Longitudinal integrated clerkships for medical students: An innovation adopted by medical schools in Australia, Canada, South Africa, and the United States

Authors

Thomas E. Norris, University of Washington
Douglas C. Schaad, University of Washington
Dawn DeWitt, University of Melbourne
Barbara Ogur, Harvard Medical School
D. Daniel Hunt, Association of American Medical Colleges
Jim Blackman, University of Washington
David Campbell, Monash University
Ian Couper, University of Witwatersrand
Diann Eley, University of Queensland
Joan Fraser, University of British Columbia
Gwen Halaas, University of Minnesota
Lori Hansen, University of South Dakota
David Hirsh, Harvard Medical School
Judith N. Hudson, University of WollongongFollow
Barry Linger, University of West Virginia
Campbell Murdoch, University of Western Australia
Jeff Pocock, University of British Columbia
Ann Poncelet, University of California, San Francisco
Roger Schauer, University of North Dakota
Paul Worley, Flinders University
Tim Zmijowskyj, Northern Ontario School of Medicine

RIS ID

32377

Publication Details

Norris, T. E., Schaad, D. C., DeWitt, D., Ogur, B., Hunt, D. Daniel., Blackman, J., Campbell, D., Couper, I., Eley, D., Fraser, J., Halaas, G., Hansen, L., Hirsh, D., Hudson, J. N., Linger, B., Murdoch, C., Pocock, J., Poncelet, A., Schauer, R., Worley, P. & Zmijowskyj, T. (2009). Longitudinal integrated clerkships for medical students: An innovation adopted by medical schools in Australia, Canada, South Africa, and the United States. Academic Medicine, 84 (7), 902-907.

Abstract

Purpose: Integrated clinical clerkships represent a relatively new and innovative approach to medical education that uses continuity as an organizing principle, thus increasing patient-centeredness and learner-centeredness. Medical schools are offering longitudinal integrated clinical clerkships in increasing numbers. This report collates the experiences of medical schools that use longitudinal integrated clerkships for medical student education in order to establish a clearer characterization of these experiences and summarize outcome data, when possible.

Method: The authors sent an e-mail survey with open text responses to 17 medical schools with known longitudinal integrated clerkships.

Results: Sixteen schools in four countries on three continents responded to the survey. Fifteen institutions have active longitudinal integrated clerkships in place. Two programs began before 1995, but the others are newer. More than 2,700 students completed longitudinal integrated clerkships in these schools. The median clerkship length is 40 weeks, and in 15 of the schools, the core clinical content was in medicine, surgery, pediatrics, and obstetrics-gynecology. Eleven schools reported supportive student responses to the programs. No differences were noted in nationally normed exam scores between program participants and those in the traditional clerkships. Limited outcomes data suggest that students who participate in these programs are more likely to enter primary care careers.

Conclusions: This study documents the increasing use of longitudinal integrated clerkships and provides initial insights for institutions that may wish to develop similar clinical programs. Further study will be needed to assess the long-term impact of these programs on medical education and workforce initiatives.