Educational Continuity in Clinical Clerkships

New England Journal of Medicine (Impact Factor: 55.87). 03/2007; 356(8):856-7. DOI: 10.1056/NEJMe068275
Source: PubMed
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    • "Underlying principles for the core clerkship year were defined through a task force and education retreat in 2004 and 2005: (1) continuity with patients (Irby 2007; Hirsh et al. 2012); (2) continuity with faculty (Irby 2007; Hirsh et al. 2012); (3) continuity with peers; (4) continuity with a healthcare system; (5) authentic roles in patient care; (6) exposure to undiagnosed patients; and (7) participation in a core curriculum relevant to their practice. "
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    ABSTRACT: Interest in longitudinal integrated clerkships (LICs) as an alternative to traditional block rotations is growing worldwide. Leaders in medical education and those who seek physician workforce development believe that "educational continuity" affords benefits to medical students and benefits for under-resourced settings. The model has been recognized as effective for advancing student learning of science and clinical practice, enhancing the development of students' professional role, and supporting workforce goals such as retaining students for primary care and rural and remote practice. Education leaders have created multiple models of LICs to address these and other educational and health system imperatives. This article compares three successful longitudinal integrated clinical education programs with attention to the case for change, the principles that underpin the educational design, the structure of the models, and outcome data from these educational redesign efforts. By translating principles of the learning sciences into educational redesign efforts, LICs address the call to improve medical student learning and potential and advance the systems in which they will work as doctors.
    Medical Teacher 07/2012; 34(7):548-54. DOI:10.3109/0142159X.2012.696745 · 1.68 Impact Factor
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    • "Recent developments in academic health care endanger these relationships; working-hour restrictions, the short stay of patients in hospitals, fragmentation of health care over specialties and health care providers, and the increased pressures upon clinical faculty all lead faculty to create controlling learning environments. The lack of sustained relationships among students, teachers and patients is a major current problem in medical education (Irby 2007) and a threat to the development of IM in medical students. "
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    ABSTRACT: Self-determination Theory (SDT), designed by Edward Deci and Richard Ryan, serves among the current major motivational theories in psychology. SDT research has been conducted in many areas, among which are education and health care, but its applications in medical education are rare. The potential of SDT to help understand processes in medical education justifies this Guide. SDT is explained in seven principles, one of which is the distinction of three innate psychological needs of human beings: for competence, for autonomy and for relatedness. Further, SDT elaborates how humans tend to internalise regulation of behaviour that initially has been external, in order to develop autonomous, self-determined behaviour. Implications of SDT for medical education are discussed with reference to preparation and selection, curriculum structure, classroom teaching, assessments and examinations, self-directed learning, clinical teaching, students as teachers and researchers, continuing professional development, faculty development and stress among trainees.
    Medical Teacher 12/2011; 33(12):961-73. DOI:10.3109/0142159X.2011.595435 · 1.68 Impact Factor

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