Verifying the curriculum of a family medicine clerkship

The learning experience during a medical school clinical rotation is largely shaped by students' patient encounters. This paper reports on how a log system for recording these encounters can be used for course planning and evaluation. Over the past 5 years, 960 third-year students completed log forms based on their clinical encounters during a required 4-week family medicine clerkship at UT Southwestern. These forms were then optically scanned and the information entered into a computerized database. Log form data revealed that the most common medical problems encountered by students in their ambulatory settings were similar to those reported in the general family practice literature. There was a great deal of consistency in the types of encounters from year to year. The data also showed some differences among clerkship sites in terms of patient demographics and the most frequently reported diagnoses. Information generated from student log forms has been used by the clerkship faculty to determine required readings, prioritize didactic topics and other teaching, adjust curriculum content, prepare support materials and develop examinations. Given the utility of the information obtained and the ease of use of optical mark encounter sheets, we recommend this system for other clerkships.     

An integrated sociocultural curriculum for community medicine in Bali, Indonesia

Since 1983, social scientists have collaborated with teaching staff at the Faculty of Medicine, Udayana University, Bali, Indonesia, to develop an integrated sociocultural curriculum for undergraduate students in community health. The Udayana curriculum is discussed in the context of an international commitment over the last two decades to appropriate education for primary health care and community health in developing countries. The authors describe their work as consultants with Udayana staff. Participants formulated a five-stage project of curriculum development and community health research that could be continued as part of an ongoing community medicine teaching program. Recommendations for integrating social science perspectives within medical domains are outlined, based on the project experience. The paper also discusses the undertaking as a 'development project' suggesting that many of the issues and problems that arose are common to bureaucratic institutions in Third World countries when development projects are initiated.     

A structured experiential curriculum in community medicine.

In order to provide experimental training in community medicine, a structured curriculum has been developed. Specific methodological skills in community medicine are identified and nine content areas are presented in seminar form during the three-year training program. Each resident is expected to participate in a community health care project and demonstrate one or more of the methodological skills identified. The experiences of two residents are reported. One involved a community health needs assessment and one, the development of a mechanism to ensure continuing consumer/provider communication.     

Future family physicians get early community contact in Morehouse curriculum

The pre-clinical curriculum of the Morehouse School of Medicine is unique in several ways. One of the ways in which this curriculum is unique is the manner in which it has involved practicing physicians in the education of medical students during their first two years of medical school. Throughout the country, many physicians have expressed an interest in this involvement of community physicians in the teaching of medical students during what might be their most impressionable period of development. The article which follows describes concisely the development of Community Medicine and Family Practice at the Morehouse School of Medicine, highlighting the issues which relate to the role of community physicians in the teaching of medical students during the pre-clinical years. It is the contention of Morehouse officials that the involvement of practicing physicians in the early education of medical students is very important and that it does not necessitate a compromise of the basic science education which is taking place at this time.     

Nutrition clinic: an integral component of an undergraduate curriculum

Piloted in 1972 in collaboration with the University Health Services, Pennsylvania State University's Nutrition Clinic and Consultation Center was designed to provide supervised beginning counseling experiences for undergraduate nutrition students, a nutrition counseling service for university students and area residents, and an applied research program. The clinic program has evolved over time and has received enthusiastic response from students, clients, health professionals, faculty, and university administration. The clinic has now become an integral part of the University Health Services program, an essential element in the undergraduate curriculum, a contributing factor in graduate education, and a nutrition counseling resource for area residents and physicians. The staff has identified several research and communication needs and fostered an interdisciplinary counseling skills research program. In addition, the clinic investment has stimulated more applied nutrition experiences for students and raised nutrition consciousness levels throughout the university and the community. Elements of this model can be adapted to available budgetary and academic resources.     

The parallel rural community curriculum: an integrated clinical curriculum based in rural general practice

INTRODUCTION: In an attempt to address the rural medical workforce maldistribution and the concurrent inappropriate caseload at the urban tertiary teaching hospitals, Flinders University and the Riverland Division of General Practice decided to pilot, in 1997, an entire year of undergraduate clinical curriculum in Australian rural general practice. This program is called the Parallel Rural Community Curriculum (PRCC). This paper is a discussion of the aims of the programme; student selection; practice recruitment; curriculum structure, and academic content, together with lessons learnt from the evaluation of the first cohort of students' experience of the course. METHODS: Independent external evaluators undertook a thematic analysis of a series of structured interviews of students and faculty involved in both the PRCC and the traditional curriculum. The mean examination results were determined and a rank order comparison of student academic performance was undertaken. RESULTS: The eight selected volunteer students reported greater access to patients and clinical learning opportunities than their mainstream counterparts and learned clinical decision making in the context of the whole patient, their family, and the available community resources. They identified patients with 'core' clinical conditions and had a longitudinal exposure to common diseases, whereas hospital-based peers had a cross-sectional exposure to highly filtered illness. The PRCC students' academic performance improved in comparison with that of their tertiary hospital peers' and in comparison to their own results in previous years. CONCLUSION: The PRCC curriculum has cut across the traditional clinical discipline boundaries by teaching in an integrated way in rural general practice. It has affirmed the potential role of true generalist physicians in undergraduate medical education.     

片医制社区医疗健康管理效果观察

目的观察片医制社区医疗健康管理效果。方法经八路社区糖尿病患者480例以片医片护一结合的形式进行社区医疗健康管理,问卷调查入组时及实施健康管理后6个月其自我管理状况。结果对社区糖尿病人群开展糖尿病健康管理后,其自我管理状况显著优于教育前,差异有统计学意义（P〈0．05）。结论通过片医片护一结合长期系统的糖尿病健康教育,可以提高患者掌握糖尿病知识的程度和治疗的依从性。