Orientation to community in a family practice residency program.

BACKGROUND

Family practice residencies are expected to include opportunities for trainees to learn about population-based approaches to health care delivery.

METHODS

To prepare them for community projects later in training, first-year residents were introduced to a community-oriented primary care (COPC) curriculum by an interdisciplinary team with representatives from public health and academic family medicine. During their mid-year orientation month, the residents spent three afternoons in community settings, each year focusing on a different public health issue. The residents spent the first afternoon discussing principles of community medicine, the COPC model, and planning community interviews. The second afternoon, they interviewed in the community. The residents reported and evaluated on the third afternoon.

RESULTS

During the 3 years described, most residents participated with enthusiasm, later reporting increased awareness and use of community resources. However, months after the third experience, a comparison of clinic records before and after the orientation showed no difference in the residents' inclusion of the health issue studied in managing their patients, although social workers and other non-physician faculty team members reported that residents consulted them more frequently following the community orientation.

CONCLUSIONS

It is important to provide residents with an efficiently designed and attractive community orientation early in training. An interdisciplinary team should plan and coordinate their experiences, but all faculty should role model good community behavior. Although the 1996 residents described behavioral changes following this brief orientation, this was not documented by a chart review.