the challenges faced.
Day four of the initiative is more classroom based where students are supported to analyse and make sense of the data they have collected and organise it in to themes. On the final day the students return to the community and present to local residents and community members what they have found.
The two teams organised their presentations using two different analogies. One team used the image of a bridge under the theme of “bridging the gap” exploring how information is shared between the community on one side of the bridge and the healthcare system on the other and along the span of the bridge there are the facilitators and barriers to accessing healthcare and information such as transport, word of mouth and trust.
The other team used the analogy of clouds to explore the clusters of information and issues that need to be negotiated and explored as local people seek information about their healthcare needs. The areas identified included the use of the internet, the prevalence of mental health issues in the area and the barriers encountered by local people when they try to get GP appointments.
This was a pilot initiative but early feedback from both students and community members indicates that it was a worthwhile and enjoyable exercise for all involved and in the future SCHeP will explore how to develop this approach with other communities and other cohorts of students.