The effect of a continuity of care clinic curriculum on cardiovascular risk management skills of medical school graduates.
BACKGROUND
The continuity of care clinic (CCC) curriculum has been added to final-year medical students, class of 2008. The goals were to improve cardiovascular risk management skills for medical students and to develop competent doctors to serve the public.


OBJECTIVE
To study the effectiveness of the curriculum by directly comparing postgraduate patient care performance between CCC participants (class of 2008) and non-CCC participants (class of 2006 and 2007).


METHODS
We collected information about both groups of graduates, when they started their doctor careers. With hospitals'permission, medical charts audits were performed and scored with a 12-task checklist of cardiovascular risk management. The scores from both groups were compared with statistical analyses.


RESULTS
Among 266 charts from 17 hospitals, there were 123 charts from 38 CCC participants and 143 charts from 52 non-CCC participants. On 9 of 12 tasks of the checklist, proportionately more CCC participants carried out the tasks than non-CCC participants. Statistical significance was shown on 5 tasks. These were ability to properly adjust antihypertensive medication (13.4% more; p = 0.002); requesting for urine protein screening (12.1% more; p = 0.006); recommending life-style modification (24.9% more; p < 0.001); requesting for serum lipid profile (25.5% more; p < 0.001); prescribing aspirin as primary prevention for cardiovascular disease (13.1% more; p = 0.007). There was no statistically significant difference for the other 7 tasks.


CONCLUSIONS
Cardiovascular risk management performance of CCC participants was better than non-CCC participants in the same period after graduations. The curriculum helped improve the cardiovascular risks management skill of postgraduates. In the public interest, this study recommends further implementation of such a program in the future.
Pandejpong
Denla
D
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. gdenla@gmail.com
Nopmaneejumruslers
Cherdchai
C
Chouriyagune
Charoen
C
D002983:Clinical Competence; D015331:Cohort Studies; D003266:Continuity of Patient Care; D003479:Curriculum; D003920:Diabetes Mellitus / Q000628:therapy*; D050171:Dyslipidemias / Q000628:therapy*; D004504:Education, Medical, Undergraduate; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D015397:Program Evaluation; D013785:Thailand