Introducing child survival and development topics into the medical curriculum of a developing country.

Introducing problem-oriented medical education in Burma with 4 modules on child survival development (CSD) to replace the traditional lecture and rote learning method was met with preliminary success. Burma has 3 medical schools graduating 500 physicians yearly with all preclinical training based on lectures and all clinical training in hospitals. Yet community health is implemented by township medical officers with less training in child health than village health workers. 4 modules were created by groups of 12 medical faculty on acute respiratory infections high-risk pregnancy protein-energy malnutrition and dengue hemorrhagic fever in 1987. Modules concentrated on physicians roles: identify children at risk for malnutrition assess severity provide acute and long-term clinical management and coordinate growth monitoring and promotion of community programs. Students face obstacles such as life-time career of rote learning by lecture scarcity of text- books closed shelves for journals daytime-only library hours no copying machines and limited audiovisual equipment. Despite these limitations students learning scores increased from 36-86% their attitudes on a Likert scale improved and they volunteered approval of many specific aspects of the student-centered approach.