Korean Medical Education Review (의학교육논단)

Yonsei university college of medicine (연세대학교 의과대학)
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Development and Operation of Longitudinal Integrated Clerkship Programs in Overseas Medical Schools

외국 의과대학에서의 장기추적통합임상실습 개발과 운영사례

  • Yeo, Sanghee (Department of Medical Education, Kyungpook National University School of Medicine)
  • 여상희 (경북대학교 의과대학 의학교육학교실)
  • Received : 2018.01.22
  • Accepted : 2018.02.21
  • Published : 2018.02.28
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Abstract

In recent years, Korean medical schools have shown a growing interest in the longitudinal integrated clerkship (LIC) as a means of improving clinical education. Some overseas medical schools have tried the LIC since the 1970s. In the 1990s, several universities in the United States, Canada, and Australia introduced LICs. A variety of studies have confirmed positive results of the LIC. Traditional block-rotation is a discipline-based, inpatient-centered practice. Instead, under the LIC system, a medical student responsible for a panel of longitudinal patients observes developments of their diseases, serving several departments simultaneously. Overseas medical schools have different LIC models depending on their affiliate hospitals' sizes and characteristics. The purpose of this study is to introduce LIC practices in Harvard Medical School and University of California San Francisco, which could be applied by Korean medical schools. This paper also aims to find out the strategies that have been able to help the two US medical schools implement the LIC successfully.

