How can experience in clinical and community settings contribute to early medical education? A BEME systematic review

Dornan, Tim; Littlewood, Sonia; Margolis, Stephen A; Scherpbier, A. J. J. A.; Spencer, John; Ypinazar, Valmae

doi:10.1080/01421590500410971

Cited by 395 publications

(350 citation statements)

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“…We also consider these findings in the context of earlier studies demonstrating that 95% of students seeking primary care careers ‘desire for longitudinal patient care opportunities’ [42, p. 324]. Whether non-LIC LCPs such as clinic or patient attachments recruit and retain for primary care workforce remains unclear [10,13,23]. …”

Section: Discussionmentioning

confidence: 83%

“…The Lancet Commission Report [1] urges educational leaders to develop curricula that will serve patient and population needs, foster better understanding of the clinical context, emphasize continuous care over episodic encounters, and broaden training venues beyond inpatient care. To address these goals, medical schools are implementing curricular structures grounded in educational continuity [5–9], including longitudinal clinical programs (LCPs) [10–13] and a subset of LCPs, longitudinal integrated clerkships (LICs) [14–16]. …”

Section: Introductionmentioning

confidence: 99%

“…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%

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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: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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A review of longitudinal clinical programs in US medical schools

Gheihman

Jun

Young

et al. 2018

Medical Education Online

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“…[1][2][3][4] That is, if premedical courses do not cover basic concepts of the actual clinical practice of a doctor, premedical students may have difficulty in understanding why their attendance at these traditional lectures is necessary, es- 36 pecially when the lectures are not directly related to their future medical specialty. Thus, maximizing the pure educational goal of understanding "human-beings" during the premedical period may be enhanced by introducing concepts of clinical practice early on.…”

Section: Introduction Of Surgery To Premedical Studentsmentioning

confidence: 99%

What We Learned from the Experience of an Introduction to Surgery Class for First Grade Premedical Students

Kang

2017

J Minim Invasive Surg

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Purpose:In order to enhance the goal of premedical education, we developed new clinical educational course of surgery for first-grade premedical students. Methods:In 2015, from September 4 th to December 18 th , the educational performance records of firstgrade premedical students were evaluated, who attended the new, optional major class Introduction to surgery for future doctors. The non-compliance score was calculated as the sum of the total frequency of absences, number of late arrivals to class, and failure to submit the pre-lecture homework. This score was correlated with students' educational performance records. The premedical students' feed-back about this new class was summarized.Results: Among 79 first-grade premedical students at Yonsei University College of Medicine, 43 premedical students (54.4%) chose to attend the new class. Premedical students' individual noncompliance scores were inversely and significantly correlated to written test performance (R 2 =0.237, p=0.001). In survey analysis, the mean score for premedical students' course satisfaction was 8.6. They strongly suggested this new educational course should be continued for first-grade premedical students with a mean rating of 9.1. Premedical students were very impressed and satisfied by laparoscopic surgical simulation and visiting the operating room, with ratings of 9.7 and 9.3, respectively. Conclusion:This class is the first movement to introduce the surgery to the premedical students in Yonsei University. In spite of their scanty medical knowledge, this clinical class can provide positive influence on educational motivation as premedical students. Further modification of this class is mandatory based on what we learned from this educational experience. Keywords INtROduCtIONIn Korea, students who wish to become doctors must complete two years of premedical coursework followed by four years of medical courses. While the personal motivations to become doctors vary, it is believed that most students enter medical school to become doctors. It is also reasonable to believe that when premedical students begin their coursework they are excited and expect to anticipate learning basic medical sciences and enhancing their knowledge of the human body. Indeed, premedical students may be eager to jump into the pathophysiology of human diseases as well as learn how to perform physical examinations, make skin incisions, suture for primary repair, and so forth.However, contrary to these expectations, most first grade medical students must take a scheduled set of humanities, sci- Introduction of Surgery to Premedical Studentswww.e-jmis.org 35 ence, biology, physics, mathematics, and language courses. First-grade premedical students have already been exposed to a similar 'ready-scheduled' educational environment during the latter parts of high school. Certainly, these scheduled classes are very important and provide an excellent opportunity for premedical students to better understand the 'humanbeings' that they will treat as patients upon becoming do...

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“…moore@med.puc.cl E n la formación de los profesionales de salud en este siglo XXI, se exige una docencia centrada en el estudiante en la cual, además de altos estándares científicos y tecnológicos, se incluyan otros dominios tales como comunicación, profesionalismo, trabajo en equipo, entre otros 1 . El contacto con pacientes siempre ha sido una parte fundamental de la formación de los profesionales de la salud; se entiende que la interacción precoz con pacientes aumenta la motivación de los estudiantes, permite una transición gradual entre los años pre-clínicos y clínicos, y favorece que el estudiante aprenda sobre temas que son difíciles de abordar desde los libros o un plano teórico, tales como empatía, responsabilidad por el paciente, profesionalismo 2 . Por otra parte, la observación de los estudiantes en interacción con sus pacientes permite el aprendizaje basado en competencias y una evaluación en las escalas más altas de la pirámide de Miller 3 .…”

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Pacientes simulados en la formación de los profesionales de salud: el lado humano de la simulación

et al. 2016

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E n la formación de los profesionales de salud en este siglo XXI, se exige una docencia centrada en el estudiante en la cual, además de altos estándares científicos y tecnológicos, se incluyan otros dominios tales como comunicación, profesionalismo, trabajo en equipo, entre otros 1 . El contacto con pacientes siempre ha sido una parte fundamental de la formación de los profesionales de la salud; se entiende que la interacción precoz con pacientes aumenta la motivación de los estudiantes, permite una transición gradual entre los años pre-clínicos y clínicos, y favorece que el estudiante aprenda sobre temas que son difíciles de abordar desde los libros o un plano teórico, tales como empatía, responsabilidad por el paciente, profesionalismo 2 . Por otra parte, la observación de los estudiantes en interacción con sus pacientes permite el aprendizaje basado en competencias y una evaluación en las escalas más altas de la pirámide de Miller 3 .El ejercicio de los profesionales de salud ha cambiado dramáticamente en los últimos años 4 . El que la estadía de los pacientes en los hospitales sea cada vez más breve, y que la mayoría de los pacientes hospitalizados tengan una condición de salud grave, hace inadecuado que sean el centro de docencia del gran número de estudiantes que hoy aprendan en los campos clínicos. Las universidades deben asegurar que tienen protocolos claros sobre los temas éticos y legales implicados en la relación paciente-estudiante y contar con un sistema que protege a los pacientes que están involucrados en cualquier aspecto de la educación médica 5 . La nueva Ley de Derechos y Deberes de los pacientes recalca la importancia de un balance favorable en la relación equipo docente-paciente, que se fundamenta en la entrega de una atención centrada en los pacientes, promoviendo una cultura de calidad y seguridad en toda la actividad 6 . Los pacientes en Chile tienen una buena disposición a

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How can experience in clinical and community settings contribute to early medical education? A BEME systematic review

Abstract: Early experience helps medical students socialize to their chosen profession. It helps them acquire a range of subject matter and makes their learning more real and relevant. It has potential benefits for other stakeholders, notably teachers and patients. It can influence career choices.

Cited by 395 publications

References 64 publications

A review of longitudinal clinical programs in US medical schools

A review of longitudinal clinical programs in US medical schools

What We Learned from the Experience of an Introduction to Surgery Class for First Grade Premedical Students

Pacientes simulados en la formación de los profesionales de salud: el lado humano de la simulación

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