Public health education in Ege University Medical Faculty: Developing a community-oriented model

Abstract

Background: Ege University Medical Faculty (EUMF) introduced a community-oriented curriculum in 2001.

Aims: To evaluate the new public health education program in EUMF curriculum.

Method: The study adopted triangulated methods. Quantitatively, a comparison of the students who were exposed to a community-oriented curriculum (Year 4 in 2007) was made with the students who were exposed to the traditional curriculum (Year 4 in 2005) in terms of their assessment of their achievement of our learning objectives. A total of 255 students in 2005 (80.7%) and 243 students in 2007 (81.5%) were surveyed using a questionnaire. Qualitatively, five focus group- and five individual interviews were performed with the 2007 cohort.

Results: Except the one related to teamwork (p > 0.05) all learning objectives yielded significantly higher scores in the 2007 cohort than in the 2005 cohort (p < 0.05). The qualitative analysis supported the achievement of objectives in the 2007 cohort. The students appreciated the relevance of public health education with clinical subjects and interactive methods, but criticized didactic lectures and written assignments.

Conclusions: A community-oriented approach is more effective in achieving a holistic approach to health problems. Improving community-based activities and assessment methods would be more successful in integrating population health into medical training.

Introduction

Medical schools have a unique purpose of educating physicians capable of meeting the needs of their communities (Wallace 1997). However the priority health needs of communities rarely align with the goals of academic medicine or with the geographic and specialty distribution of medical school graduates (Mennin et al. 2000). A number of medical schools have recently placed emphasis on community care in their curricula to encourage broader attitudes to health care, including those oriented to prevention, teamwork and socio-political issues (Davison et al. 1999; Edwards et al. 1999; Rolfe et al. 1999; Oandasan et al. 2000; Rêgo & Dick 2005; Gillam & Bagade 2006).

Public health, which is commonly defined as a population approach to health, is increasingly being defined as the population role of primary and community care (Howe et al. 2002). In order to underpin a population health perspective, the core curriculum should include dimensions of social and environmental factors that impact on health and illness; assessment and targeting population needs, principles of disease prevention and health promotion; collaboration between health professionals; skills in critical evaluation, and issues of resource management that consider equity (Davison et al. 1999; Edwards et al. 1999; Howe et al. 2002).

Table

Practice points
A small number of community-based activities does not guarantee the graduation of physicians who are willing to work in underserved areas. Students do not like didactic lectures and find interactive teaching and community-based activities more effective. The triangulation of research methods provides a synergistic effect in the evaluation of educational interventions.

The movement of the focus of medical education from the patient to the community has been a long struggle for both developed and developing countries. Attempting to change medical education to be more community-oriented may be more challenging in the developing world and there are few reports from these countries in the academic literature (Hays 2007).

Definition of the Public Health Education Program

Ege University Medical Faculty (EUMF) introduced a community-oriented curriculum in 2001 as a shift away from a traditional discipline-based curriculum. Considering the fact that the design of education programs for health professionals must reflect the priority health needs of the communities (Neufeld et al. 1997), the results of a study which assessed the burden of illness in Izmir, where EUMF is located, were incorporated into the new curriculum.

The new curriculum was organized as four phases within the first three years. Phase-1 is an introduction to medical sciences; Phase-2 covers normal structure, function and behaviour and consists of system-based blocks. Phase-3 is an introduction to pathological sciences, and Phase-4 covers pathologies also in system-based blocks, as in Phase 2. Within this framework, subjects that would not be horizontally integrated were covered under three domains. The educational committee called these domains ‘vertical corridors’ as they would be placed longitudinally within the curriculum and they included community health and field implementations (CHFI), interpersonal and clinical skills, and medical ethics and medico-legal responsibilities. Each block in each phase had an executive committee which was composed of the representatives from the relevant disciplines and from the vertical corridors in the related block. These committees developed conceptual frameworks for the curriculum of the block using related priority health problems as main themes. These committees track the ongoing programme with continuous assessment sessions. The guidebooks which include the curriculum map of each block, the topic titles, and the means of student performance assessment are handed out to the students.

