Inclusion health group members and advocates often claim that medical practitioners lack understanding of their communities and experiences, which can impact on quality of care received. This pilot study explored how fit for purpose inclusion health training is for medical students by surveying the content of the medical curriculum and how patients from inclusion health communities experience service delivery.
This research aimed to gain a greater understanding of the factors influencing the teaching and learning experiences of medical educations and students with regard to inclusion health, and explore the perceptions of civil society specialists and service users from inclusion health groups in order to gauge the effectiveness of current provision and/or need for additional development or training in this area.
We achieved this through surveys and Patient and Public Involvement (PPI) collaborations with focus groups, medical educators, and civil society advocates who may themselves have lived experience.
A secondary aim was to expand networks of practice at local, regional and national level (including through East of England National Institute for Health and Care Research Applied Research Collaborations (NIHR ARC), the Cambridgeshire Homeless Impact Research Network, and local authorities/public health teams) help develop a broader understanding of opportunities and barriers to embedding inclusion health learning and placement opportunities within undergraduate medical education.
A literature and documentary review was conducted, incorporating database searches of journal articles and reports; extant information on systematic reviews or publications which focused on curricula content and the impact on preparedness for practice of medical students supporting inclusion health groups; and publicly available medical school curricula, documentation from Royal Colleges, and other relevant grey information sources pertaining to inclusion health materials included within medical schools qualifying medical degrees.
A survey was sent to all 55 medical schools in the UK to uncover the extent of health inclusion coverage in curricula, and the approach to educational delivery and assessment of such content. The Medical Schools’ Council supported distribution of the survey to Deans, Heads of Medical Schools or alternative nominated senior leaders.
Surveys were also sent to key service providers and Non-Governmental Organisations (NGOs) working with a range of marginalised communities/inclusion health groups, to explore their opinions of the preparedness for practice/awareness of the specific socio-cultural needs and barriers to engagement impacting the groups they support, amongst non-specialist medics in contact with their client groups.
Additionally, in-depth semi-structured interviews were undertaken with suitably experienced medical academics involved in design of curricula/delivering teaching to medical students, to explore perceptions and attitudes towards health inclusion, and how they identify sources of support for teaching, including their knowledge of best practice, and availability of specialist placements for trainees interested in working in inclusion health fields.
A focus group took place with NGO/civil society representatives working on health access for inclusion health groups, with participants selected to represent a diverse range of service user groups, to explore in more depth the themes which emerge from surveys.
Findings were analysed using ‘Framework’ thematic methodologies to identify key themes in qualitative findings. Findings were also validated and co-reviewed by members of an informal advisory group consisting of specialists in inclusion health medical education, who were able to comment on the validity of findings and recommendations, as well as support reflection on the potential/experience of specialist inclusion health practitioners in relation to input to undergraduate or postgraduate training.
A follow-on consultation with community groups who were potentially able to offer inclusion health placements for medical students has taken place, with a report due to be published in summer 2025.
Medical students have been offered the opportunity to shadow and participate in follow-up activities emerging from this study as part of a student-selected component (SSC) placement, with the possibility of contributing to publications and conference presentations.
Follow-up funding applications and publications are in preparation.
Ahluwalia, S., Greenfields, M., Coker, S. and Church, K. (2024) 'An Exploration of Inclusion Health Teaching in the Undergraduate Medical Curricula – Summary Report', Anglia Ruskin Research Online (ARRO). Report. Available at: https://doi.org/10.25411/aru.26335672.v2