Identifying the need for curriculum change. When a rural training program needs reform.

OBJECTIVE

To identify what changes should be made in the University of British Columbia's rural family practice training program curriculum to help graduates be better prepared to practice.

DESIGN

Two cross-sectional surveys via mailed questionnaires: one designed to measure physicians' self-reported preparedness for practice and the other to measure the importance of various rural family medicine components.

SETTING

Rural training program graduates and preceptors representing rural communities in British Columbia.

PARTICIPANTS

Thirty-nine graduates of the rural training program between 1982 and 1991 and 14 community-based rural training program preceptors representing eight communities throughout the province participated in this study.

MAIN OUTCOME MEASURES

Percentage of graduates of the rural program who reported themselves to be underprepared on each family practice item and preceptors' mean scores for the attributed importance to rural practice of each item on this questionnaire.

RESULTS

A list of curriculum areas most in need of reform was created. This list included trauma, counseling skills, radiology, vacuum extraction, fracture care, exercising community leadership, cost-effective use of diagnostic tests, using community health resources, obtaining hospital privileges, ophthalmology, dermatology, otolaryngology, personal and professional growth, relationships with other physicians, and personnel issues.

CONCLUSIONS

Using both the level of graduates' self-reported underpreparedness and the attributed importance of elements of rural practice, as indicated by the preceptor survey, we developed a list of the areas of the rural training program curriculum most in need of reform.