A TEACHING EXERCISE FOR COMMUNITY PRECEPTORS USING STANDARDIZED STUDENTS. A. Rubin 1 ; 1 University of Vermont College of Medicine, Burlington, VT OBJECTIVES: To assess the teaching skills needs of our community based teachers.To develop and present a workshop that would allow them to practice these skillls. METHODS: As part of our HRSA project we developed a needs asssessment for our community based teachers. Of the areas in which they wanted to enhance their teaching skills, we chose four to learn and practice: Teaching Efficiently, Framing a Clinical Question, Giving Feedback, and The Difficult Student. We developed scripts and videos for a four station teaching exercise using a rolling role play and standardized students. RESULTS: Preceptors rotated in groups of four through each half-hour station. In each, a brief didactic presentation was followed by a rolling role play with a standardized student, which gave each preceptor a chance to practice. A short debriefing followed. We have presented this workshop to 60 of our preceptors in three areas of the state. CONCLUSION: Preceptors rate the workshop format as effective and``couldn't be better.'' They find the topics appropriate and practical. They especially like the student participation and the ability to practice what they learn in small groups. We don't yet know whether preceptors are using the skills they have learned. This is an area for further inquiry. OBJECTIVES: Despite expansion of programs in geriatrics, it will not be feasible to train enough geriatricians to care for all elderly patients. Several organizations have suggested that improved training of primary care physicians in geriatrics is likely to have the greatest impact on improving medical care of geriatric patients. To address this need, we have enhanced several aspects of our curriculum in geriatrics to strengthen the clinical competencies of primary care residents. Our specific objectives are 1) to improve the didactic curriculum; 2) to increase the number and quality of ambulatory clinical experiences; and 3) to develop new methods for measuring the clinical competencies of residents in geriatrics. METHODS: Primary care residents spend six months both years on structured ambulatory rotations. Two half days per week are devoted to structured didactics and eight half days to ambulatory rotations. Portions of both of these experiences are now devoted to enhanced geriatric training. Didactic curriculum: We have developed twenty specific learning objectives in geriatrics. These are taught in ten seminars accompanied by a syllabus of recent and sentinel articles. Ambulatory experiences: Ambulatory geriatric training begins in the first year on a home care rotation directed by geriatrics faculty. Second and third year residents may also work on home care and/or in a variety of geriatric health centers. Selected residents spend one half day per week during each ambulatory block in geriatric health centers as a second continuity experience. We have also begun to increase geriatric teaching in the residents' own primary care continuity clinics by recruiting more geriatrics-trained faculty to serve as core resident preceptors. Enhanced evaluation: We have enhanced our efforts at evaluating resident experiences in geriatrics with the use of a web-based evaluation system. We will also evaluate resident attitudes toward the care of older patients and the extent to which learning objective have been met. Finally, we will develop new strategies in measuring resident competency in geriatrics with a geriatric clinical evaluation exercise (geri-CEX) and with structured medical record reviews. RESULTS: We hypothesize that these methods will increase the knowledge, attitude and skills of residents in geriatrics and will result in improved competency in geriatrics for primary care physicians trained in this manner. CONCLUSION: The curriculum of structured primary care residency programs can be modified to address specific deficiencies in health manpower. We have designed a strategy for specifically enhancing the competency of primary care physicians to care for the elderly. OBJECTIVES: 1. Promote community-oriented primary care. 2. Teach medical students and residents about COPC through service learning in diverse underserved communities. 3. Develop role models in public health practice. 4. Engage the academic health center in its community. METHODS: 1. We established an "Institute for Community Health" in Cambridge and Somerville, dedicated to research and education in health promotion and disease prevention. Three health care networks (Cambridge Health Alliance, CareGroup and Partners) found common cause in a scholarly collaboration to improve the health of these communities. 2. The Community-oriented Primary Care (COPC) curriculum was chosen as one of three priority initiatives. The curriculum contains: a) experiential (research) elements: community defined projects; teams of a preceptor, medical resident and one or several medical students; year-long longitudinal projects. b) Didactic elements include a seminar series taught by faculty drawn from collaborating institutions. 3. We expect to enroll the first students in September. RESULTS: 1. Trainees will be evaluated by faculty and their community partners -in accordance with defined competencies, the quality of their products (e.g., policies, guidelines, webpages, interventions, etc.) and the sustainability of their work. 2. The faculty and currriculum will be evaluated by the community on the basis of the contributions to the local community's health, spread to other communities (within the collaborators' catchment areas), and impact on students' careers; and by the trainees. CONCLUSION: This educational model has the potential to positively influence the health of underserved communities, the careers of health professionals, and the missions of health care institutions -in Cambridge and Somerville, and beyond.