Navigating ‘C’ of the Spices Model in Twin Cities of Pakistan

This qualitative data was collected to explore practices regarding community–based activities (CBAs) of the undergraduate outcome–based integrated curriculum in medical colleges of twin cities (Rawalpindi–Islamabad) of Pakistan. The study identifies gaps and recommendations for implementing community–oriented and community–based medical education (COME & CBME) at the undergraduate level in Pakistan. The analysis shows that the lack of learning outcomes, assessment strategies, and supervisory structure hindered any improvement in the CBAs. The dominance of the clinical faculty and the Community Medicine faculty's limited motivation were identified as significant challenges hindering advancement in the CBME. The regulatory authority was proposed to combat pre–clinical versus clinical dilemmas and interdisciplinary and interprofessional issues, including multi–sectoral and community engagement challenges faced by the COME in Pakistan.本研究收集定性数据（qualitative data），旨在探究巴基斯坦双子城拉瓦尔品第-伊斯兰堡地区医学院校本科基于结果的整合课程中社区实践活动（Community-Based Activities, CBA）的实施现状。本研究明确了巴基斯坦本科阶段推行社区导向与社区为基础的医学教育（Community-Oriented and Community-Based Medical Education, COME & CBME）的现存不足，并提出针对性改进建议。分析结果表明，学习成果缺失、评估策略不完善以及督导体系缺位，阻碍了社区实践活动的提质增效。临床师资占据主导地位，加之社区医学师资积极性不足，被认定为制约社区为基础的医学教育发展的重大挑战。研究建议设立监管机构，以应对巴基斯坦社区导向与社区为基础的医学教育所面临的临床前与临床阶段困境、跨学科及跨专业问题，包括多部门协作与社区参与层面的各类挑战。