Community-based educational design for undergraduate medical education: A grounded theory study

Mora Claramita, Elsa Pudji Setiawati, Tri Nur Kristina, Ova Emilia, Cees Van Der Vleuten

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9 Citations (Scopus)
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Background: Community-based education (CBE) is strategically important to provide contextual learning for medical students. CBE is a priority for countries striving for better primary health care. However, the CBE literature provides little curriculum guidance to enhance undergraduate medical education with the primary health care context. We aim to develop a CBE framework for undergraduate medical education (from macro, meso, and micro curriculum levels) to engage students and teachers with better, more meaningful learning, within primary health care settings. Methods: We used a grounded theory methodology by interviewing eight medical educationalists and ten CBE teachers, followed with the coding process by sensitizing the concepts of 'medical education' and 'primary care', to explore any new concepts. The primary data originated from a developing country where the paradigm of high-quality primary health care is mostly unfamiliar. Three senior researchers from international associations of general practices from different countries provided validation to the results. Results: We identified a new framework for a community-based educational program. The micro-curriculum should offer opportunities for small group activities, ranging from simple to complex learning, emphasizing clinical skills, leadership, and teamwork to improve self-directed and collaborative practice. Sufficient role models and constructive feedback within primary care contexts are robust facilitators. For the meso-curriculum, comprehensive coordination on teacher-training and CBE program is needed. To ensure the sustainability of the program, faculty leaders and managers should include the macro-curriculum with a national postgraduate general practice curriculum and provide strong commitment. Conclusions: We designed a 'CBE-tree' model for the undergraduate medical curriculum. By using the CBE framework developed in this study, students and teachers may better comprehend the essential of primary health care.

Original languageEnglish
Article number258
JournalBMC Medical Education
Publication statusPublished - 11 Jul 2019
Externally publishedYes

Bibliographical note

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


  • Community-based education
  • Experiential-learning
  • General practice/family medicine
  • Primary health care
  • Student-centered learning


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