Chronic illness needs educated doctors: An innovative primary care training program for chronic illness education

Medical educators need proven curriculum innovations that prepare trainees for the expanding number of patients with chronic illnesses.

We describe and evaluate the effectiveness of a chronic illness training program, Chronic Illness Needs Educated Doctors (CINED).

Forty-seven trainees completed four instructional components: (1) measurements of the health-related quality of life of patients with chronic illnesses; (2) didactic sessions in which they described chronically ill patients and their care; (3) written narratives describing the trainees' reactions for these patients; and (4) portfolios offering evidence of chronic illness learning. We measured the accuracy of the trainees' clinical skills at the end of CINED with an objective standardized clinical exercise (OSCE).

Forty-seven trainees scored the perceptions of mental and physical health of 414 chronic illnesses patients. In 47 didactic sessions and 93 written narratives, the trainees explained the relationship between the scores and their clinical observations. Accurate differential diagnoses of and communications with chronically ill patients were observed in an OSCE by standardized patients. The trainers rated 13 of the trainees' chronic illness portfolios as excellent and the remainder satisfactory.

Initial evaluations suggest that the CINED is an effective curriculum for promoting chronic illness learning among trainees.