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Caring for Underserved Patients Through Neighborhood Health Screening: Outcomes of a Longitudinal, Interprofessional, Student-Run Home Visit Program in Singapore

Liang En, Wee; Koh, Gerald Choon-Huat MMed FM, GDGM, FCFP, MGer; Lim, Vivien Kim Geok PhD

doi: 10.1097/ACM.0b013e31821d841d
Underserved Populations

Purpose: Service learning, an effective vehicle for teaching undergraduate public health while providing underserved communities with medical care, is not well established in Asia. The authors evaluated a service learning program, Neighborhood Health Screening (NHS), in Singapore.

Method: Medical and nursing undergraduate students provided in-home medical services to patients in a low-income neighborhood (January–June 2010). The authors assessed student-reported pedagogical effectiveness in nine domains, asked students for qualitative feedback on their experiences, assessed patients' satisfaction with NHS, and tracked clinical outcomes.

Results: Of the 240 medical and 34 nursing students who participated, 222 (93%) and 34 (100%), respectively, completed the questionnaire; 136 of the medical students (57%) also provided qualitative feedback. Most students felt NHS was beneficial across all domains. Male medical students were less likely to report increased understanding of deficiencies in the health care system and long-term management of chronic disease; preclinical students were more likely to report improvements in comprehending ethical issues, critical thinking and action skills, and gaining and applying knowledge. Qualitative feedback supported quantitative findings. Patients were satisfied with NHS: 266 (75%) agreed that NHS improved their health, and 301 (85%) felt NHS provided sufficient time to address their issues. After a single year, amongst patients with known hypertension, treatment increased from 63% to 93% (P < .001), and blood pressure control amongst those who were on treatment improved from 42% to 79% (P < .001).

Conclusions: Service learning can make an important contribution to medical teaching and patient care in Asia.

Mr. Wee is a third-year undergraduate medical student, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.

Dr. Koh is assistant professor, Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.

Dr. Lim is associate professor, Department of Management and Organisation, National University of Singapore Business School, National University of Singapore, Singapore.

Correspondence should be addressed to Dr. Koh, Block MD3, #03-20, 16 Medical Drive, Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore 117597; fax: (+65) 67791489; telephone: (+65) 5164979; e-mail: Gerald_Koh@nuhs.edu.sg.

First published online May 25, 2011

© 2011 Association of American Medical Colleges