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 practise. DESIGN Two cross-sec tional surveys via mailed questionnaires: one designed to measure phys icians' self-reported preparedness for practice and the other to measu re the importance of various rural family medicine components. SETTING Rural training program graduates and preceptors representing rural co mmunities in British Columbia. PARTICIPANTS Thirty-nine graduates of t he rural training program between 1982 and 1991 and 14 community-based rural training program preceptors representing eight communities thro ughout the province participated in this study. MAIN OUTCOME MEASURES Percentage of graduates of the rural program who reported themselves t o be underprepared on each family practice item and preceptors' mean s cores 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, rad iology, vacuum extraction, fracture care, exercising community leaders hip, cost-effective use of diagnostic tests, using community health re sources, obtaining hospital privileges, ophthalmology, dermatology, ot olaryngology, personal and professional growth, relationships with oth er physicians, and personnel issues. CONCLUSIONS Using both the level of graduates' self-reported underpreparedness and the attributed impor tance of elements of rural practice, as indicated by the preceptor sur vey, we developed a list of the areas of the rural training program cu rriculum most in need of reform.