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References

  1. Ogur B, Hirsh D, Krupat E, Bor D. The Harvard Medical School-Cambridge integrated clerkship: an innovative model of clinical education. Acad Med. 2007;82(4):397-404. https://doi.org/10.1097/ACM.0b013e31803338f0
  2. Norris TE, Schaad DC, DeWitt D, Ogur B, Hunt DD; Consortium of Longitudinal Integrated Clerkships. Longitudinal integrated clerkships for medical students: an innovation adopted by medical schools in Australia, Canada, South Africa, and the United States. Acad Med. 2009;84(7):902-7. https://doi.org/10.1097/ACM.0b013e3181a85776
  3. Diuguid-Gerber J, Porter S, Quiah SC, Nickerson K, Jones D, Audi Z, et al. The Columbia-Bronx VA amalgamative clerkship: an effective, 12-week, integrated, longitudinal clinical experience. Med Educ Online. 2017;22(1):1301630. https://doi.org/10.1080/10872981.2017.1301630
  4. Poncelet A, Bokser S, Calton B, Hauer KE, Kirsch H, Jones T, et al. Development of a longitudinal integrated clerkship at an academic medical center. Med Educ Online. 2011;16. https://doi.org/10.3402/meo.v16i0.5939.
  5. Poncelet AN, Mazotti LA, Blumberg B, Wamsley MA, Grennan T, Shore WB. Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system. Perm J. 2014;18(2):50-6. https://doi.org/10.7812/TPP/13-137
  6. Myhre DL, Woloschuk W, Pedersen JS. Exposure and attitudes toward interprofessional teams: a three-year prospective study of longitudinal integrated clerkship versus rotation-based clerkship students. J Interprof Care. 2014;28(3):270-2. https://doi.org/10.3109/13561820.2013.829425
  7. Pipas CF, Peltier DA, Fall LH, Olson AL, Mahoney JF, Skochelak SE, et al. Collaborating to integrate curriculum in primary care medical education: successes and challenges from three US medical schools. Fam Med. 2004;36 Suppl:S126-32.
  8. Hirsh D, Walters L, Poncelet AN. Better learning, better doctors, better delivery system: possibilities from a case study of longitudinal integrated clerkships. Med Teach. 2012;34(7):548-54. https://doi.org/10.3109/0142159X.2012.696745
  9. Heck JE, Latessa RA, Beaty N. The third-year longitudinal integrated clerkship at the Asheville campus of the University of North Carolina School of Medicine. N C Med J. 2014;75(1):56-8.
  10. Epstein-Lubow G, Cineas S, Yess J, Anthony D, Fagan M, George P. Development of a longitudinal integrated clerkship at the Warren Alpert Medical School of Brown University. R I Med J (2013). 2015; 98(9):27-31.
  11. Couper I, Worley PS, Strasser R. Rural longitudinal integrated clerkships: lessons from two programs on different continents. Rural Remote Health. 2011;11(2):1665.
  12. Thistlethwaite JE, Bartle E, Chong AA, Dick ML, King D, Mahoney S, et al. A review of longitudinal community and hospital placements in medical education: BEME guide no. 26. Med Teach. 2013;35(8): e1340-64. https://doi.org/10.3109/0142159X.2013.806981
  13. Poncelet A, Hirsh D. Longitudinal integrated clerkship: principles, outcomes, practical tools, and future directions. North Syracuse (NY): Gegensatz Press; 2016.
  14. Hauer KE, Hirsh D, Ma I, Hansen L, Ogur B, Poncelet AN, et al. The role of role: learning in longitudinal integrated and traditional block clerkships. Med Educ. 2012;46(7):698-710. https://doi.org/10.1111/j.1365-2923.2012.04285.x
  15. Hirsh D, Gaufberg E, Ogur B, Cohen P, Krupat E, Cox M, et al. Educational outcomes of the Harvard Medical School-Cambridge integrated clerkship: a way forward for medical education. Acad Med. 2012;87(5):643-50. https://doi.org/10.1097/ACM.0b013e31824d9821
  16. Latessa RA, Swendiman RA, Parlier AB, Galvin SL, Hirsh DA. Graduates' perceptions of learning affordances in longitudinal integrated clerkships: a dual-institution, mixed-methods study. Acad Med. 2017;92(9):1313-9. https://doi.org/10.1097/ACM.0000000000001621
  17. Strasser R, Hirsh D. Longitudinal integrated clerkships: transforming medical education worldwide? Med Educ. 2011;45(5):436-7. https://doi.org/10.1111/j.1365-2923.2011.03939.x
  18. Association of American Medical Colleges. Curriculum reports [Internet]. Washington (DC): Association of American Medical Colleges [cited 2018 Jan 22]. Available from: https://www.aamc.org/initiatives/cir/402412/01a.html.
  19. Worley P, Couper I, Strasser R, Graves L, Cummings BA, Woodman R, et al. A typology of longitudinal integrated clerkships. Med Educ. 2016;50(9):922-32. https://doi.org/10.1111/medu.13084
  20. Hirsh DA, Ogur B, Thibault GE, Cox M. "Continuity" as an organizing principle for clinical education reform. N Engl J Med. 2007;356(8):858-66. https://doi.org/10.1056/NEJMsb061660
  21. Teherani A, Irby DM, Loeser H. Outcomes of different clerkship models: longitudinal integrated, hybrid, and block. Acad Med. 2013;88(1):35-43. https://doi.org/10.1097/ACM.0b013e318276ca9b
  22. Hirsh DA, Holmboe ES, ten Cate O. Time to trust: longitudinal integrated clerkships and entrustable professional activities. Acad Med. 2014;89(2):201-4. https://doi.org/10.1097/ACM.0000000000000111
  23. Gaufberg E, Hirsh D, Krupat E, Ogur B, Pelletier S, Reiff D, et al. Into the future: patient-centredness endures in longitudinal integrated clerkship graduates. Med Educ. 2014;48(6):572-82. https://doi.org/10.1111/medu.12413
  24. Walters L, Greenhill J, Richards J, Ward H, Campbell N, Ash J, et al. Outcomes of longitudinal integrated clinical placements for students, clinicians and society. Med Educ. 2012;46(11):1028-41. https://doi.org/10.1111/j.1365-2923.2012.04331.x
  25. Ogur B, Hirsh D. Learning through longitudinal patient care-narratives from the Harvard Medical School-Cambridge Integrated Clerkship. Acad Med. 2009;84(7):844-50. https://doi.org/10.1097/ACM.0b013e3181a85793
  26. O'Brien BC, Hirsh D, Krupat E, Batt J, Hansen LA, Poncelet AN, et al. Learners, performers, caregivers, and team players: descriptions of the ideal medical student in longitudinal integrated and block clerkships. Med Teach. 2016;38(3):297-305.