What students say about learning and teaching in longitudinal ambulatory primary care clerkships

Prislin, Michael D.; Feighny, K M; Stearns, Jeffrey A.; Hood, J; Arnold, Louise; Erney, S; Johnson, Lara

doi:10.1097/00001888-199806000-00015

Cited by 34 publications

(24 citation statements)

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“…Wilson & Cleland 2008) understanding that the learning outcomes were the same as those of students undertaking traditional block rotations if such activities were running in parallel. Some outcomes were very broad and more related to program objectives rather than assessable outcomes, for example: integration of basic and clinical science (Bell 2008), humanism in patient care (Bell et al 2008;Couper & Worley 2010), concepts relating to the doctor-patient relationship (Lewin et al 1999;Carney et al 2005), primary care needs of rural, underserved communities (Florence et al 2007;Halaas et al 2008), development of insights into community-based Bell et al 2008;Berger & Schaffer, 1986;Denz-Penhey et al 2004;Hadac et al 1979;Hamilton et al 1998;Henley et al 2000;Hirsh et al 2012;Lemon et al 1995;Lewin et al 1999;Lubetkin et al 1999;Ogur et al 2007;Peters et al 2001;Poncelet et al 2011;Poole et al 2010;Prislin et al 1998;Ringdahl et al 2009;Schauer & Schieve, 2006;Stagg et al 2009;Verby 1988;von Below et al 2008;Wee et al 2011;Wilson & Cleland, 2008 Student 1:1 interviews 14 Couper et al 2011;Denz-Penhey et al 2004Denz-Penhey & Murdoch 2008;Hamilton et al 1998;Hauer et al 2012;Walmsley et al 2009;W...…”

Section: What Learning Outcomes/objectives Are Defined?mentioning

confidence: 99%

A review of longitudinal community and hospital placements in medical education: BEME Guide No. 26

et al. 2013

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Background: Traditionally, clinical learning for medical students consists of short-term and opportunistic encounters with primarily acute-care patients, supervised by an array of clinician preceptors. In response to educational concerns, some medical schools have developed longitudinal placements rather than short-term rotations. Many of these longitudinal placements are also integrated across the core clinical disciplines, are commonly termed longitudinal integrated clerkships (LICs) and often situated in rural locations. This review aimed to explore, analyse and synthesise evidence relating to the effectiveness of longitudinal placements, for medical students in particular to determine which aspects are most critical to successful outcomes. Method: Extensive search of the literature resulted in 1679 papers and abstracts being considered, with 53 papers ultimately being included for review. The review group coded these 53 papers according to standard BEME review guidelines. Specific information extracted included: data relating to effectiveness, the location of the study, number of students involved, format, length and description of placement, the learning outcomes, research design, the impact level for evaluation and the main evaluation methods and findings. We applied a realist approach to consider what works well for whom and under what circumstances. Findings: The early LICs were all community-based immersion programs, situated in general practice and predominantly in rural settings. More recent LIC innovations were situated in tertiary-level specialist ambulatory care in urban settings. Not all placements were integrated across medical disciplines but were longitudinal in relation to location, patient base and/or supervision. Twentyfour papers focussed on one of four programs from different viewpoints. Most evaluations were student opinion (survey, interview, focus group) and/or student assessment results. Placements varied from one half day per week for six months through to full time immersion for more than 12 months. The predominant mechanism relating to factors influencing effectiveness was continuity of one or more of: patient care, supervision and mentorship, peer group and location. The success of LICs and participation satisfaction depended on the preparation of both students and clinical supervisors, and the level of support each received from their academic institutions. Conclusion: Longitudinal placements, including longitudinal integrated placements, are gaining in popularity as an alternative to traditional block rotations. Although relatively few established LICs currently exist, medical schools may look for ways to incorporate some of the principles of LICs more generally in their clinical education programmes. Further research is required to ascertain the optimum length of time for placements depending on the defined learning outcomes and timing within the programme, which students are most likely to benefit and the effects of context such as location and type of integration.

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Section: What Learning Outcomes/objectives Are Defined?mentioning

confidence: 99%

A review of longitudinal community and hospital placements in medical education: BEME Guide No. 26

et al. 2013

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“…Medical students are on the wards seeing patients and attending the RMO ward rounds, and are therefore in uenced to a greater extent by RMOs than faculty members, because of the greater time spent together (Sheets et al, 1991). In support of this observation, it is reported that students are reported to obtain approximately one third of their knowledge during clinical clerkships from RMOs (Sheets et al, 1991;Bing-You & Tooker, 1993) and student feedback has been used to provide insights into the effectiveness of resident rotations (Prislin et al, 1998). This proximity allows both formal and informal teaching, and therefore we wished to investigate whether student learning could be facilitated, and if it would be successful.…”

Section: Introductionmentioning

confidence: 96%

Residents as Teachers: Outcomes of a Brief Training Programme

Thomas

Harris²,

Rendina³

et al. 2002

Education for Health: Change in Learning & Practice

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“…13 Proponents of a longitudinal curriculum have also upheld the value of learning the natural history of a disease from a patient firsthand and forming a relationship with a patient rather than focusing learning on a complaint or disease. 14 Many programs have implemented longitudinal preceptorships with a goal of teaching about continuity of care, but logistical challenges may prevent implementation for some medical schools. 1,2 Limited reports have described what students learn about continuity of care in longitudinal preceptorships that attempt to teach about continuity of care.…”

Section: Medical Student Educationmentioning

confidence: 99%

“…Others have surveyed students about skills and knowledge they acquired in longitudinal rotations. 14 At the University of Washington, preclinical medical students participate in an 8-12 week preceptorship during their first year. One purpose of this experience is to provide early exposure to patients and engage students in a dialogue about the utility of continuity of care.…”

Section: Medical Student Educationmentioning

confidence: 99%

Medical Student Education

Lippa¹

2006

Ophthalmology

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What students say about learning and teaching in longitudinal ambulatory primary care clerkships

Cited by 34 publications

References 0 publications

A review of longitudinal community and hospital placements in medical education: BEME Guide No. 26

A review of longitudinal community and hospital placements in medical education: BEME Guide No. 26

Residents as Teachers: Outcomes of a Brief Training Programme

Medical Student Education

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