Learners, performers, caregivers, and team players: Descriptions of the ideal medical student in longitudinal integrated and block clerkships

Abstract

Background: Hidden curriculum literature suggests that different learning environments and curricular designs reinforce disparate values and behaviors.

Aim: This study explores potential differences in learning environments afforded by two clerkship models through perceptions of the ideal student.

Methods: In this qualitative study, research assistants interviewed 48 third-year students and 26 clinical supervisors from three US medical schools. Students and supervisors participated in longitudinal integrated clerkships (LICs) or block clerkships. Students and supervisors described the ideal student in their clerkship. Using phenomenographic techniques, authors identified five ideal student profiles and coded students’ and supervisors’ descriptions for alignment with one or more profiles.

Results: Most students in both models described an ideal student who matched a learner profile (proactive and self-directed). More LIC students described an ideal student who fit a caregiver profile (engaging with and advocating for patients) and more block students described performer (appearing knowledgeable and competent) and team-player (working well with others) profiles. Supervisors’ descriptions paralleled students’ descriptions but with less emphasis on caregiving.

Conclusions: Ideal student descriptions in LIC and block models may reflect different learning experiences and values emphasized in each model. These findings suggest implications for students’ construction of professional identities that warrant further exploration.

Acknowledgements

The authors thank the University of California, San Francisco ESCape works in progress group, Dr. Patricia O’Sullivan and Dr. Arianne Teherani for helpful feedback on the manuscript. They also thank DB Reiff, Jennifer McGinnis, and Taleesha Becker for research assistance.

Declaration of interest: This study was funded in part by the Josiah Macy, Jr. Foundation and the UCSF Academy of Medical Educators.

The authors report no conflicts of interest. Ethical approval: This study was approved by the institutional review boards of the University of California, San Francisco, the University of South Dakota, and Harvard Medical School.