Comparing a longitudinal integrated clerkship with traditional hospital-based rotations in a rural setting

Abstract

Context: Longitudinal integrated clerkships (LIC) are widely used as an educational method, particularly in rural areas. They are good for facilitating hands-on learning and deep relationships between student, patients, and supervisors.

Objectives: This study sought to examine and compare learning experience of third-year rural medical students studying specialties (women’s health, aged care, child and adolescent heath, mental health, general practice) by either a traditional hospital-based rotation or a LIC in a rural general practice setting.

Methods: Data was collected from two groups of rural students (LIC; traditional hospital-based) over two academic years, utilizing focus groups to investigate general experiences of living and learning rurally, within the different educational models.

Results: Results reaffirmed that there was no perceived academic disadvantage to studying medicine rurally. Studying medicine in a rural area provides increased access to patients, more hands-on experience, and close relationships with patients and colleagues. LIC students reported increased confidence in clinical skills, felt better prepared for internship, however experienced more social isolation than students in hospital-based rotations.

Conclusions: Students undergoing a rural LIC feel more confident in their clinical skills and preparedness for practice than other rural students. This study supports the use of LICs as a powerful educational tool.

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 (LIC): “Characterized by being the central element of clinical education whereby medical students: (1) participate in the comprehensive care of patients over time; (2) participate in continuing learning relationships with these patients’ clinicians; and (3) meet the majority of the year’s core clinical competencies, across multiple disciplines simultaneously through these experiences”

(Consensus LIC definition, International Consortium of Longitudinal Integrated Clerkships, Cambridge MA, 2007)

Notes on contributors

Rebecca Caygill, BSc(Hons), is a Research Assistant in Rural Medical Education, based at the Shepparton Department of Rural Health. She is an early career researcher with a study background in psychology, and an interest in the mental health and wellbeing of rural medical students.

Mia Peardon, BA(Hons), DipEd, is an early career researcher in the area of medical education based at the Shepparton Department of Rural Health. Mia has a background in teaching and education and has a particular interest in medical educator development and accreditation.

Catherine Waite, BA(Hons), MPhil, is a PhD candidate in the School of Social Sciences at Monash University. Her field of interest is young people in regional communities. Catherine has also worked as a Research Assistant in the area of Medical Education and Rural Health.

Julian Wright, BSc(Hons), MBBS, MSc, MD(Res), FHEA, FAcadMEd(UK), FRCP(UK), FRACP, is the Director of Medical Student Education at the University of Melbourne’s Rural Clinical School, a Fellow of UK Academy of Medical Educators, and Professor of Medicine. Previously a UK Royal College of Physicians Tutor for Medicine, and Director of Postgraduate Medical Education at one of UKs largest hospital trusts.