Designing a curriculum in a clinical setting: an iterative process.

A curriculum for the training of medical students was designed and implemented in a functioning clinical setting. The multidisciplinary, multiprofessional staff of a primary care center participated with professional educators in an iterative process for curriculum development. A three-stage plan was conceived: behaviorally oriented educational objectives were constructed, instructional methodologies to satisfy these objectives were created, and evaluation instruments were designed. Throughout each stage the educators facilitated the process by teaching the staff the necessary techniques for the design and implementation of the curriculum. The curriculum that resulted from this process is focused on those issues that are important to team delivery of primary care. An important outcome of the project is the increased enthusiasm and competence of the professional staff in the teaching of students in the health professions.