Task-oriented processes in care (TOPIC): a proven model for teaching ambulatory care

The TOPIC model conceptualizes the work of family physicians as five prototypical visits (new problem, checkup, chronic illness, psychosocial problem, and behavioral change) and four major processes (physician information processing, patient-physician relationship development, integration of information and relationship, and lifelong learning). This paper describes methods for teaching this model to clerkship students and reports 4 years of outcome data. The instruction included seminars at the beginning of the rotation, a laminated pocket card as a reminder in clinical sites, a clerkship "passport" with examples of TOPIC verbal presentations, and student self-study for the end-of-rotation Clinical Performance Examination (CPX). Evaluation outcomes include student perceptions of the seminars and student performance on the CPX. Students rated the usefulness of the seminars favorably. The CPX scores showed that students performed most of the tasks expected for each prototypical visit. Students learned the tasks presented in the seminars and demonstrated them during the CPX. The model is robust since students learned the material despite some changes in teaching methods.