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.