Training in public health skills at the VU University Medical Center in Amsterdam: The PREPARE model

Background
During medical school, and especially during their clerkships, medical students are confronted with many different patients with their various different problems. They learn to solve these problems by means of problem-solving skills. However, these skills mainly focus on clinical problems, and less attention is paid to public health problems, in which prevention and advice are the most important aspects.
Objectives
Introduction of an instrument to analyse public health problems in a structured way during clerkships.
Methods
In the Netherlands, an instrument was developed in which students are taught in a structured way to solve public health problems. This so called PREPARE model integrates, step-wise the skills that are related to communication (presentation of the problem), analysing the determinants of the problem (relevance for public health), presenting the evidence of the effectiveness of interventions and preventive action (evidence), choosing a certain preventive action and advising the different parties involved (prevention and advice, including health promotion), recognizing the need for registration (registration) and the applying feedback mechanisms after the action has taken place (evaluation).
The final assessment of the students is based on a presentation, in which the students can demonstrate their skills in all seven steps of the model. 
Results
To our knowledge this model is a new tool to improve the skills in public health training. Evaluation by students shows that the model gives a good structure for analyzing public health problems, and the different parts of the prepare-model are described well.
Conclusion
Public Health skills are improved by the introduction of a model to analyse public health problems on a structured way.