Healthcare students’ prevention training in a sanitary service: analysis of health education interventions in schools of the Grenoble academy | BMC Medical Education

Design of the study

This was a cross-sectional study aimed at describing the health education interventions carried out by UGA sanitary service students between November 2021 and January 2022 in schools at the Grenoble academy, which covered 5 departments with a population of 3.35 million and 619,719 pupils.

The UGA sanitary service

The sanitary service involved students in medicine (3rd year), pharmacy (5th year), physiotherapy (4th year), maieutic (2nd year), and nursing (3rd year). Students received theoretical and practical training in health education methods.

Basic knowledge was provided through 20 to 30 h of online courses, in the form of commented slide shows divided into seven modules. Two modules introduce the determinants of health, the concepts of health education and the role of the school in health promotion. The other five modules deal with specific prevention themes: addictive behaviors, nutrition and physical activity, sexual health, mental health and vaccinations.

For the practical training, a two-day seminar was organized. Derived from the Unplugged programme, the seminar presented, in an interactive mode, an approach to health education through the development of psychosocial competences. Students were invited to experiment with tools and animation activities that contribute to group reflection and exchange on a chosen prevention theme.

The students were divided into small groups (16 to 20) and supervised by two instructors. The instructors were healthcare professionals from the same five disciplines as the sanitary service students. The students were grouped according to their host structures. They were assigned to the placements according to an algorithm that took into account their wishes, the number of students desired by each structure, and their original field of study, with the aim of forming multi-professional groups.

At the end of the seminar, the students contacted the host establishment to discover the context, analyze the request and plan their intervention during November, December and January. The theme of the intervention was chosen according to the needs identified by the school, as perceived by the teachers, particularly the head teacher.

After having designed their sessions and had their intervention plan validated by the pedagogical referent, the students had to deliver the intervention in the school. One pair of students is responsible for conducting 5 interactive and progressive sessions with the same group of pupils (class or half of a class) under the supervision of a national education professional. These sessions were meant to contain “ice-breaker” activities (playful and collective activities aimed at energizing the group, improving its cohesion and generating a friendly climate), and interactive reflective activities such as workshops, group games or aimed debates at developing the pupils ‘ psychosocial competences. At the end of the session, the students had their interventions evaluated by the pupils. Each group of students assigned to the same school wrote an intervention report according to a predefined format and submitted it to UGA for validation of the internship.

Study populations

The study focused on groups of students who intervened in schools (nursery schools, primary schools, secondary schools, or high schools). Student groups working in non-school settings (universities, associations, public services) were excluded from the study.

data collection

The intervention reports were read and analyzed by two independent evaluators, MK and PF, epidemiologist physicians, and the information of interest was transcribed on a standardized form (see appendix).

General information includes the composition of the student group, the school, the grade level involved and the number of pupils receiving the intervention. Information on the preparation of the intervention includes analysis of the request, details of the literature search and the appropriateness of the intervention plan. Information on the content of the intervention includes the theme of the intervention, ice-breaker activities and interactive reflective activities. Depending on the tools and activities used, the evaluators identified and rated the psychosocial competences mobilized among the relevant cognitive, social or emotional skills. Organizational information includes the number and duration of health education sessions delivered for a class, and the time spent preparing the intervention, on transportation and on working with pupils. The presence of an evaluation of the intervention by the pupils and the results of this evaluation were recorded. After comparing the forms, the discrepancies between evaluators were resolved by consensus after re-reading the report and the data were entered into an Excel file. This file does not contain any direct or indirect identifiers of pupils and schools.

statistical analysis

Qualitative variables were described by proportions and their 95% confidence intervals; quantitative variables by median and 25th-75th percentiles.

Associations between variables were analyzed using the chi² test or Fisher’s exact probability test if necessary, for qualitative variables; Student’s t test or Wilcoxon non-parametric test, for quantitative variables. Missing data were not replaced. The threshold of statistical significance was set at 5%, in a two-sided situation.

Analyzes were performed with Stata SE software (version 15.0 or later, StataCorp, College Station, TX, USA).