Development of a Longitudinal Behavioural Medicine Continuity Curriculum for Third Year Medical Students

Reports on Medical education consistently confirm a cluster of findings regarding primary care and Behavioural medicine: a large percentage of patients with psychosocial problems first present to primary care physicians; managed care and health economics accelerate demands and time constraints; medical students receive few opportunities to develop effective basic skills in establishing therapeutic relationships with patients and measuring progress over time. A unique opportunity occurred to test a new student training model. The course is one year long and built into the required primary care continuity clinic: one half day per week preceptorship. Key features of the curriculum include: orientation to the common behavioural issues, use of brief rating scales for screening and referral, interdisciplinary team training, preceptors teach and monitor the therapeutic process and problem based didactic skills workshops in clinical management. Evaluations include video tape analysis of skills, patient logs, use of psychological rating scales, and end of year tests using performance exams (clinical simulations). Implications for curriculum design and assessment will be discussed.