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The availability of a framework for the definition of generic objectives for community-based education (CBE) programmes may assist in the rational design of objectives for specific CBE programmes. Factors impacting on community health from the perspective of a developing country were collected. Potential assistance from medical students to communities to improve their health status was determined. Competencies required in students to execute tasks in the community were defined and eventually educational objectives to develop these competencies in the students were established. Factors impacting on community health and activities of medical students in CBE programmes were identified by review of literature and Internet resources. Competencies desired for execution of tasks by students and educational objectives to develop these competencies were defined by us and checked against pertinent literature. A draft table representing the 4 elements of the framework was discussed by an international group of experts for external validation. A total of 26 factors impacting on community health were identified and clustered in 5 domains. Twenty-one generic objectives for CBE programmes were defined to develop the required competencies in students. Analogues of each of these 21 objectives were found in at least 1 publication specifying objectives for specific CBE programmes but none of these publications stated any objective not covered by our list of generic objectives. It proved possible to develop a framework to define generic objectives for CBE programmes. An example was elaborated from the perspective of a medical school in a developing country. [ABSTRACT FROM AUTHOR]

The evidence suggests that a longitudinal training of communication skills embedded in a rich clinical context is most effective. In this study we evaluated the acquisition of communication skills under such conditions. In a longitudinal design the communication skills of a randomly selected sample of 25 trainees of a three-year postgraduate training programme for general practice were assessed at the start and at the end of training. Eight videotaped real life consultations were rated per measurement and per trainee, using the MAAS-Global scoring list. The results were compared with each other and with those of a reference group of 94 experienced GPs. The mean score of the MAAS-Global was slightly increased at the end of training (2.4) compared with the start (2.2). No significant difference was found between the final results of the trainees and the reference group. According to the criteria of the rating scale the performance of both trainees and GPs was unsatisfactory. The results of this study indicate that communication skills do not improve in a three-year postgraduate training comprising both a rich clinical context and a longitudinal training of communication skills, and that an unsatisfactory level still exists at the end of training. Moreover, GPs do not acquire communication skills during independent practice as they perform comparably to the trainees. Further research into the measurement of communication skills, the teaching procedures, the role of the GP-trainer as a model and the influence of rotations through hospitals and the like, is required. [ABSTRACT FROM AUTHOR]