A national general pediatric clerkship curriculum: The process of development and implementation

Objective. To describe a new national general pediatrics clerkship curricul um, the development process that built national support for its use, and cu rrent progress in implementing the curriculum in pediatric clerkships at US allopathic medical schools. Curriculum Development. A curriculum project team of pediatric clerkship di rectors and an advisory committee representing professional organizations i nvested in pediatric student education developed the format and content in collaboration with pediatric educators from the Council on Medical Student Education in Pediatrics (COMSEP) and the Ambulatory Pediatric Association ( APA). An iterative process or review by clerkship directors, pediatric depa rtmental chairs, and students finalized the content and built support for t he final product. The national dissemination process resulted in consensus among pediatric educators that this curriculum should be used as the nation al curricular guideline for clerkships. Monitoring Implementation. Surveys were mailed to all pediatric clerkship d irectors before dissemination (November 1994), and in the first and third a cademic years after national dissemination (March 1996 and September 1997). The 3 surveys assessed schools' implementation of specific components of t he curriculum. The final survey also assessed ways the curriculum was used and barriers to implementation. Outcomes. The final curriculum provided objectives and competencies for att itudes, skills, and 18 knowledge areas of general pediatrics. A total of 21 6 short clinical cases were also provided as an alternative learning method . An accompanying resource manual provided suggested strategies for impleme ntation, teaching, and evaluation. A total of 103 schools responded to surv ey 1; 84 schools to survey 2; and 85 schools responded to survey 3 from the 125 medical schools surveyed. Before dissemination, 16% of schools were al ready using the clinical cases. In the 1995-1996 academic year, 70% of scho ols were using some or all of the curricular objectives/ competencies, and 45% were using the clinical cases. Two years later, 90% of schools surveyed were using the curricular objectives, 88% were using the competencies, 66% were using the clinical cases. The extent of curriculum use also increased . Schools using 11 or more of the 18 curriculum's knowledge areas increased from 50% (1995-1996) to 73% (1996-1997). Conclusion. This new national general pediatric clerkship curriculum develo ped broad support during its development and has been implemented very rapi dly nationwide. During this period the COMSEP and the APA have strongly sup ported its implementation with a variety of activities. This development an d implementation process can be a model for other national curricula.