The Learning Experiences of Medical Students in a Longitudinal Integrated Clerkship and Traditional Block Rotations in Taiwan: A Comparative Mixed-methods Study

Yaw-Wen Chang ； Wen-Hui Fang ； Wen-Chii Tzeng ； Pauling Chu ； David A. Hirsh

《Journal of Medical Education》 25卷3期 (2021/09) Pp. 139-154

https://doi.org/10.6145/jme.202109_25(3).0001

摘要

Purpose: An increasing number of medical schools are implementing longitudinal integrated clerkships (LICs), but less is known about LICs in tertiary teaching hospitals. This study compares the learning experiences of LIC and traditional block rotation (TBR) students and explores the principle of educational continuity at a metropolitan tertiary teaching hospital in Taiwan. Methods: This mixed-methods study included semi-structured interviews and surveys of fifth-year medical students, including 12 LIC students, who took their clinical clerkships at Tri-Service General Hospital in the academic year 2015/16. A research assistant interviewed LIC and TBR students to explore their learning experiences. The questionnaire asked students about their sense of self-efficacy in practice, experiences of patient follow-up, and clinical supervision. The authors performed qualitative thematic analysis on interview data and analyzed the surveys quantitatively comparing the two clerkship models. Results: Qualitative analysis revealed three main themes: ＂views on the path＂, ＂support from preceptors＂, and ＂being with patients.＂ In these domains, compared to the TBRs, the LIC design appears to have offered different learning experiences to the 5th-year medical students. In the questionnaire data, the LIC students perceived higher self-efficacy on seeing how social context affects patients and their problems and reported having more opportunities to interact longitudinally with patients and preceptors. Conclusions: From the students' perspectives, LIC students had important and different opportunities to interact with their preceptors and patients compared to their TBR peers. From the view of curriculum design, this inpatient-predominant LIC program adhered to the principle of educational continuity.

關鍵字

undergraduate medical education ； longitudinal integrated clerkship ； mix-methods research ； curriculum evaluation ； clinical learning

參考文獻

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