Public Health Department, an academic unit within the EUMF, has developed an educational programme for the public health topics in the curriculum maps. This programme has learning objectives in three areas.

1. Holistic care and evaluation of the health care needs: to view patients in their entirety by understanding the effects of multiple variables on health and disease, to understand the importance of identifying the health care needs of the community; to be aware of the principles of community diagnosis and critical analysis.

2. Health care: To understand the importance of community-oriented health care system in which the primary care physician plays an integral role, to be aware of the barriers which prevent the access to health care, to recognize the importance of a team approach.

3. Prevention: To acknowledge the primacy, and responsibility for prevention of illness and health promotion.

The public health education in the previous curriculum consisted of 135 hours of didactic lectures and 22 hours of skills training in the first three years. The new education programme has three components: didactic lectures (100 hours), integrated case discussions (18 sessions) and group activities (83 hours per student). Integrated case discussions are sessions on commonly-seen problems of the community (childhood obesity, diabetes, diarrhoea etc.) in which the faculty from the related disciplines are involved. Group activities are composed of problem-solving sessions which include critical appraisal of health data, social determinants of health, health promotion. Besides, there are also discussion sessions on movies about environmental factors and community-based activities. For the problem-solving sessions we divide the class into eight sections of 34–35 students each. At the beginning of each session the instuctors divide these sections further into small groups of up to five students.

Community-based activities are carried out with groups of three students. The students in their second year work in primary health care centres and are supervised by the trainer general practitioners there for three half-day periods. The third-year students also visit the same centres for seven days. As part of the activities in the primary care centres, students in both years make home visits to a baby and a pregnant woman. Additionally, site visits (primary health care centres, hospital outpatient clinics, schools, factories) are made with groups of 12 students. All didactic lectures are given in the auditorium and attended by the class as a whole, whereas students rotate in small groups for problem-solving sessions and community-based activities. Thus, the timing of the latter activities varies for each group with respect to the related theoretical courses.

In every block two quizzes composed of short-answer questions are conducted and an exam composed of multiple-choice questions (MCQ) is applied at the end of each block. In the latter exams, the questions are weighted according to the amount of lecture hours of each discipline. Short-answer questions focus on factual knowledge, while the main purpose of MCQs is to assess students' understanding of and ability to reason using subject matter content. CHFI evaluates student achievement also by essay-question assignments which are used in order to reveal studentsã abilities to reason, analyse, synthesize and report.

Aim

The evaluation of the new public health education program in the community-oriented curriculum of EUMF is the focus of the present study. Our hypothesis was that students who were exposed to the community-oriented curriculum would achieve higher grades for the relevant learning objectives than the control students who were exposed to the traditional curriculum. As well as testing this hypothesis, we aimed to explore students’ perceptions of our new education program.

Method

We evaluated our program using a triangulated methodology: our hypothesis was tested quantitatively using a control group post-test only design (Van Dalen 1979), and focus groups and interviews were used to explore students’ perceptions on CHFI.

Quantitative method

All fourth-year students, (316 students in 2005 and 298 students in 2007) at EUMF were invited to participate in the study in the first month of the academic year. The questionnaire was self-administered and did not include the names of the students for the sake of confidentiality. Students were told that participation was voluntary. We received 255 (80.1%) and 243 (81.5%) questionnaires from 2005 and 2007 cohorts, respectively.

The questionnaire included questions on students’ sociodemographic characteristics, their opinions about whether they want to work in remote areas at any time in their lives, whether they would choose general practice as a career, and a scale for assessing the learning objectives of the CHFI.

