Context and setting In India, a report by national consultants on public health education recommended student-centred, problem-oriented and community-based training for medical undergraduates. However, most medical colleges lack field-based teaching for demonstration and participatory education for undergraduates because of the poor availability of resources.
Why the idea was necessary Field visits are arranged for students to give them first-hand understanding of public health problems. Here, the challenge for teachers is to select a field-based participatory teaching tool for field visits of short duration. Conventionally, the ‘transect walk’ is a qualitative tool and technique which uses participatory research and action. It allows participants to gain a bird’s eye view of the locality and focuses on problem identification and management of local resources. The present study explored the utility of the transect walk as a public health teaching and learning tool for medical undergraduates.
What was done A batch of 65 first year medical undergraduates were taken for a transect walk in the village of Pulai, which has a population of 946 inhabitants. This exercise was undertaken as a part of the students’ camp curriculum during Social Service Camp, which is held under the National Social Service (NSS) Scheme. Students were divided into 13 small groups. A written checklist on the transect walk was given to each group to help its members retain their focus. The checklist was based on guidelines disseminated by the Institute for Participatory Practices, Patna, India. The self-managed small groups were asked to take a transect walk in the village and to observe the surroundings on a given set of indicators, to encourage villagers to explain things as they progressed on the walk, and to take detailed notes. After 1 hour of the walk, group members summarised their findings in a text report carried out as a piece of group work and shared the various lessons learned with other groups. Content analysis of qualitative data in the form of the text report was undertaken using atlas-ti Version 5.0 (Scientific Software Development GmbH, Berlin, Germany). For better validity of the results, two faculty members independently analysed the text data to assess student understanding. Ethical principles were adhered to throughout.
Evaluation of results and impact This approach offered active student-centred learning with minimal resources and time requirements. It ensured the interaction of students with villagers on local health problems. Students reported their observations and learning on a wide variety of public health-related topics, such as the power and water supplies to the village, waste disposal systems, sanitation of latrines, housing, kitchen gardens, livestock, use of televisions and telephones, use of alternative sources of energy (solar energy), use of smokeless chulha (a stove made from clay), leisure time activities, addictions and religious faith. Students received a quick cross-sectional overview of health problems in the village. Walking together in small groups with local people removed barriers in communications and villagers expressed their views on different aspects of the public health topic more candidly, which does not usually happen in a community meeting or even in a one-to-one interview. Thus, the transect walk can be utilised as a teaching and learning tool for the quick orientation of medical undergraduates to public health issues.