TY - JOUR
T1 - Continuity in Undergraduate Medical Education
T2 - Mission Not Accomplished
AU - Evans, Daniel B.
AU - Henschen, Bruce L.
AU - Poncelet, Ann N.
AU - Wilkerson, Lu Ann
AU - Ogur, Barbara
N1 - Publisher Copyright:
© 2019, Society of General Internal Medicine.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Evidence is mounting that longitudinal medical student clerkships provide better educational experiences than traditional block clerkship “silos.” Education studies across institutions demonstrate positive effects of continuity on medical students, including creating patient-centered learning environments, improving fidelity of evaluations and feedback, improving medical student patient-centeredness, enabling more autonomous functioning in the clinical workplace, and increased recruitment and retention of students into primary care careers. Outcome studies show potential for longitudinal students to add value to patient care. This perspective piece summarizes the current evidence basis for longitudinal clerkships broken down by Kirkpatrick level (reactions, perceptions/attitudes, knowledge, behaviors, and patient benefits). Despite this evidence, expansion of longitudinal clerkships has been slow—i.e., fewer than half of current US medical schools offer one. While more recent curricular innovations center around Entrustable Professional Activities (EPAs), there are clear opportunities for medical schools to use longitudinal clerkships as a lens through which EPAs can be effectively evaluated. This perspective highlights the synergy between longitudinal clerkships and EPAs, showing that successful implementation of the former should empower the latter. While large, complex educational interventions are daunting tasks, change is needed. Regulatory organizations should mandate continuity-focused experiences for US medical graduates.
AB - Evidence is mounting that longitudinal medical student clerkships provide better educational experiences than traditional block clerkship “silos.” Education studies across institutions demonstrate positive effects of continuity on medical students, including creating patient-centered learning environments, improving fidelity of evaluations and feedback, improving medical student patient-centeredness, enabling more autonomous functioning in the clinical workplace, and increased recruitment and retention of students into primary care careers. Outcome studies show potential for longitudinal students to add value to patient care. This perspective piece summarizes the current evidence basis for longitudinal clerkships broken down by Kirkpatrick level (reactions, perceptions/attitudes, knowledge, behaviors, and patient benefits). Despite this evidence, expansion of longitudinal clerkships has been slow—i.e., fewer than half of current US medical schools offer one. While more recent curricular innovations center around Entrustable Professional Activities (EPAs), there are clear opportunities for medical schools to use longitudinal clerkships as a lens through which EPAs can be effectively evaluated. This perspective highlights the synergy between longitudinal clerkships and EPAs, showing that successful implementation of the former should empower the latter. While large, complex educational interventions are daunting tasks, change is needed. Regulatory organizations should mandate continuity-focused experiences for US medical graduates.
KW - Entrustable Professional Activities
KW - Longitudinal Integrated Clerkship
KW - continuity in medical education
KW - undergraduate medical education
KW - value-added medical education
UR - http://www.scopus.com/inward/record.url?scp=85069740960&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85069740960&partnerID=8YFLogxK
U2 - 10.1007/s11606-019-04949-0
DO - 10.1007/s11606-019-04949-0
M3 - Article
C2 - 31346908
AN - SCOPUS:85069740960
VL - 34
SP - 2254
EP - 2259
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
SN - 0884-8734
IS - 10
ER -