In order to create an initial set of candidate statements in the scale, we reviewed the literature evaluating public health education and listed all educational objectives of CHFI. A panel of the research team further refined this initial set. All items were positive statements. Finally, we implemented the questionnaire with 71 interns in 2005 and got feedback on the relevance and comprehensibility of the statements. The final scale consisted of 19 statements related to holistic care and evaluation of health care needs; health care; and prevention. Students scored their achievements in terms of the learning objectives on a 5 point Likert scale (strongly agree = 1; agree = 2; neither agree, nor disagree = 3; disagree = 4; strongly disagree = 5).

Only those cases with values other than 0 (for no response) for particular questions were analysed. The learning objectives scale was found to be reliable with an alpha coefficient of 0.94. In order to find out if there were any significant differences between the two cohorts, chi-square analysis, t-test and Mann-Whitney test (when the data were not normally distributed) were performed.

Qualitative method

In 2007, one month after the questionnaire was administered, all fourth-year students were asked to participate in interviews. Sixty-two students who volunteered to participate were divided into ten groups composed of equal numbers of males and females. Six groups out of ten were randomly selected for focus group interviews. Since the fifth group ceased to provide new information, it was decided not to continue with more sessions. The number of focus group participants differed from 4 to 7 and the total number was 29. Among the rest of the volunteers five students were selected randomly for individual in-depth interviews.

A question route, covering the main topics of the interviews was developed during a workshop. The opening question was on what the CHFI represents. This was followed by the question on the knowledge, skills, professional behaviour and attitudes that the students gained in CHFI. Other questions were on more specific characteristics of CHFI, such as relevance and style of teaching, assessment and the instructors.

All interviews were implemented under the guidance of an experienced moderator (HH). An observer (IE) took written notes during the sessions. Both the moderator and the observer were not familiar with this cohort. At the beginning of the sessions, the moderator explained the aim of the interview and emphasised its confidentiality. Interviews were recorded to audiotapes.

All verbal data were transcribed from audiotape, supported by contemporary notes. Four of the authors organized the statements into codes and further into emergent categories encompassing the codes. All the data were compared with categories until a saturation point was reached where no further information was forthcoming (Strauss & Corbin 1990). To ensure reliability, this thematic analysis was done through a consensus-building process in which writing was coded independently. Subsequently, all four compared the codes and categories and so reached a final list of categories by consensus.

Results

Quantitative results

The 2005 and 2007 cohorts of students were similarly distributed with regard to gender, rural background and perceived level of income of their families (Table 1). There was no significant difference (t = 1.669; p = 0.96) between the mean ages (2005 cohort; 21.77 ± 0.96; 2007 cohort; 21.62 ± 1.07) of the groups.

Table 1.  Student's characteristics and intention on working in remote areas in 2005 and 2007 cohorts

Variable		2005 cohort (%)	2007 cohort (%)
Gender	Female	45.5	40.7	p > 0.05
	Male	54.5	59.3
Rural background	No	94.4	95.2	p > 0.05
	Yes	5.6	4.8
Perceived level of the	Very good + good	29.2	26.1	p > 0.05
income of her/his	Neither good nor bad	68.0	70.5
family	Very bad + bad	2.8	3.3
Intention on working	Yes	56.6	67.4	p < 0.05
in a remote area at any	No	25.1	14.2
time in her/his life	Undecided	18.3	18.4

A greater proportion of students in the 2007 cohort (67.4%) than in the 2005 cohort (56.6%) stated that they wanted to work in remote areas; the proportion of the uncertain students did not change (Table 1). Two students (0.8%) in the 2005 cohort and five students (2.1%) in the 2007 cohort declared that they wanted to work as a general practitioner in the future.

Figures 1–3 display error-bars of scores for the 2005 and 2007 cohorts on the educational objectives. Except for the objective related to team-work (p > 0.05) (Figure 2), which was classified under the health care title, all items yielded significantly higher scores in the 2007 cohort than in the 2005 cohort (p < 0.05). On the other hand, the evaluations of the 2007 cohort for all objectives were below 4. The highest objective score was obtained for the statement ‘CHFI made me understand the socio-cultural and environmental characteristics of my future patients’ (Figure 1).

