Development of a longitudinal integrated clerkship at an academic medical center

• Published in: Medical education online 2011-01, Vol.16 (1), p.5939-10
• Main Authors: Poncelet, Ann, Bokser, Seth, Calton, Brook, Hauer, Karen E., Kirsch, Heidi, Jones, Tracey, Lai, Cindy J., Mazotti, Lindsay, Shore, William, Teherani, Arianne, Tong, Lowell, Wamsley, Maria, Robertson, Patricia
• Format: Article
• Language: English
• Subjects: academic medical center; Academic Medical Centers; Adult; Analysis of Variance; Clinical Clerkship; clinical education; Clinical skills; continuity; Curriculum; education; Education, Medical, Undergraduate - methods; Educational Measurement - methods; Educational Status; Emergency Medicine - education; Faculty, Medical; Female; Focus Groups; Humans; Inpatients; Interdisciplinary approach; Learning; longitudinal integrated clerkship; Longitudinal Studies; Male; medical; Medical students; Patient-Centered Care; Preceptors; Professors; Program Development; Program Evaluation; Qualitative Research; San Francisco; Teaching; Trend; undergraduate
• ISSN: 1087-2981; 1087-2981
• DOI: 10.3402/meo.v16i0.5939

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.