Continuity in Undergraduate Medical Education: Mission Not Accomplished

Daniel B. Evans, Bruce L. Henschen, Ann N. Poncelet, Lu Ann Wilkerson, Barbara Ogur

Research output: Contribution to journalArticle

Abstract

Evidence is mounting that longitudinal medical student clerkships provide better educational experiences than traditional block clerkship “silos.” Education studies across institutions demonstrate positive effects of continuity on medical students, including creating patient-centered learning environments, improving fidelity of evaluations and feedback, improving medical student patient-centeredness, enabling more autonomous functioning in the clinical workplace, and increased recruitment and retention of students into primary care careers. Outcome studies show potential for longitudinal students to add value to patient care. This perspective piece summarizes the current evidence basis for longitudinal clerkships broken down by Kirkpatrick level (reactions, perceptions/attitudes, knowledge, behaviors, and patient benefits). Despite this evidence, expansion of longitudinal clerkships has been slow—i.e., fewer than half of current US medical schools offer one. While more recent curricular innovations center around Entrustable Professional Activities (EPAs), there are clear opportunities for medical schools to use longitudinal clerkships as a lens through which EPAs can be effectively evaluated. This perspective highlights the synergy between longitudinal clerkships and EPAs, showing that successful implementation of the former should empower the latter. While large, complex educational interventions are daunting tasks, change is needed. Regulatory organizations should mandate continuity-focused experiences for US medical graduates.

Original languageEnglish (US)
Pages (from-to)2254-2259
Number of pages6
JournalJournal of general internal medicine
Volume34
Issue number10
DOIs
StatePublished - Oct 1 2019

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Undergraduate Medical Education
Medical Students
Medical Schools
Students
Workplace
Lenses
Primary Health Care
Patient Care
Outcome Assessment (Health Care)
Learning
Organizations
Education

Keywords

  • Entrustable Professional Activities
  • Longitudinal Integrated Clerkship
  • continuity in medical education
  • undergraduate medical education
  • value-added medical education

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Continuity in Undergraduate Medical Education : Mission Not Accomplished. / Evans, Daniel B.; Henschen, Bruce L.; Poncelet, Ann N.; Wilkerson, Lu Ann; Ogur, Barbara.

In: Journal of general internal medicine, Vol. 34, No. 10, 01.10.2019, p. 2254-2259.

Research output: Contribution to journalArticle

Evans, Daniel B. ; Henschen, Bruce L. ; Poncelet, Ann N. ; Wilkerson, Lu Ann ; Ogur, Barbara. / Continuity in Undergraduate Medical Education : Mission Not Accomplished. In: Journal of general internal medicine. 2019 ; Vol. 34, No. 10. pp. 2254-2259.
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