Figure 1. Comparison of student scores for the learning objectives under ‘holistic care & evalution of health care needs’ in 2005 and 2007 cohorts.

Figure 2. Comparison of student scores for the learning objective under ‘health care’ in 2005 and 2007 cohorts.

Figure 3. Comparison of student scores for the learning objectives under ‘prevention’ in 2005 and 2007 cohorts.

Qualitative results

The focus group discussions and individual interviews yielded five major themes (understanding of CHFI; population perspective, attitudes and behaviours gained in CHFI; course design; style of teaching and learning; student performance assessment).

• 1. Understanding of CHFI

The majority of participant (22, 64.7%) had the view that despite its importance, community health and social aspects of medicine were not among the most engaging subjects. Some students stated that they perceive these subjects as matters of common sense or general culture.

Community health is something we always come across in life. It looks ordinary and simple. The topics are on subjects that we have been taught since elementary school, things we already know.

When the students were asked what the CHFI represents, most of the students (30, 88.2%) articulated the main subjects of CHFI, like the determinants of health and diseases in a global perspective, health promotion activities in population and principles of assessment of health care needs.

• 2. Population perspective, attitudes and behaviours gained in CHFI

The students (18, 52.9%) have noted that the topics they have studied in CHFI have made them more capable of assessing health events using a more critical approach. The students have implied that they have comprehended the necessity of analysing disease not only using their biomedical knowledge, but also taking into account the educational level, occupation, the environment and the housing of the patient when they are taking a history. Students (26, 76.5%) stated that CHFI gave a population perspective to their practice of medicine and improved their clinical work.

I have started to evaluate patients not only with their diseases but as a whole with their living environment, work, family and habits.

Even if you are a good doctor from the medical point of view, even if you treat patients, the more important point in the community health approach is to eradicate the source of the disease.

Some students (13, 38.3%) have implied that as a result of CHFI they could transfer their knowledge of health promotion topics to their relatives or friends and that they could give health education sessions on environmental health, preparedness for earthquakes, safe sex, immunization and nutrition.

• 3. Course design

Most participants (26, 76.5%) expressed the view that CHFI was relevant to other basic sciences and clinical subjects.

When studying digestion, we learned about water sanitation, food hygiene. When studying the respiratory system we learned about occupational diseases, air pollution. The integration was fine.

Students (19, 55.9%) made positive remarks on early contact with CHFI and expressed that community health learning should be continued also in the clinical clerkships. Students appreciated the course design's mixture of practice training and didactic lectures. However the students criticized the time lag between didactic lectures and related practices.

Those who attend practice sessions right after the didactic lectures are luckier; sometimes the time between sessions and lectures lengthens and therefore is less effective.

• 4. Style of teaching and learning

Didactic lectures were the most criticized component of CHFI. Students evaluated lectures as boring and since the participation was not compulsory, many of them chose not to attend the lectures.

Having theoretical lectures is a waste of time.

The lessons embedded in my memory are always the group activities; I don’t remember the theoretical lectures.

On the other hand, students appreciated the new ways of learning. Students expressed that the practice-based and interactive teaching methods used in small-group activities made learning easier. Community-based activities were evaluated as educative and fun.

Home visits made me understand the different problems that families are facing. The living conditions of some families shocked me.

Community-based activities were generally good with minor organizational troubles. That is understandable because we are too crowded.

Achieving something as a group is different; it makes you learn to respect the others and to work together.

Students also criticized themselves and reported that not everybody in the small groups, especially students who do not attend the lectures, contributes to the group discussions equally.

Our friends who do not attend the lectures are unfamiliar with the topic during the group activities, so they cannot comment on the topic.

Students (15, 44.1%) appreciated the faculties’ student-centred teaching approach.

