Critical Analysis: COBES Influence on Rural Workplace Selection

This critical review assesses a research article focusing on the perceived usefulness of Community Based Education and Services (COBES) in influencing medical students' rural workplace choices. The review covers the article's abstract, introduction, methodological rigor, results, and discussion, evaluating the study's design, data collection methods, and the validity of its conclusions. The study included stakeholders of COBES which consisted of the medical students, lecturers, health facility staffs and the community members. It highlights the impact of COBES on students' career preferences and their willingness to work in rural areas, while also noting limitations such as the focus on a single school in Ghana and the exclusion of perspectives from students post-graduation. The review concludes that while the study provides valuable insights, its generalizability is limited due to these factors.

Running head: CRITICAL REVIEW
Critical Review
Name of the Student:
Name of the University:
Author Note:

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Abstract
The title of the article is informative and is able to convey the information by targeting the exact
audience. The abstract section itself has provided a detailed information of the results little
insights into the background, method and the conclusion section. The title is appropriate
considering the fact that it can portray the objective and the research question of the study. The
paper is presented in a consistent way with the abstract providing an overall insight into the
study, and the paper is written is a proper structured way that can be helpful in replicability of
the methods.

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Introduction
The Community Based Education and Service (COBES) has been described as learning
activities that the utilizes the community as an active learning environment. This learning
environment not only consists of the students but also the members of the community, teacher,
several representatives of the other sectors that play an active part in the educational experience
of the student. The introduction section also highlights the students under the COBES
programme in the early part of the training are actively exposed to the primary health and the
public health needs of the communities that are living in the rural areas. This article lacks a
proper introduction section, whereas It has been substituted by a background section that
highlights what COBES is all about and the main focus of the article is also seen in this section
(Amalba et al., 2016).
Secondly, it has been highlighted in the article that the healthcare professionals in Ghana
have migrated towards the cities and it has created similar situation like brain drain. This has
deprived the country of the modern provisions of healthcare. Presently, the attention is paid on
the retaining and educating the medical doctors in Africa. The clarity of the introduction is well
evident in the above sections and it has provided a basis or the focus of the study.
Methodological Rigour
It is important to highlight that the study included the stakeholders of COBES which
consisted of the medical students, lecturers, health facility staffs and the community members.
The Inclusion criteria for the study included the young community members that were above the
age of 18 years. women leader’s advocates, youth leaders, and political leaders of the community
that have lived in the community for an immediate 5 years. The Medical students that were

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explicitly included for the study were the medical student of the 3rd and the 4th year. The reason
cited for not considering the second year medical students because they did not meet the criteria
of visiting the community twice. Considering the vastness of the communities and the wide
number of districts, the author has used a multistage random sampling technique has been used
to select the two communities and 4 districts. While the sampling process is apt considering the
fact that the in each of the district, 3 to 4 communities have been selected so that the students can
be posted based upon the previous criteria. A total of 4 districts have been selected through the
lottery process and again for the community selection, a random process is employed to select
two communities among the randomly selected districts. Therefore, the process followed by the
authors needs to be praised because any doubt of biasness has been eliminated by the process of
randomization and lottery. The lecturers are also qualified individuals that have previous
experiences of handling the COBES programme and also provided guidance to the students by
participating in the previous assessments or being district coordinators. The purpose of the study
was explained in a detailed way to all the participants and like the same way informed consents
were taken from the participants before their participation. Written consent form the participants
is a must step whenever human subjects are taken into consideration. Furthermore, the
methodology of the study incorporated the aspects of anonymity and confidentiality for the
participants (Durning & Carline, 2015). The data collection used for the study involved the open
ended questionnaires, interviews and the focus group discussions for the data collection. The
three forms of data collection techniques are performed to collect data from the desired
population, and the purpose is to reflect the ground reality. While it is important to note that the
questionnaires, focus group discussions and the interviews are conducted at the different levels.
This was done to engage with the different levels of the stakeholders. While the focus group

