Evaluating family medicine residency COPC programs: meeting the challenge.
BACKGROUND AND OBJECTIVES: We conducted a review of the evaluation literature and outcomes from community-oriented primary care (COPC) programs in US family medicine residencies since 1969. METHODS: We used a Medline and ERIC search for "community-oriented primary care" in English from 1969-2005. RESULTS: Twenty-two articles were found that concerned US family medicine residency COPC. Six surveys over 25 years reported stable rates of COPC teaching (approximately 40%). Eight descriptive and eight evaluative papers described 14 residency COPC programs. Teaching and learning methods included block and longitudinal rotations and COPC projects. Evaluation methodologies included one quasi-experimental control group study, pretests and posttests of knowledge and attitudes, focus groups, and semi-structured interviews. Reported outcomes included changes in residents' knowledge, attitudes, and behaviors; effect on graduates' career choice and future practice; and impact on patient care and community health. CONCLUSIONS: Few studies have evaluated residency COPC programs. Evaluation has been less than rigorous, with variable results, but at least one study indicates positive outcomes at each evaluation level. More residency programs must evaluate and disseminate outcomes from their COPC projects to determine the value of COPC to residents, colleagues, community partners, and funding agencies.