• 5. Student Performance Assessment

Students found the questions of CHFI in multiple-choice exams very difficult, but approved the short-answer questions in quizzes. They have stated that they dislike doing assignments, find them time-consuming. They were unclear about the assessment criteria for the assignments.

Assignments are not quite necessary; I personally just do them to get a pass.

Discussion

A population perspective and attitudes towards medicine that medical students possess and later develop, depend on curriculum style and emphasis (Rolfe et al. 1999; Oandasan et al. 2000). Therefore it becomes important to study how desired attitudes and competences can be developed and the practice of social and preventive medicine may become more purposeful (Scott & Neighbor 1985). This paper describes the experience of a public health education program in a Turkish medical faculty that adopted a community-oriented curriculum in the year 2003. Our study which aimed to evaluate this program indicated important differences between the students exposed to community-oriented and traditional curricula. These differences were observed in their self-assessment on the level of achievement of learning objectives and in the intention to practise in remote areas. The study also provided valuable information on students' views regarding population health issues and community health education.

This study utilized a triangulated methodology. The quantitative findings indicated that the 2007 cohort achieved learning objectives at a higher level than the 2006 cohort for each of the three areas; i.e. holistic care and evaluation of the health care needs, health care, and prevention. The qualitative results supported the achievement of learning objectives in the 2007 cohort. The students articulated almost all of the main learning objectives and noted that they already started to use the skills they adopted in CHFI in clinical settings and everyday life. The comparison of two medical schools in Australia confirms our results (Rolfe et al. 1999). The students who were exposed to a community-oriented curriculum had significantly more positive attitudes towards different aspects of community medicine than the students who were exposed to a traditional curriculum. There was even a significant difference between the schools with regards to teamwork; this dimension of community health has been the lowest scored attitude for the students. The teamwork was the only learning objective that lacked significant difference for the two cohorts in Ege University. This may have resulted from the fact that our students have few opportunities to participate in multi-professional education.

Graduating physicians who are responsive to community health needs and willing to work in underserved areas is one of the prime goals of community-oriented education (Mennin & Petroni-Mennin 2006; Magzoub & Schmidt 2000). In this study, the ratio of students who were willing to work in a remote area was higher for the 2007 cohort. This finding is consistent with the studies which show that community-oriented training programmes and educational activities at primary care or remote areas increase the possibility of choosing to serve at regions of deprivation (Henderson et al. 2002; Senf et al. 2003; Curran & Rourke 2004; Veitch et al. 2006). The ratio determined in the 2007 cohort is almost identical to the results of the first year (66%) and sixth year (64%) students of The Medical School of James Cook University in Australia (Veitch et al. 2006). However the question asked of EUMF students was formulated as ‘Would you like to serve as a physician in a remote area in any period of time in your life?’ For that reason this ratio might include students who would like to work in remote areas only for a limited period of their lives. Furthermore our students do not want to serve the primary care level. This may be related to the low proportion of community-based activities within the curriculum. The health system which promotes specialization and has a market-oriented approach may be an important factor that determines the choices of our students, similar to what is reported in other countries (Mariolis et al. 2007; Glick & Prywes 2000).

Woodward reported that undergraduate medical students are primarily interested in the diagnosis and treatment of individual cases; population-based health care is seldom regarded as important (Woodward 1994; Rêgo & Dick 2005). It was reported that students might be afraid that focusing on population health issues could compromise their ability to practise acute medicine (Rêgo & Dick 2005). The qualitative data of the current study indicated that our students' attitudes towards community health issues were not negative overall. Our students have stated that the topics discussed in CHFI have changed their point of view and that they have started using this knowledge in clinical settings. However, similar to the students in Queensland School of Medicine, our students perceived the community health issues to be matters of common sense or general culture (Rêgo & Dick 2005). This may be related to the historical dominance of basic and clinical sciences within medical programmes and the assimilation of students into a 'culture of objectivity'. Rêgo & Dick (2005) also noted that the students' educational backgrounds might influence their attitude towards population health issues. Our students have an educational background dominated by natural sciences, one not balanced with the social sciences. Besides, they succeeded in entering medical school through an exam based on these disciplines. These factors could have made it difficult for them to understand community health topics.