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discussion was done for the convenience of the female members of the community. The key
informant interviews can be considered as a personalised approach of data collection that
focused on the individual grievances and choices.
Therefore, going through the methods section it can be said that the methodology
followed can be replicated because the procedure of the study focussed on randomization and
data collection techniques that do not required much resource.
Results
The study is a qualitative research and it can be considered from the qualitative study of
the guided interviews, focus group discussion and from the open ended questionnaires. It is
important to mention that there are 170 questionnaires and 134 responded and majority of the
respondents were male responders that belonged from the 3rd and the 4th year. It is a highlighting
fact that about 45 percent of the students have indicated that COBES will definitely influence
their choice of career and at the same time 444 percent has also indicated that COBES will
influence their career. While 60 percent of the students have indicated that COBES will
influence their location of practice. Similarly, it has been highlighted by the females that the
COBES is unable to influence their choice of speciality. The students in the fourth year are likely
to have reported that COBES is beneficial in comparison to the third year students. The results of
the focus group discussion and interviews have highlighted that the COBES helps in the
promotion of the health education and promotion, serves as a role model for the younger
populations, provides service to the community, the students get benefited from the different
types of activities in the communities due to COBES (Kuper, Lingard & Levinson, 2008).

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The results of the study are indicated accurately through the actual representation of the
data through the SPSS analysis. The results summary highly focuses on the choices the students
and the students are influenced by the COBES programme. The data is represented by the usage
of only a single table which summarized all the data. However, the study has also highlighted
some of the interview responses that directly shape the flow of the study and representation. It is
important to mention that the research question was based on the why the brain drain is occurring
within the health professionals in Africa and how this can be reduced through effective means.
The results have a clear relation with the methodologies that are used in the study process. The
results of the study propose clear and transparent implications that can be effectively used and
implemented to receive the benefits in the African health sector (Amalba et al., 2016).
Discussion
The discussion section has highlighted that the 60 percent of the students have
highlighted that their experience with the COBES have influenced the preference of location of
practice. Majority of the students have indicated that they are willing to work in the rural areas.
the highlighted fact is that the COBES can be used effectively to help the healthcare
professionals to get acclimatized and prepare themselves to work in the rural area and it will help
bring the and equal distribution of the healthcare professionals so that the rural communities can
be benefitted. Even after the conduct of the COBES programme in the rural areas, it is important
to mention that there must be an urge of the healthcare professionals to choose the rural area and
he choice of the career. The discussion section has a direct connection with the results and the
background section. However, it has missed to highlight anything from the methodology section,
which is justiciable due to the reflection of the methodology in the results section (Kuper,
Lingard & Levinson, 2008).

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The major limitation of the study presents that the students of third and the fourth year
are only included in the study. It is important to note that the students that have participated in
the COBES activities have done that for almost two consecutive years and this will definitely the
mind-set of the student. However, the highlighting fact is that perception and views of the
students might change after their graduation (Amalba et al., 2016). The authors have failed to
take this progress into the study. Furthermore, the study has been carried out in a single school in
Ghana which makes it difficult to generalize the study. The study has been connected with the
other research works and have highlighted the practical implications perfectly (Lingard, 2015).
Overall evaluation
To study has a consistent flow and the sections are built well based on the findings. The
results section has mentioned some of important responses of the interviews. However, the
limitations of the study will hinder in the generalization and higher degree of applicability.

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Reference
Amalba, A., van Mook, W. N. K. A., Mogre, V., & Scherpbier, A. J. J. A. (2016). The perceived
usefulness of community based education and services (COBES) regarding students’
rural workplace choices. BMC Medical Education, 16, 130.
Durning, S. J. & Carline, J. D. (Eds.) (2015). Review Criteria for Research Manuscripts (2nd
ed.)
Kuper, A., Lingard, L. & Levinson, W. (2008) Critically appraising qualitative research. British
Medical Journal, 337, 687-689.
Lingard, L. (2015). Joining a conversation: the problem/gap/hook heuristic. Perspectives on
Medical Education, 4, 252-253.