This study found that preceptors continue to be satisfied with teaching students. Intrinsic reasons remain an important motivation to precept, but monetary compensation may have increasing importance. Physicians responded more negatively than other health provider groups to several questions, suggesting that their needs might be better met by redesigned teaching models.

Tailoring support to better meet individual degree groups' preferences can maximize resources and may encourage preceptor retention. Special attention to physicians' needs may be warranted to avoid decreased preceptor numbers in this at-risk group. Future studies are needed to determine whether these findings are unique to North Carolina, which has a strong infrastructure to support preceptors.

The longitudinal relationship of preceptor and student in LIC models affords specific, important opportunities for teaching and learning. The concise list of LIC preceptor tips can be used by preceptors to further optimise their teaching in the LIC setting. We identify student perceptions of the most effective teaching practices and develop tips for LIC preceptors.

UNC School of Medicine medical students participating in a longitudinal integrated curriculum in a community setting outperformed fellow students who completed a more TBR curriculum within the school's academic medical center. Differences were found in performance on standard tests of clinical knowledge (six NBME exams and Step 2 CK exam), documented breadth of clinical experiences, and likelihood of choosing primary care residency programs.

Consumers, health delivery planners, and public officials are calling for patient-centered, primary care-based, costeffective health care. The Asheville campus of the University of North Carolina School of Medicine has responded to this need by developing a longitudinal integrated clerkship that trains third-year medical students to provide such care. The University of North Carolina (UNC) School of Medicine launched its Asheville campus in July 2009 with 4 third-year medical students. The regional campus-a collaboration of the UNC School of Medicine, Mission Health System, and the Mountain Area Health Education Centeris part of UNC's broader strategy of expanding enrollment to meet North Carolina's need for more physicians [1]. The Asheville campus now has 10 third-year medical students, and this established program has outcomes data demonstrating its academic effectiveness and its positive impact on both students and faculty members.Longitudinal integrated clerkships (LICs) are increasingly being recognized as an effective alternative to traditional block rotations for medical students [2,3]. Key features of an LIC curriculum include students' participation in providing comprehensive care for an identified group of patients over time, and a continuous learning relationship with supervising clinician-preceptors. Through these experiences, LICs help students meet core clinical competencies across multiple disciplines simultaneously [4].The Asheville campus of the UNC School of Medicine was the first location in North Carolina to offer an LIC curriculum. The LIC pairs students with attending physicians in each of the core third-year outpatient-based specialties; students participate in each specialty for a half-day per week throughout the third year. The typical third-year schedule is shown in Table 1. As a result of this schedule, students experience continuity with patients and physicians. Students also follow their patients over time through the health care system. The small class size and gradual expansion of the LIC program have enabled academic and clinical leaders in Asheville and Chapel Hill to refine the curriculum as needed, and this program has emerged nationally as an innovative educational companion to the changing health care system.Traditionally third-year clinical training in US medical schools is structured such that the reference point is the clinical specialty or hospital service. In contrast, the patient is the educational reference point of the clinical experience in an LIC. The LIC patient-centered learning method allows the student to experience the health system from the patient's perspective as a series of specialties and silos that are often unconnected. From this perspective, the student can clearly see both the primary care provider's role as the care connector and the value of a better integrated health care system. Objective evidence shows that students become more aware of the patient's perspective because of this experience; compared with national norms, the patient-centeredness of...