Undergraduate teaching of primary health care. A Delphi study

OBJECTIVE: Given both the limited experience of Undergraduate Teaching in Primary Health Care (PHC) and the lack of contact between different teaching centres, we sought to identify the minimum contents of a potential Syllabus. We made a distinction between items of knowledge required and skills students would have to develop. DESIGN: We undertook a Delphi study, which was longitudinal, prospective and observational. PARTICIPANTS: We defined three groups of experts among groups with PHC teaching experience. 20 Associate Lecturers at Undergraduate level, attached to Health centres; 20 postgraduate PHC teachers, and 7 University staff members involved with Public Health and Preventive and Community Medicine teaching. MAIN MEASUREMENTS AND RESULTS: The reply rate from the three questionnaires was about 60%. There was a high level of agreement. Of the items of knowledge which scored highest, we noted: the doctor-patients relationship, the Promotion of Health and Health education, Integrated Health Programmes, Prevention of Disease and Care of Risk-Groups. Of the skills, we pointed to the Clinical Interview, the construction of a Clinical History at the PHC level, Detection of Risk factors and Physical Examination. CONCLUSIONS: The most valued items of knowledge are those related to the overall Conception of Health, Promotion and Prevention. The most highly-scored skills are those concerning the Doctor-Patient relationship. Questions relating to the Individual are prioritised over those concerning Family and Community. There is a high level of agreement that the acquisition of the necessary theoretical knowledge must be accompanied by the ability to put them into practice.