ABSTRACT
BACKGROUND: Diversifying the medical student body without striving for equity in the clerkship (first full-time clinical training year) learning environment disadvantages under-represented in medicine (UIM) students and undermines the educational process. CONTEXT: To characterise and address inequities within an internal medicine clerkship, we conducted a multi-phased process to promote equity in the clerkship learning environment at an urban medical school with multiple sites. we conducted a multi-phased process to promote equity in the clerkship learning environment INNOVATION: The process to improve the learning environment and equity in the clerkship included: (i) a literature review and needs assessment (focus group) with UIM students; (ii) a medicine clerkship retreat with school leaders and diversity experts to reflect on the needs assessment data and generate interventions to improve equity; (iii) a member checking session with UIM students to ensure that the proposed solutions addressed the inequities that were noted in the needs assessment. IMPLICATIONS: The needs assessment revealed eight themes in the clerkship learning environment that were mapped to a published framework describing barriers encountered by UIM students. These themes informed the development of five clerkship pilot interventions. Implementing interventions inspired by UIM student perspectives may improve the learning environment in clinical clerkships by encouraging a culture of equity. The three-phased approach described here provides leaders who direct educational programmes with a framework to initiate change by characterising inequities as a springboard for developing solutions.
Subject(s)
Clinical Clerkship , Students, Medical , Focus Groups , Humans , Internal Medicine , LearningABSTRACT
This article was migrated. The article was marked as recommended. Longitudinal integrated clerkships (LICs) are a curricular structure for medical clerkships grounded in continuity across learning environments and experiences. There has yet to be a peer-reviewed article directly advising students in LIC programs. Twelve tips were created based on a comprehensive literature review of LICs and supported by the cumulative experience of the authors. They are ordered in four sequential groups: The first three tips discuss the importance of the relationships that are built between students and their patients (Tip 1), preceptors (Tip 2), and peers (Tip 3). Next we cover health systems, and offer advice on how students can integrate their learning (Tip 4), use technology to their advantage (Tip 5), and practice systems thinking (Tip 6). We then discuss the educational benefits when students take an active role in patient care (Tip 7), their own learning (Tip 8), and the feedback process (Tip 9). Finally, we cover the importance of self-care (Tip 10), reflection (Tip 11) and patience (Tip 12) during a LIC. These tips are designed to help students understand the pedagogical theory that underpins LICs, take an active role in their education, and maximize learning and wellness during their clerkship.
ABSTRACT
Introduction: Longitudinal integrated clerkships (LICs) are an increasingly popular clerkship model that relies heavily on community-based preceptors. The availability of an engaged and prepared community-based faculty is crucial to the success of these programs. Teachers in these programs are often geographically separate from medical school campuses, are engaged in busy practices, and have limited time to devote to faculty development activities. Methods: We created a series of five brief faculty development podcasts directed towards community-based teachers in LICs from three US medical schools. Topics included encouraging continuity, bedside teaching, encouraging student ownership of patients, communicating and managing patient results between clinic days, and choosing the right patients for continuity. The podcasts were sent via a grouped text message just prior to preceptors' morning commute time. Pre- and postsurveys assessed the acceptability and effectiveness of the podcasts. Results: Among the 33 postintervention survey responders, 27 (81.8%) listened to at least three podcasts, 21 (63.6%) found them moderately or very helpful, 23 (69.7%) perceived that the podcasts altered their teaching style, 23 (69.7%) would likely or highly likely listen to further podcasts, and 18 (54.5%) would likely or highly likely recommend the podcasts to colleagues. Discussion: In a cohort of multispecialty faculty teaching in LICs, educational podcasts were well received and perceived by preceptors to impact their teaching style. Texting these podcasts to other community-based preceptors may offer an effective strategy for providing faculty development to busy clinicians.
