# The curative-to-preventive perspective shift of medical students through community dementia programs: a qualitative study based on transformative learning theory

## TL;DR

This study shows how community dementia programs help medical students shift from focusing on treatment to prevention, using transformative learning theory.

## Contribution

The study introduces a framework for medical education that uses transformative learning to shift students from curative to preventive healthcare perspectives.

## Key findings

- Medical students experienced cognitive awakening and reflection through disorienting dilemmas and self-examination.
- Participation in community programs enhanced students' preventive knowledge and practical skills.
- Transformative learning theory effectively guided a shift in students' professional identity toward prevention.

## Abstract

Preventive healthcare has become a global health priority, yet a significant implementation gap persists in community settings. Traditional medical education predominantly emphasizes curative approaches, inadequately preparing students for the growing demands of community-based preventive care. With the rising prevalence of dementia, a condition where early intervention and prevention strategies are crucial, there is an urgent need to shift medical students’ perspectives from treatment-focused to prevention-oriented practice. This study aimed to explore how medical students’ participation in community dementia prevention programs facilitated their curative-to-preventive perspective shift, using transformative learning theory (TLT) as the conceptual framework.

A qualitative descriptive design was employed, conducting semi-structured interviews with 21 medical students from community dementia prevention programs at a medical university in Guizhou Province, China. Data analysis utilized Braun and Clarke’s deductive thematic analysis framework guided by TLT.

The study identified four major themes and 11 sub-themes. The themes included: (1) Cognitive awakening and reflection, encompassing encountering disorienting dilemmas, self-examination and critical reflection, and role perception transformation; (2) Skill acquisition, including building preventive knowledge frameworks, community intervention design, and development of practical skills; (3) Practice integration and role reconstruction, comprising health promoter role practice, prevention practice capabilities enhancement, and professional identity evolution in prevention; (4) Personal experience-driven preventive healthcare awakening, including impact of family dementia experience and experience-triggered preventive awareness.

This qualitative study identified four themes characterizing medical students’ transformative learning (TL) journey in community dementia prevention programs. The synergistic interaction between structured TLT-based progression and experiential pathways facilitated students’ paradigm shift from treatment-centered to prevention-focused healthcare approaches. Our findings recommend that medical educators should intentionally design learning environments that incorporate TLT, integrate community-based practice into core curricula through problem-driven approaches, and systematically leverage students’ personal experiences to foster critical reflection and enhance learning motivation, thereby preparing future healthcare professionals to serve as prevention-oriented change agents.