Development of a competency-based approach to teaching preventive medicine

A collaborative project to develop a competency-based curriculum and associated instructional materials for teaching preventive medicine to medical students has been undertaken by the Association of Teachers of Preventive Medicine in cooperation with the Center for Educational Development in Health at Boston University. A general model of physician responsibilities in the preventive dimension of clinical practice was elaborated and specific performance objectives were delineated. Specifications of physician performance were verified through Delphi and questionnaire surveys among approximately 100 practicing physicians. Three facets of physician performance emerged as warranting special attention: planning a practice-based program of clinical prevention, adapting the program to the needs of individual patients, and assisting patients to modify behavior patterns. Competency-based educational objectives were derived from the physician performance objectives. An instructional system to facilitate attainment of these objectives is under development. It incorporates five modules based on the following themes: the epidemiologic basis of clinical prevention, methods of clinical prevention, management planning for preventive services, clinical health and risk appraisal, and intervention for behavior change. Each module consists of units of instruction which specify expected learning outcomes, provide guidelines for evaluation of student performance, and recommend appropriate learning activities and resources.