Longitudinal integrated clerkships from start to finish: A medical curriculum innovation.

Stellenbosch University embarked on a renewal of its MBChB programme guided by an updated set of core values developed by the multidisciplinary curriculum task team. These values acknowledged the important role of (among others) context and generalism in the development of our graduates as doctors of the future for South Africa. This report describes the overall direction of the renewed curriculum focusing on two of the innovative educational methods for Family Medicine and Primary Health Care training that enabled us to respond to these considerations. These innovations provide students with both early longitudinal clinical experience (now approximately 72 h per year for each of the first 3 years) and a final longitudinal capstone experience (36 weeks) outside the central tertiary teaching hospital. While the final year experience will run for the first time in 2027 (the first year launched in 2022), the initial experience has got off to a good start with students expressing the value that it brings to their integrated, holistic learning and their identity formation aligned with the mission statement of this renewed curriculum. These two curricular innovations were designed on sound educational principles, utilising contextually appropriate research and by aligning with the goals of the healthcare system in which our students would be trained. The first has created opportunities for students to develop a professional identity that is informed by a substantial and longitudinal primary healthcare experience.Contribution: The intention is to consolidate this in their final district-based experience under the supervision of specialist family physicians and generalist doctors.

Exposing an interprofessional class of first years to an underserved community contributed to students' contextualisation of the determinants of health.

Students often find the primarily theoretical, classroom-based teaching of Public Health early on in undergraduate health professions curricula boring, failing to see its relevance for their future careers. An innovative approach to this challenge, based on social constructivist theory, was introduced at a South African university. First-year students were divided into interprofessional groups to visit an underserved community. In preparation for this experience, groups gathered information on "their" community after attending lectures/workshops. The objective of this study was to determine how exposing an interprofessional class of first years to an underserved community, contributed to students' contextualisation of the determinants of health. A mixed method methodology was used. Data were generated by analysing 40 randomly selected reflective reports and an online questionnaire (completed by 85% of the class) following the community visit. Data showed that it is after this first-hand exposure that students had a deeper affective-cognitive realisation of health inequity and was able to better contextualise the impact of determinants of health on individuals and communities. This community visit gave students a better grasp of what is needed to collaborate interprofessionally in addressing health inequity and served as intrinsic motivation to develop as change agents.