UK longitudinal integrated clerkships: where are we now?

McKeown, Andrew; Mollaney, Jenna; Ahuja, Neha; Parekh, Ravi; Kumar, Sonia

doi:10.1080/14739879.2019.1653228

Cited by 22 publications

(25 citation statements)

References 11 publications

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“…Other institutions such as Imperial College and Hull York Medical School have piloted LIC programmes that run in primary and secondary care. It remains to be seen within the UK whether LIC will be introduced more widely into medical school curricula, but early student feedback is positive [23,24]. The COVID-19 pandemic may provide valuable insight into assessing how clinical placements can be improved within the medical curriculum in the UK.…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on final year medical students in the United Kingdom: a national survey

et al. 2020

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Background: The coronavirus disease (COVID-19) global pandemic has resulted in unprecedented public health measures. This has impacted the UK education sector with many universities halting campus-based teaching and examinations. The aim of this study is to identify the impact of COVID-19 on final year medical students' examinations and placements in the United Kingdom (UK) and how it might impact their confidence and preparedness going into their first year of foundation training. Methods: A 10-item online survey was distributed to final year medical students across 33 UK medical schools. The survey was designed by combining dichotomous, multiple choice and likert response scale questions. Participants were asked about the effect that the COVID-19 global pandemic had on final year medical written exams, electives, assistantships and objective structured clinical examinations (OSCEs). The survey also explored the student's confidence and preparedness going into their first year of training under these new unprecedented circumstances. Results: Four hundred forty students from 32 UK medical schools responded. 38.4% (n = 169) of respondents had their final OSCEs cancelled while 43.0% (n = 189) had already completed their final OSCEs before restrictions. 43.0% (n = 189) of assistantship placements were postponed while 77.3% (n = 340) had electives cancelled. The impact of COVID-19 on OSCEs, written examinations and student assistantships significantly affected students' preparedness (respectively p = 0.025, 0.008, 0.0005). In contrast, when measuring confidence, only changes to student assistantships had a significant effect (p = 0.0005). The majority of students feel that measures taken during this pandemic to amend their curricula was necessary. Respondents also agree that assisting in hospitals during the outbreak would be a valuable learning opportunity. Conclusions: The impact on medical student education has been significant, particularly affecting the transition from student to doctor. This study showed the disruptions to student assistantships had the biggest effect on students' confidence and preparedness. For those willing to assist in hospitals to join the front-line workforce, it is crucial to maintain their wellbeing with safeguards such as proper inductions, support and supervision.

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Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on final year medical students in the United Kingdom: a national survey

et al. 2020

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“…In order to facilitate timely development, the learning outcomes and assessment of the LIC remained the same as for 'block-rotation' students (as has been the case for several UK programmes [5,25]). LIC students are expected to cover fourth year block content (including a variety of specialities such as child and women's health) longitudinally.…”

Section: Contextmentioning

confidence: 99%

“…Many benefits of LICs have been evidenced, including increased recruitment to general practice, and relationship building between communities, educational institutions and faculty [2][3][4]. However, there are gaps in knowledge relating to how LICs operate in different UK contexts and how the components integrate for a student learning experience that meets the needs of students, medical schools, communities and the medical profession [5].…”

Section: Introductionmentioning

confidence: 99%

“…Yet, over time, this uptake has resulted in a diversification of what is known and understood as the purpose of an LIC, highlighting a need to explicate how LICs work in different contexts. Through international collaboration, Worley et al developed a typology to address this divergence, resulting in the raising of many questions about the intricacies regarding structured teaching time, patient encounters, and faculty input [2,5,8]. The components of LICs which are unique to medical student clinical placements are also those which are implemented variously [3,9,10].…”

Section: Introductionmentioning

confidence: 99%

“…Within the UK, despite publishing one of the early initiatives [23], the prevalence of LICs has lagged behind other countries including Australia, United States, South Africa and Canada [2,7,24,25]. Recent literature has postulated at various reasons as to why the UK healthcare landscape may make the LIC model more complex to implement given the relationships between primary and secondary healthcare settings [5] and institutional hidden curricula [26]. Yet, there are small-scale LICs at medical schools such as Dundee, Imperial and Cardiff [27,28] that have proven successful, placing students at the forefront of healthcare delivery.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Not all who wander are lost: evaluation of the Hull York medical school longitudinal integrated clerkship

Brown

Crampton

Anderson

et al. 2020

Education for Primary Care

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Longitudinal integrated clerkships (LICs) are increasingly available within the United Kingdom, but gaps in knowledge remain regarding their efficacy and the influence of local context. In 2019-20, the Hull York Medical School ran a pilot LIC for 6 fourth-year medical students. This work describes the longitudinal qualitative programme evaluation. LIC students participated in two focus groups, one after four months, and another at the end of the programme. In total, 16 faculty were also interviewed regarding their experiences in developing, implementing and running the LIC. Students' GP supervisors were difficult to engage in detailed evaluation due to the COVID-19 pandemic, and so were briefly surveyed at the end of the LIC. All data were pooled and analysed together using reflexive thematic analysis. Two major themes were identified: 'Trajectory of the LIC', describing the learning curve students and faculty encounter, and 'Institutional decision making', describing the need for clarity regarding the programme's purpose. The programme was largely positively received, but areas for improvement locally, and transferrable recommendations, were identified. Aligning assessment to programme aims is an important area for future development, alongside balancing structured with unstructured time, and supporting students as they navigate a J-shaped learning curve.

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A comparative study of the effect of the Time for Dementia programme on medical students

Banerjee

Jones

Wright

et al. 2021

Int J Geriat Psychiatry

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Background Traditional healthcare education typically focuses on short block clinical placements based on acute care, investigations and technical aspects of diagnosis and treatment. It may therefore fail to build the understanding, compassion and person‐centred empathy needed to help those with long‐term conditions, like dementia. Time for Dementia was developed to address this. Method Parallel group comparison of two cohorts of UK medical students from universities, one participating in Time for Dementia (intervention group) and one not (control group). In Time for Dementia students visit a person with dementia and their family in pairs for 2 hours three times a year for 2 years, the control group received their normal curriculum. Results In an adjusted multilevel model (intervention group n = 274, control n = 112), there was strong evidence supporting improvements for Time for Dementia participants in: total Approaches to Dementia Questionnaire score (coefficient: 2.19, p = 0.003) and its person‐centredness subscale (1.32, p = 0.006) and weaker evidence in its hopefulness subscale (0.78, p = 0.070). There was also strong evidence of improvement in the Dementia Knowledge Questionnaire (1.63, p < 0.001) and Dementia Attitudes Scale (total score: 6.55, p < 0.001; social comfort subscale: 4.15, p < 0.001; dementia knowledge subscale: 3.38, p = 0.001) scores. No differences were observed on the Alzheimer's Disease Knowledge Scale, the Medical Condition Regard Scale or the Jefferson Scale of Empathy. Discussion Time for Dementia may help improve the attitudes of medical students towards dementia promoting a person‐centred approach and increasing social comfort. Such patient‐focused programmes may be a useful complement to traditional medical education.

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UK longitudinal integrated clerkships: where are we now?

Cited by 22 publications

References 11 publications

The impact of the COVID-19 pandemic on final year medical students in the United Kingdom: a national survey

The impact of the COVID-19 pandemic on final year medical students in the United Kingdom: a national survey

Not all who wander are lost: evaluation of the Hull York medical school longitudinal integrated clerkship

A comparative study of the effect of the Time for Dementia programme on medical students

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