Longitudinal integrated clerkships^*

Abstract

There is increased interest in longitudinal integrated clerkships (LICs) due to mounting evidence of positive outcomes for students, patients and supervising clinicians. Emphasizing continuity as the organizing principle of an LIC, this article reviews evidence and presents perspectives of LIC participants concerning continuity of care, supervision and curriculum, and continuity with peers and systems of care. It also offers advice on implementing or evaluating existing LIC programs.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Longitudinal Integrated Clerkship: “Clerkship” refers to the practice of medicine by medical students during their final year(s) of study; “longitudinal” applies to a long-term clinical clerkship usually of one full academic year; and “integrated” describes continuous and concurrent community and hospital clinical experiences for each learner.

Notes on contributors

Professor Judith Nicky Hudson, BSc, BMBS, MSc, PhD, FHEA, has extensive experience in medical education, including curriculum innovation and/or establishment of new medical programs at the Universities of Adelaide, Wollongong and Newcastle in Australia, and Peninsula Medical School in England. As an Associate Dean of Community-Based Health Education at Wollongong, she implemented “whole class” longitudinal integrated clerkships distributed in regional, rural and remote NSW. Her research interests include interprofessional education, peer-assisted learning, assessment, longitudinal integrated clerkships and rural health workforce. She is a Conjoint Professor of the University of Newcastle, a Clinical Professor of the University of Wollongong, and Associate Editor of “Rural and Remote Health”.

Professor Ann N. Poncelet, MD, is a Professor of Clinical Neurology, Mr. and Mrs. David George Rowe and Stephen W. Rowe Endowed Chair for Teaching in Neurology at the University of California San Francisco (UCSF). She is co-director of the first UCSF longitudinal integrated clerkship (LIC) and oversees all UCSF LIC programs. She is a member of the Consortium of Longitudinal Integrated Clerkships (CLIC) since 2007 and hosted the third CLIC annual meeting at UCSF in 2008. She has published on the outcomes of longitudinal integrated clerkships with a focus on the impact of longitudinal relationships with patients and the peer community.

Dr Kath M. Weston, BSc(Hons), PhD, AFANZAHPE, is a Senior Lecturer in Public Health at the Graduate School of Medicine, University of Wollongong, Australia. Her research and scholarly interests include medical education, building research capacity in primary care, public health, medical humanities, and the history of public health medicine. She also collaborates on a public health research project to investigate area-level socioeconomic disadvantage in chronic disease. Her recent publications relate to the development of clinical scholarship in rural and regional general practices where medical students learn in a longitudinal integrated clerkship, and investigation of knowledge and understanding of research ethics in medical education.

Professor John A. Bushnell, PhD, FNZCCPsych, MNZICD, an educator and clinical psychologist, has worked for most of his career in academic, research, and clinical roles in medical settings, moving to Australia in 2005 to lead the establishment of a new medical school at the University of Wollongong. His research interests have focused on the epidemiology of mental disorders, management of psychological issues in primary care, and medical education. Back in New Zealand, he retains involvement in various research projects; is a Clinical Professor at the University of Wollongong and Illawarra Institute for Mental Health; and a part-time consultant in supervision, research, and evaluation.

Professor Liz Farmer, BSc, MBBS, FRACGP, PhD, MAICD, is a Clinical Professor at the Universities of Wollongong, Flinders and Adelaide. In national roles, she Chairs the Australian Medical Council (AMC) Prevocational Accreditation Committee, the AMC Research Committee and the Medical Board Australia Expert Advisory Group on Revalidation. She was previously the Dean of Medicine at the University of Wollongong and Executive Director, Workforce Innovation and Reform at Health Workforce Australia. Her special interests include medical and health science education, innovation, curriculum development, the assessment of competence and performance of doctors, health accreditation, regulation, policy and governance.