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Erschienen in: Journal of General Internal Medicine 10/2018

03.08.2018 | Innovation and Improvement: Innovations in Medical Education

Longitudinal Continuity Learning Experiences and Primary Care Career Interest: Outcomes from an Innovative Medical School Curriculum

verfasst von: Christine D. Ford, MA, Premal G. Patel, MD, Victor S. Sierpina, MD, Mark W. Wolffarth, MD, Judith L. Rowen, MD

Erschienen in: Journal of General Internal Medicine | Ausgabe 10/2018

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Abstract

Background

Medical students in the USA have negative perceptions of primary care careers, which are exacerbated by the hidden curriculum and medical school culture. Longitudinal integrated clerkships (LICs) have shown promise in ameliorating this situation by promoting student/preceptor continuity relationships and helping students maintain empathy.

Aim

The aim of this study is to describe the Student Continuity of Practice Experience (SCOPE) program and demonstrate program outcomes using evaluation data from residency match results, course evaluations, and student grades.

Setting

University of Texas Medical Branch, an academic health center in Galveston, Texas.

Participants

Undergraduate medical students.

Program Description

Learners participate in a longitudinal curriculum designed to enhance their skills as primary care physicians. They regularly attend continuity clinic, establishing a panel of patients by their third year. Students receive frequent feedback from a faculty mentor on assignments and clinical performance.

Program Evaluation

SCOPE students have high primary care residency match rates and experience patient continuity rates comparable to an intern. Their interest in primary care increases between years one and three, a departure from typical medical student trends.

