Personal and Social Transformative Learning through Community‑Based Education: Insights from Training Socially Accountable Medical Doctors at a Historically Disadvantaged University in the Eastern Cape, South Africa.

Abstract

Background: In 2014, the Faculty of Health Sciences at Walter Sisulu University introduced a 20‑week long integrated longitudinal clinical clerkship (ILCC) rotation block as part of its commitment to community‑based education and social responsiveness, with the goal of ensuring that the curriculum is updated to align with the contemporary health system challenges in South Africa. Aim: To explore whether medical student participants underwent social and personal transformative learning in understanding complex societal health needs during their integrated longitudinal community clerkship program. Methods: This was an exploratory qualitative research study conducted among 113 5^th year medical students based at 8 selected hospitals during their 20‑week‑long community clerkship. Data were collected through six focus group discussions, complemented by data from reflective learning journal entries. Audio recordings were transcribed verbatim and merged with complementary data for thematic analysis in NVivo Version 13®. Results: Adaptation challenges, improved social relations, coping with work demands, acquisition of relevant knowledge and skills, perceived inadequate support from the training institution and perceived lengthy programme duration emerged as key themes and were linked to personal and social transformation. Conclusion: Personal and social transformation may have transpired amongst the student participants, as demonstrated by the observed thematic consistency between data sources. Further complementary studies are required to assess whether there was a shift in students' understanding of community health needs and how the ILCC may have assisted the students in responding to community needs to have a comprehensive conclusion on whether the ILCC can be a tool for transformative learning.