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The ABC of caring for doctors caring for patients: Longitudinal Integrated Clerkships

Day: Sunday 28 August
Time: 0930-1230
Venue: Lyon Congress Centre

Presenters: Kay Mohanna1, John Cookson1
1 Three Counties Medical School, University of Worcester, UK

Background: In Longitudinal Integrated Clerkships (LIC) learning is achieved together longitudinally rather than in blocks of specialities.  It can work well for students, patients and staff in community settings in rural and remote areas, where transport links are few, and where clinicians take responsibility for a wide range of patient presentations.  In a more recent model, in secondary or tertiary centres in large urban centres where transport links are good, students are supervised by clinicians from multiple specialist disciplines concurrently. Between these models, is there a place for a community-based programme drawing on both primary and secondary care provision even when where distance is not a primary concern?  In particular can 'immersion' in a learning environment longitudinally over time facilitate the development of professional identify, leading to increased sense of Autonomy, Belongingness and Competence (West and Coia 2019)? Are there educational benefits in learning in an integrated environment, chiefly in primary care but with access to specialist clinics and community hospital beds?  What is needed in terms of supervision and support? What are the downsides in both educational and management terms?
Who Should Participate: Curriculum designers, especially those thinking of developing or running an LIC, medical students
Structure of Workshop: Plenary session: Review of the literature, experience from semi-rural England. Small group work: ‘You have been employed to give advice on setting up a LIC in the 4th year of a 5 year undergraduate course. This would replace time normally given to a wide range of specialties, including primary care. General medicine and surgery are in the 3rd and 5th years and additional primary case is also timetabled in the 5th year. Describe an outline approach to this challenge?’ Plenary session: Feedback and summarise
Intended Outcomes: By the end of the workshop attendees should be able to;

  • outline the research evidence for LIC

  • decribe the potential strengths and weaknesses of LICs as a way of increasing the sense of Autonomy, Belongingness and Competence in learners

  • describe some of the ‘dos and don’ts’ of setting up an LIC in rural and semi-rural settings in developed countries

  • outline an approach to designing an LIC within a 5 year undergraduate course

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