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

Abstract

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.

Exploring the Impact of Pre-course High-Fidelity Simulation on Professional Socialization of Medical Students in Emergency Medicine Internship Rotation—A Qualitative Approach

“…Without these interactions, the likelihood of students to exhibit high levels of anxiety, feelings of marginalization, perceived stress and overall lack of readiness for practice increases (1,6,(16)(17)(18)(19). Due to this, it is necessary that we provide students with support during this period as they move through multiple specialties during their rotations (13,19,20). In light of this necessity, we developed a novel pre-Emergency Medicine (EM) rotation orientation curriculum underpinned by simulationbased education to enhance interns' transition process into the EM.…”

Patient outcomes in a Longitudinal Integrated Clerkship: A systematic literature review

“…Twenty‐six studies were included 16,26,45–68 . LIC programmes at 16 institutions were described, representing six countries: Australia, Canada, South Africa, Taiwan, the United Kingdom and the United States.…”

“… Students bring efficiencies to consultations by completing histories and examinations for preceptors 50,67 Students bring thoroughness to consultations 49 and give attention and time to the patient 51,59,66 Students share patient information with healthcare professionals and across healthcare settings 45,49,51,59,64 Students support communication between healthcare professionals, 51,57,60 and healthcare settings 53 …”

“…Both patients 49,51,56,58,59,64 and students 52,53,57 perceived growth in their relationship when students offered empathetic, compassionate and patient centred care. Students made up for shortfalls in the healthcare system, by offering the time to listen and support, 53 emotional support that was missing from healthcare professionals 51 and gender‐related support 56 …”

Focus on patients in medical education

“…The study of Chang et al [ 6 ] explored the implementation of longitudinal integrated clerkships (LICs) in Taiwan which contributed to patient-centeredness and identified values such as care facilitation, companionship, and empathy. LIC students offered care facilitation by serving as a bridge between the physicians and patients, by reminding, consulting, tracking disease progression, and researching solutions for problems.…”