How to enhance students’ learning in a patient-centered longitudinal integrated clerkship: factors associated with students’ learning experiences
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Purpose: Longitudinal integrated clerkships (LICs) have been introduced in medical schools, as learning relationships with clinical faculty or peers are important components of medical education. The purpose of this study was to investigate the characteristics of student-faculty and student-student interactions in the LIC and to identify other factors related to whether students understood and acquired the program’s main outcomes.Methods: The study was conducted among the 149 third-year students who participated in the LIC in 2019. We divided the students into groups of eight. These groups were organized into corresponding discussion classes, during which students had discussions with clinical faculty members and peers and received feedback. Clinical faculty members and students were matched through an e-portfolio, where records were approved and feedback was given. A course evaluation questionnaire was completed and analysed.Results: A total of 144 valid questionnaires were returned. Logistic regression analysis showed that relevant feedback in discussion classes (adjusted odds ratio [AOR], 5.071; p<0.001), frequency of e-portfolio feedback (AOR, 1.813; p=0.012), and motivation by e-portfolio feedback (AOR, 1.790; p=0.026) predicted a greater likelihood of understanding the continuity of the patient’s medical experience. Relevant feedback from faculty members in discussion classes (AOR, 3.455; p<0.001) and frequency of e-portfolio feedback (AOR, 2.232; p<0.001) also predicted a greater likelihood of understanding the concept of patient-centered care.Conclusion: Student-faculty interactions, including relevant feedback in discusstion classes, frequency of e-portfolio feedback, and motivation by e-portfolio feedback were found to be important factors in the LIC program.
Abstract
Purpose: Longitudinal integrated clerkships (LICs) have been introduced in medical schools, as learning relationships with clinical faculty or peers are important components of medical education. The purpose of this study was to investigate the characteristics of student-faculty and student-student interactions in the LIC and to identify other factors related to whether students understood and acquired the program’s main outcomes.Methods: The study was conducted among the 149 third-year students who participated in the LIC in 2019. We divided the students into groups of eight. These groups were organized into corresponding discussion classes, during which students had discussions with clinical faculty members and peers and received feedback. Clinical faculty members and students were matched through an e-portfolio, where records were approved and feedback was given. A course evaluation questionnaire was completed and analysed.Results: A total of 144 valid questionnaires were returned. Logistic regression analysis showed that relevant feedback in discussion classes (adjusted odds ratio [AOR], 5.071; p<0.001), frequency of e-portfolio feedback (AOR, 1.813; p=0.012), and motivation by e-portfolio feedback (AOR, 1.790; p=0.026) predicted a greater likelihood of understanding the continuity of the patient’s medical experience. Relevant feedback from faculty members in discussion classes (AOR, 3.455; p<0.001) and frequency of e-portfolio feedback (AOR, 2.232; p<0.001) also predicted a greater likelihood of understanding the concept of patient-centered care.Conclusion: Student-faculty interactions, including relevant feedback in discusstion classes, frequency of e-portfolio feedback, and motivation by e-portfolio feedback were found to be important factors in the LIC program.
참고문헌 (26)
- Worley P, "A typology of longitudinal integrated clerkships", Med Educ, 50(9), pp.922~932 (2016)
- Poncelet A, "Alliance for Clinical Education. Longitudinal integrated clerkships: principles, outcomes, practical tools, and future directions" (2016), Gegensatz Press
- Walters L, "Outcomes of longitudinal integrated clinical placements for students, clinicians and society", Med Educ, 46(11), pp.1028~1041 (2012)
- Hirsh D, "Educational outcomes of the Harvard Medical School-Cambridge integrated clerkship : a way forward for medical education", Acad Med, 87(5), pp.643~650 (2012)
- Ogur B, "The Harvard Medical School-Cambridge integrated clerkship : an innovative model of clinical education", Acad Med, 82(4), pp.397~404 (2007)
- Couper I, "Rural longitudinal integrated clerkships : lessons from two programs on different continents", Rural Remote Health, 11(2), pp.1665~ (2011)
- Bartlett M, "The do’s, don’ts and don’t knows of establishing a sustainable longitudinal integrated clerkship", Perspect Med Educ, 9(1), pp.5~19 (2020)
- Myhre DL, "Academic performance of longitudinal integrated clerkship versus rotation-based clerkship students : a matchedcohort study", Acad Med, 89(2), pp.292~295 (2014)
- Woloschuk W, "Comparing the performance in family medicine residencies of graduates from longitudinal integrated clerkships and rotation-based clerkships", Acad Med, 89(2), pp.296~300 (2014)
- Kilminster SM, "Teaching in the new NHS : the specialised ward based teacher", Med Educ, 35(5), pp.437~443 (2001)
- Thomas PA, "A controlled trial of team-based learning in an ambulatory medicine clerkship for medical students", Teach Learn Med, 23(1), pp.31~36 (2011)
- Young JQ, "Faculty and resident engagement with a workplace-based assessment tool : use of implementation science to explore enablers and barriers", Acad Med, 95(12), pp.1937~1944 (2020)
- Han H, "Learning in the real place : medical students’ learning and socialization in clerkships at one medical school", Acad Med, 90(2), pp.231~239 (2015)
- Bird EC, "Using small case-based learning groups as a setting for teaching medical students how to provide and receive peer feedback", Med Sci Educ, 27(4), pp.759~765 (2017)
- Abraham RM, "Using deliberate practice framework to assess the quality of feedback in undergraduate clinical skills training", BMC Med Educ, 19(1), pp.105~ (2019)
- Bleasel J, "Feedback using an ePortfolio for medicine long cases : quality not quantity", BMC Med Educ, 16(1), pp.278~ (2016)
- 김주휘, "Establishing a Patient-centered Longitudinal Integrated Clerkship: Early Results from a Single Institution", Journal of Korean Medical Science, 35(50), pp.1~10 (2020), 대한의학회[DOI]
- Bernabeo EC, "Lost in transition : the experience and impact of frequent changes in the inpatient learning environment", Acad Med, 86(5), pp.591~598 (2011)
- Morelock JA, "Shifting patients : how residency programs respond to residency review committee requirements", Am J Med, 115(2), pp.163~169 (2003)
- Driessen E, "Portfolios in medical education : why do they meet with mixed success? : a systematic review", Med Educ, 41(12), pp.1224~1233 (2007)
- Tochel C, "The effectiveness of portfolios for post-graduate assessment and education : BEME Guide No 12", Med Teach, 31(4), pp.299~318 (2009)
- Chertoff J, "Status of portfolios in undergraduate medical education in the LCME accredited US medical school", Med Teach, 38(9), pp.886~896 (2016)
- Dent JA, "A practical guide for medical teachers" (2013), Elsevier
- Burgess A, "Planning peer assisted learning(PAL)activities in clinical schools", BMC Med Educ, 20(Suppl 2), pp.453~ (2020)
- Koles PG, "The impact of team-based learning on medical students’academic performance", Acad Med, 85(11), pp.1739~1745 (2010)
- Hall D, "The problem of free-riding in group projects : looking beyond social loafing as reason for non-contribution", Act Learn High Educ, 14(1), pp.37~49 (2013)