A PRECEDE-PROCEED Approach in the Advocacy for Computer-based Education on Correct Medical Certification of Cause of Death among Physician-Learners

Abstract

Objective. Mortality data is a critical input to public health decision-making and planning. Yet, about 36% of underlying causes of death reported by physicians in 2018 are considered garbage codes, not useful in analyzing public health and mortality (PSA, 2018). We used the PRECEDE-PROCEED approach to develop, implement, and report an advocacy and education Project to improve training on medical certification of cause of death (MCCOD) among senior medical students and interns.

Methods. An MCCOD Instructional Design and eLearning course was introduced and validated in 33 medical education institutions. Lessons enhanced these education materials and are proposed for nationwide adoption. In the middle of the COVID-19 pandemic, the Project fast-tracked the training of physician-learners on the correct cause of death reporting and certification.

Results. Awareness of correct MCCOD and its personal and public health value reached at least 4000 learners, over a hundred medical faculty, and all deans of medical colleges in the Philippines.

Conclusion. The PRECEDE-PROCEED Model provided a clear and practicable framework for the advocacy and
education efforts to train senior medical students and interns on MCCOD. It can similarly guide other medical
education innovations by defining predisposing, enabling, and reinforcing factors then considering these factors for intervention strategies, implementation, process evaluation, outcome evaluations, and impact evaluations.