Discussion

SCOPE appears to promote and maintain primary care career interest in participants and has transferability to other institutions.
Literatur
2.
Zurück zum Zitat Hauer KE, Durning SJ, Kernan WN, Fagan MJ, Mintz M, O’Sullivan PS, Battistone M, DeFer T, Elnicki M, Harrell H, Reddy S. Factors associated with medical students' career choices regarding internal medicine. JAMA 2008 Sep 10;300(10):1154–64.CrossRefPubMed Hauer KE, Durning SJ, Kernan WN, Fagan MJ, Mintz M, O’Sullivan PS, Battistone M, DeFer T, Elnicki M, Harrell H, Reddy S. Factors associated with medical students' career choices regarding internal medicine. JAMA 2008 Sep 10;300(10):1154–64.CrossRefPubMed
3.
Zurück zum Zitat Stone VE, Kormos WA, Levitan SE, Shannon S, Michener JL, Martin JJ, Barry MJ. Physician education and training in primary care. In: Culliton B, Russell S, eds. Who will provide primary care and how will they be trained? Proceedings of a Conference Sponsored by the Josiah Macy, Jr. Foundation; 2010; Durham, N.C. Josiah Macy, Jr. Foundation; 2010. p 109–65. Stone VE, Kormos WA, Levitan SE, Shannon S, Michener JL, Martin JJ, Barry MJ. Physician education and training in primary care. In: Culliton B, Russell S, eds. Who will provide primary care and how will they be trained? Proceedings of a Conference Sponsored by the Josiah Macy, Jr. Foundation; 2010; Durham, N.C. Josiah Macy, Jr. Foundation; 2010. p 109–65.
4.
Zurück zum Zitat Clinite KL, Reddy ST, Kazantsev SM, Kogan JR, Durning SJ, Blevins T, Chou CL, Diemer G, Dunne DW, Fagan MJ, Hartung PJ. Primary care, the ROAD less traveled: what first-year medical students want in a specialty. Acad Med 2013; 88(10):1522–8.CrossRefPubMed Clinite KL, Reddy ST, Kazantsev SM, Kogan JR, Durning SJ, Blevins T, Chou CL, Diemer G, Dunne DW, Fagan MJ, Hartung PJ. Primary care, the ROAD less traveled: what first-year medical students want in a specialty. Acad Med 2013; 88(10):1522–8.CrossRefPubMed
5.
Zurück zum Zitat Jeffe DB, Whelan AJ, Andriole DA. Primary care specialty choices of United States medical graduates, 1997–2006. Acad Med 2010 Jun 1; 85(6):947–58.CrossRefPubMed Jeffe DB, Whelan AJ, Andriole DA. Primary care specialty choices of United States medical graduates, 1997–2006. Acad Med 2010 Jun 1; 85(6):947–58.CrossRefPubMed
6.
Zurück zum Zitat Bodenheimer T, Berenson RA, Rudolf P. The primary care–specialty income gap: why it matters. Ann Intern Med 2007; 146(4):301–6.CrossRefPubMed Bodenheimer T, Berenson RA, Rudolf P. The primary care–specialty income gap: why it matters. Ann Intern Med 2007; 146(4):301–6.CrossRefPubMed
7.
Zurück zum Zitat Bennett KL, Phillips JP. Finding, recruiting, and sustaining the future primary care physician workforce: a new theoretical model of specialty choice process. Acad Med 2010; 85: S81-S8.CrossRefPubMed Bennett KL, Phillips JP. Finding, recruiting, and sustaining the future primary care physician workforce: a new theoretical model of specialty choice process. Acad Med 2010; 85: S81-S8.CrossRefPubMed
8.
Zurück zum Zitat Hafferty FW. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med 1998 Apr;73(4):403–7.CrossRefPubMed Hafferty FW. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med 1998 Apr;73(4):403–7.CrossRefPubMed
9.
Zurück zum Zitat Erikson CE, Danish S, Jones KC, Sandberg SF, Carle AC. The role of medical school culture in primary care career choice. Acad Med 2013; 88(12):1919–26.CrossRefPubMed Erikson CE, Danish S, Jones KC, Sandberg SF, Carle AC. The role of medical school culture in primary care career choice. Acad Med 2013; 88(12):1919–26.CrossRefPubMed
10.
Zurück zum Zitat Compton MT, Frank E, Elon L, Carrera J. Changes in US medical students’ specialty interests over the course of medical school. J Gen Intern Med 2008; 23(7):1095–100.CrossRefPubMedPubMedCentral Compton MT, Frank E, Elon L, Carrera J. Changes in US medical students’ specialty interests over the course of medical school. J Gen Intern Med 2008; 23(7):1095–100.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Babbott D. The stability of specialty preferences among U.S. medical school graduates in 1983. JAMA 1988; 259:1970–5.CrossRefPubMed Babbott D. The stability of specialty preferences among U.S. medical school graduates in 1983. JAMA 1988; 259:1970–5.CrossRefPubMed
12.
Zurück zum Zitat Walters L, Greenhill J, Richards J, Ward H, Campbell N, Ash J, Schuwirth LW. Outcomes of longitudinal integrated clinical placements for students, clinicians and society. Med Educ 2012; 46: 1028–41.CrossRefPubMed Walters L, Greenhill J, Richards J, Ward H, Campbell N, Ash J, Schuwirth LW. Outcomes of longitudinal integrated clinical placements for students, clinicians and society. Med Educ 2012; 46: 1028–41.CrossRefPubMed
13.
Zurück zum Zitat Poncelet AN, Mazotti LA, Blumberg B, Wamsley MA, Grennan T, Shore WB. Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system. Perm J 2014; 18: 50.CrossRefPubMedPubMedCentral Poncelet AN, Mazotti LA, Blumberg B, Wamsley MA, Grennan T, Shore WB. Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system. Perm J 2014; 18: 50.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Henschen BL, Bierman JA, Wayne DB, Ryan ER, Thomas JX, Curry RH, Evans DB. Four-year educational and patient care outcomes of a team-based primary care longitudinal clerkship. Acad Med 2015; 90: S43-S9.CrossRefPubMed Henschen BL, Bierman JA, Wayne DB, Ryan ER, Thomas JX, Curry RH, Evans DB. Four-year educational and patient care outcomes of a team-based primary care longitudinal clerkship. Acad Med 2015; 90: S43-S9.CrossRefPubMed
15.
Zurück zum Zitat Ellaway R, Graves L, Berry S, Myhre D, Cummings BA, Konkin J. Twelve tips for designing and running longitudinal integrated clerkships. Med Teach 2013; 35: 989–95.CrossRefPubMedPubMedCentral Ellaway R, Graves L, Berry S, Myhre D, Cummings BA, Konkin J. Twelve tips for designing and running longitudinal integrated clerkships. Med Teach 2013; 35: 989–95.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Stagg P, Prideaux D, Greenhill J, Sweet L. Are medical students influenced by preceptors in making career choices, and if so how? A systematic review. Rural Remote Health [Internet]. 2012 [cited 2017 Apr 24]; 12 (1832):[about 21 p.]. Available from http://www.rrh.org.au. Stagg P, Prideaux D, Greenhill J, Sweet L. Are medical students influenced by preceptors in making career choices, and if so how? A systematic review. Rural Remote Health [Internet]. 2012 [cited 2017 Apr 24]; 12 (1832):[about 21 p.]. Available from http://​www.​rrh.​org.​au.
17.
Zurück zum Zitat Norris TE, Schaad DC, DeWitt D, Ogur B, Hunt DD. Longitudinal integrated clerkships for medical students: an innovation adopted by medical schools in Australia, Canada, South Africa, and the United States. Acad Med 2009; 84: 902–7.CrossRefPubMed Norris TE, Schaad DC, DeWitt D, Ogur B, Hunt DD. Longitudinal integrated clerkships for medical students: an innovation adopted by medical schools in Australia, Canada, South Africa, and the United States. Acad Med 2009; 84: 902–7.CrossRefPubMed
18.
Zurück zum Zitat Schultz KW, Kirby J, Delva D, Godwin M, Verma S, Birtwhistle R, Knapper C, Seguin R. Medical students' and residents' preferred site characteristics and preceptor behaviours for learning in the ambulatory setting: a cross-sectional survey. Med Educ 2004 Dec;4(1):12. Schultz KW, Kirby J, Delva D, Godwin M, Verma S, Birtwhistle R, Knapper C, Seguin R. Medical students' and residents' preferred site characteristics and preceptor behaviours for learning in the ambulatory setting: a cross-sectional survey. Med Educ 2004 Dec;4(1):12.
Metadaten
Titel
Longitudinal Continuity Learning Experiences and Primary Care Career Interest: Outcomes from an Innovative Medical School Curriculum
verfasst von
Christine D. Ford, MA
Premal G. Patel, MD
Victor S. Sierpina, MD
Mark W. Wolffarth, MD
Judith L. Rowen, MD
Publikationsdatum
03.08.2018
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 10/2018
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-018-4600-x

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