The Effect of a Continuity of Care Clinic Curriculum on Cardiovascular Risk Management Skills of Medical School Graduates
Denla Pandejpong MD*, Cherdchai Nopmaneejumruslers MD*, Charoen Chouriyagune MD*
Affiliation : * Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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).
Material and Method: 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.
Conclusion : 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.
Keywords : Clinical competence, Continuity of patient care, Curriculum, Education, Medical, Graduate, Educational measurement, Program evaluation
