A preclinical training model for chronic care education

Chronic illnesses are not only major health threats for half of the world's population, but these diseases are also increasing rapidly. Medical training, however, has not kept pace with this increase in chronic illness.

I describe two instructional modules whose goals were to teach preclinical medical students to (1) screen for diabetic neuropathies and provide counseling for improved diabetic foot care, and (2) screen for tobacco use and provide counseling for smoking cessation. All educational activities took place during an orientation to the modules or during ambulatory patient encounters. Preclinical students (n = 280), who were supervised by 157 family physicians, screened and counseled a total of 3,640 patients. Program outcomes were assessed by analyzing student's responses to attitudinal questionnaires, student's documentation of the diabetic foot and tobacco use screenings, and postcards on which patients wrote their reactions to screening and counseling. In addition, the physician supervisors evaluated the impact of the modules on their practices.

Analysis of data indicated that medical students, supervising physicians and patients benefited from the screening and counseling activities.

We believe that these successful educational modules offer a training model for teaching medical students to intervene in chronic illnesses.