DEVELOPING CURRICULA TO PROMOTE PREVENTIVE MEDICINE SKILLS - THE TEACHING IMMUNIZATION FOR MEDICAL-EDUCATION (TIME) PROJECT

Context.-Vaccines are underused in the United States, resulting in nee dless morbidity, Many experts have concluded that clinician education is critical to increasing the nation's vaccination rates. Objective.-T o develop and evaluate case-based curricular materials on immunization s that promote preventive medicine skills. Design.-Before-and-after tr ial of an educational intervention. Setting and Participants.-Medical schools and primary care residency programs from 20 institutions acros s the United States participated in the Teaching Immunization for Medi cal Education (TIME) project. Intervention.-A multidisciplinary team d eveloped learning objectives, abstracted clinical cases, and created c ase-based modules that use contextual learning and small-group interac tion to solve clinical and public health problems. The case-based meth ods are multistation clinical teaching scenarios (MCTS) and problem-ba sed learning (PBL). Main Outcome Measures.-Knowledge gained by learner s from pretest to posttest and the overall ratings of the sessions by learners and facilitators based on evaluation questionnaires. Results. -Pretest and posttest results were obtained on a total of 1122 learner s for all modules combined, For the MCTS method, mean scores increased from the 10-item pretest to the posttest by 3.1 items for measles, 3. 8 for influenza, 1.8 for hepatitis B, 3.9 for pertussis, 1.9 for adult vaccination, 1.9 for childhood vaccination, and 2.6 for Haemophilus i nfluenzae type b (P<.01 for each), For the PBL method, mean scores inc reased by 3.4 items for measles, 3.3 for influenza, 2.6 for hepatitis B, and 2.5 for pertussis (P<.01 for each), Most learners (MCTS, 98%; P BL, 89%) and most facilitators (MCTS, 97%; PBL, 100%) rated the sessio ns overall as very good or good. Conclusions.-Use of TIME modules incr eases knowledge about immunizations, an essential step to improving va ccination practices of future clinicians. Given the realities of decre ased faculty time and budgets, educators face major challenges in deve loping case-based curricula that prepare learners for the 21st century , Nationally tested libraries of cases such as the TIME modules addres s this dilemma.