The development and evaluation of a community attachment scheme for first-year medical students.

This paper describes the development over 14 years of a Community Attachment Scheme for First Year Medical Students in Sheffield, together with feedback from tutors and students. The scheme involves pairs of students visiting families expecting a baby or experiencing an illness. The families are identified by general practitioners who act as tutors together with a behavioural scientist for groups of eight to 10 students. The scheme provides first-year students with practical experience of sociology and psychology in terms of family dynamics and illness behaviour. Assessment is part of the degree examination, and involves a written assignment on the family, together with tutors' assessments. The development of the attachment scheme took place in three phases, which are described together with feedback from tutors and students, as well as changes in methods of assessment. The basis of the Community Attachment Scheme has been self-directed problem-based learning in small groups with continuous assessment, and these principles have now extended to the rest of the medical curriculum in Sheffield, of which the Community Attachment Scheme is an integral part.