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Using immediate reflections of patient encounters
to identify medical curriculum objectives and continuing education
needs
David A. Keegan, MD. The Schulich School of Medicine, University
of Western Ontario
Objective: To develop a structure for prospective analysis
of patient encounters by a rural family physician (RFP) with a broad
clinical practice to identify reference themes for undergraduate
and family medicine residency curricula.
Methods: Consecutive patient encounters were analyzed
(immediately following each encounter) by the RFP, recording demographic
information and diagnoses. Concepts considered after each patient
encounter in each of the following categories were recorded: basic
science of the healthy individual, illness development, therapeutics,
management plan, and health promotion.
Results: 442 sequential patient encounters were recorded
over 11 days in a rural community. The data collection method was
intuitive and easily integrated within clinical practice. This process
also yielded the unanticipated benefit of identifying continuing
education needs for the study RFP.
Conclusions: The basic science and clinical concepts
that an RFP considers while providing medical care can be clearly
identified, serving as an excellent reference for undergraduate
and family medicine residency curriculum design. Knowledge gaps
are also identified in this prospective analytical approach, thereby
directing personalized continuing education.
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