Previous studies suggested that the community health issues should be delivered in a way that demonstrates their clinical relevance (Maudsley 2003; Whelan & Black 2007). Our students found CHFI relevant with regards to other basic and clinical subjects. The use of curriculum mapping in EUMF, have made it simpler for students to understand the relevance of community health to clinical practice. Curriculum mapping might be of as much benefit to faculty as it is to students. Involvement of the Public Health Department in the curriculum development process provided the faculty with a holistic overview of the structure and delivery of the curriculum. However the faculty from other disciplines who took responsibility for planning but no role in lecturing of CHFI, have obstructed the complete integration that could be achieved. On the other hand, it was emphasized that if other faculty, who have a clinical or basic science background are unclear about the content and importance of population health issues, then they are unlikely to feel comfortable in teaching these topics (Rêgo & Dick 2005). The fact that the community health lectures are delivered only by the public health department faculty has prevented problems that could arise from lack of standardization and difference in context. The sessions in which faculty from other disciplines cooperated and discussed clinical topics, have supported integration.

In EUMF an important part of public health education is devoted to student-centred learning activities like small-group discussions and community-based activities. Our students appreciated these learning methods and suggested that the proportion of activities should be increased and didactic lectures decreased. Although the lecturers of Public Health Department have participated in the ‘training the teachers’ programme, since the number of the students in didactic lectures might be around 300 they did not generally use innovative methods. But this feedback of students indicates that we should more adopt case studies to our lectures in order to emphasize the clinical relevance. In order to provide an interactive learning environment, we also used assessment methods that encourage active learning and promote critical analytic skills of students. However our students dislike performance assessments with MCQ and essay questions which require more systematic and in-depth thinking. Moreover the students found their homework time consuming and tiring. When one considers that the majority of our students have educational backgrounds which rarely use strategies that encourage synthesis of all related information, it is expected that they might well have difficulties with problem-solving activities. Moreover, essay questions should have reliable and fair scoring criteria and students should exactly know what is expected of them (Reiner et al. 2002). The essay questions in CHFI need improvement in this respect. In addition, some other complex learning outcomes which can be more directly assessed with other methods (e.g. performance assessment, simulations) instead of essay questions may be used in CHFI (Reiner et al. 2002).

Within the concept of community-oriented medical education there is a wide spectrum of potential models, from community-orientation within a more traditional course to one where the course is entirely set within the community (Hays 2007). Our curriculum takes the priority health problems of our country into consideration and includes a small number of learning activities that take place within the community. However the length of time spent learning in communities is important in order to guarantee that the students will learn about the whole patient and deal with the social, financial, environmental, political and ethical aspects of medical care (Mennin et al. 2000). If there had been more community-based activities in our curriculum, then the level of achievement of learning objectives and the percentage of students choosing to work in remote areas and in primary care could have been higher.

The most important challenge we encountered during the implementation of CHFI was the large number of students. In order to overcome this problem, we repeated the group activities eight or twelve times, so there was in total more time allocated to community health education when compared with the former curriculum. For that reason some of the other faculty members started to see CHFI as a threat for the time allocated for their subjects and have articulated their feelings to the students. Some studies have shown that student attitudes towards educational reform may be ambivalent in the early stages and that innovation may be resisted especially if different learning cultures exist within the same curriculum (Rosenthal & Ogden 1998; Preston-Whyte & Fraser 1997). The stability of our school administration and curriculum development committee about the continuation of CHFI was the most important support for the sustainability of our program.

