Graduates’ Perceptions of Learning Affordances in Longitudinal Integrated Clerkships: A Dual-Institution, Mixed-Methods Study

Latessa, Robyn; Swendiman, Robert A.; Parlier, Anna Beth; Galvin, Shelley L.; Hirsh, David

doi:10.1097/acm.0000000000001621

Cited by 28 publications

(65 citation statements)

References 34 publications

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“…We chose these goals for the association analysis without prior review of the quantitative data. We selected the seven program goals by considering themes currently prominent in the clinical medical education design literature, including educational continuity [5–8,21,26], longitudinal programs [13,23], LICs [15,16,18,27,28], and the future of medical education in the US [1–4]. The seven program goals selected were ‘exposure to specific patient populations,’ ‘exposure to social medicine,’ ‘exposure to primary care,’ ‘developing clinical skills,’ ‘developing professional skills,’ ‘understanding the patient experience,’ and ‘fostering longitudinal relationships.’…”

Section: Methodsmentioning

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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Section: Methodsmentioning

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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Section: Tip 2: Invest In Strong Relationships With Your Preceptorsmentioning

confidence: 99%

“…This may explain why most students in LICs cite continuity with preceptors as a major contributing factor to their success (Mihalynuk et al, 2008;Latessa et al, 2017). Students attest that this relationship provides a supportive and trusting environment in which they feel "safe to make mistakes" (Hirsh, Holmboe and ten Cate, 2014;Latessa et al, 2017). These trusting relationships with preceptors are essential for efficient learning, conflict resolution, and integrating students within a community of practice (Dornan et al, 2007;Walters et al, 2011;Bates et al, 2013;Zak, 2017;Wolfe, Hoang and Denniston, 2018).…”

Section: Tip 2: Invest In Strong Relationships With Your Preceptorsmentioning

confidence: 99%

Twelve Tips for Students in Longitudinal Integrated Clerkships

Pepper¹,

Riegels²,

Ziv³

et al. 2019

MedEdPublish

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Longitudinal integrated clerkships (LICs) are a curricular structure for medical clerkships grounded in continuity across learning environments and experiences. There has yet to be a peer-reviewed article directly advising students in LIC programs. Twelve tips were created based on a comprehensive literature review of LICs and supported by the cumulative experience of the authors. They are ordered in four sequential groups: The first three tips discuss the importance of the relationships that are built between students and their patients (Tip 1), preceptors (Tip 2), and peers (Tip 3). Next we cover health systems, and offer advice on how students can integrate their learning (Tip 4), use technology to their advantage (Tip 5), and practice systems thinking (Tip 6). We then discuss the educational benefits when students take an active role in patient care (Tip 7), their own learning (Tip 8), and the feedback process (Tip 9). Finally, we cover the importance of self-care (Tip 10), reflection (Tip 11) and patience (Tip 12) during a LIC. These tips are designed to help students understand the pedagogical theory that underpins LICs, take an active role in their education, and maximize learning and wellness during their clerkship.

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“…In contrast to traditional block rotations, LICs restructure clinical education to provide students' educational continuity-continuity of care, curriculum, and supervision [5][6][7][8]. Through continuity, LICs reshape learning relationships and the learning environment [9,10]. The literature on LICs reports educational benefits [4,5,11], and LICs support humanistic professional identity formation [12,13], increase patient-centeredness [1,3,11,14], and may improve communication skills [5,15,16].…”

Section: Introductionmentioning

confidence: 99%

Patient perceptions of students in a longitudinal integrated clerkship in Taiwan: a qualitative study

et al. 2021

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Background Longitudinal integrated clerkships (LICs) are a model of clinical education growing rapidly in Western contexts. LICs use educational continuity to benefits students’ clinical learning and professional identity formation. Patient-centered care is a core component of medical professionalism in the West. To support patient-centered care, education leaders in Taiwan restructured clinical education and implemented the first longitudinal integrated clerkship in East Asia. We aimed to investigate patients’ perceptions of longitudinal relationships with the LIC students within Taiwan’s Confucian cultural and social context. Methods We invited patients or their family members who were cared for longitudinally by a LIC student to participate in the study. Participating patients or their family members undertook semi-structured interviews. We analyzed data qualitatively using a general inductive approach to identify themes in the patients’ descriptions of their experiences interacting with the LIC students. Results Twenty-five patients and family members participated in interviews: 16 patients and 9 family members. Qualitative analysis of interview transcripts identified three themes from patients’ experience receiving care from their LIC students: care facilitation, companionship, and empathy. To provide care facilitation, LIC students served as a bridge between the physicians and patients. Students served patients by reminding, consulting, tracking disease progression, and researching solutions for problems. To provide companionship, students accompanied patients interpersonally like a friend or confidant who listens and provides a presence for patients. To provide empathy, patients reported that students showed sincere concern for patients’ experience, feelings, and mood. Conclusion In our study, Taiwanese patients’ perspectives of LIC students suggested the value of care facilitation, companionship, and empathy. We discuss these themes within the context of Confucian culture and the Taiwanese context of care.

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Graduates’ Perceptions of Learning Affordances in Longitudinal Integrated Clerkships: A Dual-Institution, Mixed-Methods Study

Cited by 28 publications

References 34 publications

A review of longitudinal clinical programs in US medical schools

A review of longitudinal clinical programs in US medical schools

Twelve Tips for Students in Longitudinal Integrated Clerkships

Patient perceptions of students in a longitudinal integrated clerkship in Taiwan: a qualitative study

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