|LETTER TO THE EDITOR
|Year : 2011 | Volume
| Issue : 1 | Page : 491
Photo-elicitation as a Public Health Teaching and Learning Tool
Amol R Dongre
Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India
|Date of Submission||23-May-2010|
|Date of Acceptance||06-Dec-2010|
|Date of Web Publication||29-Apr-2011|
Amol R Dongre
Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Dongre AR. Photo-elicitation as a Public Health Teaching and Learning Tool. Educ Health 2011;24:491
In India, the need for student-centered, problem-oriented and community-based training of public health for medical undergraduates has been emphasized by the World Health Organization Country Office1. Active involvement of students during field visits presents an opportunity for the quick orientation of students to common public health problems2. Photo-elicitation is a teaching tool based on the principle of using one or more images, paintings or any other type of visual representation in an interview and asking informants to comment on them. The images can be produced by the informant or provided by the researcher3. This letter describes how using a photo-elicitation process engages medical undergraduates to promote discussion between students, community members and faculty on public health problems.
The present pilot formative research was done at the Department of Community Medicine at the Sri Manakula Vinayagar Medical College and Hospital in rural Pondicherry (renamed Puducherry), a union territory of India. Out of 130 students in the third semester, a class of 20 students posted in the department was taken to a nearby village for field visits. Students were divided into five small, self-managed groups, and each group was asked to take a brief walk in the village to interact with the local community. Students were asked to take photographs on their mobile phone cameras of a situation which, according to them, was a visible public health problem in that locality. A physician faculty member in Community Medicine and a social worker accompanied the students and observed the process.
After a one hour visit in the village, faculty and students returned to the classroom. Student groups were then asked to write a brief note using their photographs and field observations. Following this, the group was invited to reflect on their photographs and discuss observations. In a subsequent plenary session, each group made a brief presentation of their work and shared their learning perspectives with the others.
Data were collected in the form of faculty’s field observations, students’ brief reports and notes taken during group presentations and discussion. The content analysis of data was undertaken to understand what was observed by students, what was noted by faculty and what was discussed. Students were informed about the exercise and gave their written consent to have the collected information analyzed. Permission from both the director of the Medical College and the local village leader was also obtained.
Students captured photographs of scenarios like traditional methods of cooking and agricultural work, a roadside fish seller, a water tank, heaps of garbage and stagnant water near a hand pump and an old lady chewing betel nuts. The process of photo-elicitation and its interpretation by the students offered an opportunity to promote discussion and bridge gaps in interpretation between students and faculty. A brief discussion was also held on topics that escaped the students’ attention such as indoor air pollution, hygiene, sanitation, vector breeding, organic farming for land biodiversity and addictions affecting oral health (Table 1).
Table 1: Description of the process and outcomes of photo-elicitation in medical student learning
Overall, this exercise actively engaged the students, while ensuring dialog between them, community members, peers and faculty. Since the students were new to the subject of Community Medicine, their observations and interpretations were limited, but this gap served as a guide for faculty to facilitate the discussion. Photographs allowed students to recall their field observations, and the group work promoted collaboration with their colleagues.
The exercise in photo-elicitation provided a glimpse into how using student-generated visual data can lead to a dialog between students and faculty, while offering an opportunity to direct students’ attention to topics that have previously eluded them. Photo-elicitation has attracted modest attention in qualitative health research, sociological, anthropological investigations and nursing education, but its application in medical education has, to-date, been limited4,5.
Students usually have little control over what, and how, they are taught. In this exercise, text and images were utilized to promote students’ active participation and communication of what they saw. In this learning approach, students had to take responsibility for their education, which is one of the recent recommendations of the World Federation of Medical Education6. As a student-driven exercise, photo-elicitation may raise unanticipated topics for discussion; hence faculty need to be flexible and ready to facilitate new emerging topics or direct the focus onto missed observations, utilizing their knowledge and experiences.
In summary, this use of the photo-elicitation technique helped to raise issues that were otherwise missed by the students and facilitated a discussion to bridge the observation/interpretation gaps between students and faculty. It also offered students a practical exposure to skills of observation and interpretation on a visible public health problem of their choosing.
Amol R. Dongre
Associate Professor, Department of Community Medicine
Sri Manakula Vinayagar Medical College and Hospital, Madagedipeth, India
1. Garg BS, Zodpey S. Status paper on public health courses in India. World Health Organization Country Office - India. New Delhi; 2006.
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3. Bignante E. The use of photo-elicitation in field research. EchoGeo, 2010; 11. (Online) Available at http://echogeo.revues.org/11622
4. Banks M. Using visual data in qualitative research. Singapore: SAGE publications Asia-Pacific Pvt. Ltd; 2009.
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6. Lorenz LS, Kolb B. Involving the public through participatory visual research methods. Health Expectations. 2009; 12(3):262-274.