In the present study, the triangulation of research methods integration of quantitative and qualitative methods provided a synergistic effect in interpreting results. Qualitative methods used two complementary techniques, focus groups and in-depth interviews. We used focus groups because the interaction is important in drawing data on relevant issues and exposing divergence between the different groups (Moffat et al. 2004). Since focus groups can sometimes be dominated by certain participants (Moffat et al. 2004) we also carried out individual in-depth interviews in order to obtain a full perspective of opinions and to allow students to speak outside the focus group situation. This approach facilitated triangulation of data, which is important in establishing the validity of findings (Moffat et al. 2004). One of the strengths of this study was the comparison of two cohorts exposed to traditional and community-oriented curricula. The two cohorts were similar with respect to their sociodemographic features and selection criteria for entering medical school; thus, some of the difference in achievement levels of learning objectives can be attributed to the educational intervention. There are a number of limitations of our study, however. The responses represent students’ self-reports of their level of achievement of learning objectives, and do not necessarily reflect what they will actually do in their future practice. Therefore a long-term evaluation of the CHFI with a longitudinal design is needed to measure the final competence of the students. Moreover since all of the items in the questionnaire were positively stated, the results may have a response acquiescence bias (Carr & Krause 1978). The possibility of bias threatens also the validity of our qualitative data. Students may have felt that they should respond to questions in a socially desirable or 'community-oriented' manner. Additionally, although the qualitative data was analysed separately by four of the authors, the fact that two of them were members of the public health department might also have caused some bias.

We present these findings with the hope that other educators in public health may find learning about our experiences useful during the process of changing a traditional curriculum to an innovative and community-oriented one. This study has shown that a community-oriented approach is more effective in achieving learning objectives than the traditional curriculum and is more acceptable to the students. Although students consider public health topics as ‘common sense’, they have comprehended their relevance to clinical knowledge. Increasing the share of community-based educational activities, and improving assessment methods in order to achieve in-depth learning would ensure that students acquire a holistic view of health problems.

Ethical approval

Necessary permission was granted by the Education Committee of the School of Medicine since this study is part of the new medical curriculum. No ethical approval was sought because of the anonymous nature of this study.

Declaration of interest: The authors would like to thank the students who participated in this study. The study was funded by Ege University Science and Technology Center.

Additional information

Notes on contributors

Zeliha A. Öcek

ZELIHA ÖCEK, PhD, is an Assistant Professor in the Department of Public Health and a Member of Council of Block 3, Ege University Medical Faculty.

Meltem ÇiÇeklioğlu

MELTEM CICEKLIOGLU, MD, M.Ed is an Associate Professor in the Department of Public Health and a Member of Council of Block 4, Ege University Medical Faculty. She has a master's degree in educational program and teaching.

Şafak Taner Gürsoy

SAFAK TANER GURSOY, MD, PhD is an Assistant Professor in the Department of Public Health, and a Member of Council of Block 1, Ege University Medical Faculty.

Feride Aksu

FERIDE AKSU, MD, is a Professor in the Department of Public Health, a Member of Education Council, the Head of Department of Public Health and Former Head of Department of Medical Education.

Meral Türk Soyer

MERAL TURK SOYER, MD, is an Assistant Professor and a Member of Council of Block 2, Ege University Medical Faculty.

Hür Hassoy

HUR HASSOY, MD, is a Specialist in the Department of Public Health, Ege University Medical Faculty.

Işıl Ergin

IŞIL ERGIN, MD, is a Specialist in the Department of Public Health, Ege University Medical Faculty.

Abdullah Sayıner

ABDULLAH SAYINER, MD, is a Professor in the Department of Chest Diseases and Former Vice Dean, Ege University Medical Faculty.

Gülşen Kandiloğlu

GÜLŞEN KANDILOĞLU, MD, is a Professor in the Department of Pathology, Head of Department of Pathology, Former Head of Education Council and Former Head of Department of Medical Education, Ege University.