Educational Outcomes of the Harvard Medical School–Cambridge Integrated Clerkship

Hirsh, David M.; Gaufberg, Elizabeth; Ogur, Barbara; Cohen, Pieter A.; Krupat, Edward; Cox, Malcolm; Pelletier, Stephen R.; Bor, David H.

doi:10.1097/acm.0b013e31824d9821

Cited by 193 publications

(216 citation statements)

References 33 publications

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“…The restructuring of the medical education focusing the patient-centredness is a current relevant issue worldwide [5][6][7][8][9][10]21,22 . Operationally, our main goal in offering the "doctor--patient relationship" discipline was to maximize the learning and retention of fundamental humanistic and ethical knowledge and communication skills, particularly based on a reflective practice.…”

Section: Discussionmentioning

confidence: 99%

“…The medical students must be stimulated to develop a critical own view toward the attitudes and communicative skills linked to the provision of patient care 6,16 . Educational strategies that encourage the examination of these attitudes and behaviours might result in the better understanding of the lapses of the doctor-patient relationship [5][6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

“…In 1969, the pioneer, Enid Balint 1 , who devoted much of her career to the study of the doctor-patient relationship, introduced the term "patient-centred medicine", which was related to the understanding of the patient as a unique human being 2,4 . Since then, various educational strategies have been adopted in the teaching-learning process aiming at the improvement of the doctor-patient relationship [5][6][7][8][9] . It should be highlighted that this contact is a special process of human interaction comprising significant dimensions of the clinical practice that includes technical, humanistic and ethical knowledge.…”

Section: Introductionmentioning

confidence: 99%

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Impacto da “Disciplina Relação Médico-Paciente” sobre Atitudes Centradas no Paciente

Silva

Ribeiro

Nogueira

et al. 2017

Rev. bras. educ. med.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impacto da “Disciplina Relação Médico-Paciente” sobre Atitudes Centradas no Paciente

Silva

Ribeiro

Nogueira

et al. 2017

Rev. bras. educ. med.

View full text Add to dashboard Cite

show abstract

“…In the LIC model, students care for a diverse panel of patients whom they follow across multiple clinical settings over extended periods of time, in lieu of traditional block rotations within discrete specialties [6,14,17]. The literature describes LIC goals, structures, and outcomes [15–21]; less is known about the broader array of LCPs that do not meet LIC criteria [10,13,22].…”

Section: Introductionmentioning

confidence: 99%

A review of longitudinal clinical programs in US medical schools

Gheihman

Jun

Young

et al. 2018

Medical Education Online

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Background: Longitudinal clinical experiences are a common component of undergraduate medical curricula, yet these programs have not been systematically characterized in US medical schools.Objective: Our study sought to identify and characterize longitudinal clinical programs (LCPs) in US medical schools and measure associations between programs’ structures and goals.Design: Using a mixed-methods approach, we conducted a secondary analysis of data from publicly available websites. We conducted a systematic keyword search of the websites of 137 LCME-accredited US medical schools to identify LCPs. We included programs with student–patient interactions of at least six months. We categorized programs using qualitative thematic analysis and compared associations between program structures and goals.Results: We identified 98 LCPs in 69 schools. Half (52.0%) of LCPs occurred during the core clinical year. Program structures included ‘clinic attachments’ (50.0%), ‘longitudinal integrated clerkships’ (26.5%), and ‘patient attachments’ (20.4%). We identified goals in 89 programs, including ‘exposing students to specific topics, patient demographics, or practice settings’ (78.7%); ‘clinical or professional skill development’ (65.2%); and ‘understanding the patient experience’ (19.1%). Patient attachments were associated with ‘exposure to specific patient demographics’ (P = .04) and ‘understanding the patient experience’ (P = .03). Pre-clinical programs were associated with clinical skills development (P = .01).Conclusions: Our study identifies the scope and nature of LCPs in US medical schools. Understanding connections between educational structures and goals may guide program design and research investigations of educational processes and outcomes.

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“…Students in continuity clerkships consistently report increased confidence with providing care to high-risk patients [1,2], increased responsibility and ownership for patient care [1–5], and increased satisfaction with the continuity experience for learning and receiving feedback when compared with block clerkships [6,7]. Additionally, students in continuity clerkships performed better than their peers on preceptor assessments and in-training evaluations while performing similarly on standardized exams [6,8].…”

Section: Introductionmentioning

confidence: 99%

Impact of an education-centered medical home on quality at a student-volunteer free clinic

Russi

Bhaumik

Herzog

et al. 2018

Medical Education Online

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Background: The continuity provided by longitudinal clerkships has documented benefits to medical student education. Yet, little quantitative data exist on the association between longitudinal clerkships and patient outcomes.Objective: This study compares screening metrics of a longitudinal clerkship called the education-centered medical home (ECMH) with the standard clinical model at a student-volunteer free clinic (SVFC). In the ECMH model, the same attending physician staffs one half-day of clinic with same group of students weekly for 4 years. Standard clinical models are staffed with students and physicians who come to the SVFC based on availability.Design: ECMH students aimed to increase human immunodeficiency virus (HIV) screening rates in their patient panel as part of a quality improvement project. Students prepared individualized care plans prior to patient visits that included whether screening had been performed. They were also reminded to confirm completion of testing. Percentages of patients screened for HIV before and after establishment of the ECMH were compared with four standard clinical models. Screening rates for breast, colon, and cervical cancer, as well as hepatitis C, served as secondary endpoints.Results: While screening rates were initially similar between models (43.2% and 34.8% for the ECMH and standard clinical panels, respectively, p = 0.32), HIV screening rates increased from 43.2% to 95.0% in the ECMH compared with a significantly smaller increase from 35.0% to 50.0% in the standard clinical panel (p < 0.0001). Additionally, the ECMH resulted in statistically significantly increased screening rates for cervical cancer (p < 0.001) and hepatitis C (p < 0.0001).Conclusions: This study demonstrates an association between a longitudinal ECMH clerkship and improved quality metrics at an SVFC. Even measures not targeted for intervention, such as colorectal cancer and hepatitis C, showed significant improvement in screening rates when compared with the standard clinical model.

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Educational Outcomes of the Harvard Medical School–Cambridge Integrated Clerkship

Cited by 193 publications

References 33 publications

Impacto da “Disciplina Relação Médico-Paciente” sobre Atitudes Centradas no Paciente

Impacto da “Disciplina Relação Médico-Paciente” sobre Atitudes Centradas no Paciente

A review of longitudinal clinical programs in US medical schools

Impact of an education-centered medical home on quality at a student-volunteer free clinic

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