Evaluation and improvement of quality during practical training in primary health care at health centers of Murcia

BACKGROUND: To describe the Public Health in Primary Health Care practice for medical students Program objectives, quality of training evaluation method, and implementation results. METHODS: 6 learning objectives were designed and training implemented in 3 Health Centers in the 90-91 academic course. Evaluation included the objectives level of difficulty, and homogeneity in achievement rates between objectives, within Centres and between Centres. Evaluation results were analyzed and used to design changes to increase homogeneity and achievement rates. Same evaluation was performed in the 91-92 academic course to document improvement. RESULTS: In the first evaluation there were highly significant differences in overall (p. 0.01) achievement rates between centers. Within centres between objectives difficulty was not homogeneous either (p. > 0.001). After implementing remedial actions, differences in difficulty and achievement rates within and between centres decreased. Increased homogeneity affected mostly to two previously less homogeneous objectives. CONCLUSIONS: Quality assurance methods can be successfully applied to improve training of clearly defined and quantified Primary Health Care learning objectives.