Perceptions and valuation of a community-based education and service (COBES) program in Uganda

Background: Community-based education and service (COBES) has been promoted to improve the education of health professionals, particularly in low-resource settings. However, few evaluations have been performed to guide program development. Aim: This study assessed student and educator perceptions and valuation of a Ugandan COBES program. Methods: We administered an internet-based survey to students, faculty, and site tutors associated with the Makerere University College of Health Sciences COBES program. Results: 255 surveys were completed. Response rates varied (students, 188/684, 27.5%; faculty-site supervisors, 15/23, 65.2%; faculty general, 38/312, 12.2%; site tutors, 14/27, 51.9%). Students valued the COBES program (93.5% some/high value). Tutors enjoyed their work (92.9% agreeing/strongly agreeing). Faculty (n = 53) felt COBES was valuable (90.2% agreeing/strongly agreeing). High student valuation was associated with high quality accommodation (aOR 4.7, 95% CI = 1.6-13.4), free accommodation (aOR 2.9, 95% CI = 1.2-6.8), and tutors who demonstrated enthusiasm for teaching (aOR 3.4, 95% CI = 1.1-10.0). Areas identified for improvement included financial support, student preparation, and tutor training, feedback, and supervision. Conclusion: In this study, COBES was perceived positively by students and educators and learning environment and quality of teaching both contributed to valuation of COBES. Well-implemented COBES programs may offer an opportunity to enhance health sciences education.