Student Perspectives on Inpatient Clinical Experiences in a Longitudinal Integrated Clerkship Curriculum: A Cross-Sectional Study.

Abstract

Introduction: Longitudinal Integrated Clerkship (LIC) curriculum allows students to participate in rotations of all medical disciplines simultaneously. This model has gained popularity amongst medical schools and is evidenced to improve relationships between patients, students, and faculty compared to a traditional block schedule. The University of South Dakota Sanford School of Medicine (SSOM) implemented a comprehensive outpatient LIC curriculum for all campuses in 2014. The SSOM consists of 4 campuses (rural and urban) situated across the state, which leads to varying student experiences depending on site placement. To address issues of dissatisfaction with patient continuity and scheduling challenges, a hybrid inpatient and outpatient LIC was implemented in 2023.

Methods: A pre- and post-mixed methods analysis regarding the implemented hybrid inpatient and outpatient clinical experiences was conducted with third-year medical students. Participants completed an anonymous online survey about satisfaction with patient continuity and scheduling. The first survey was conducted in December 2022 for students enrolled in the 2022-2023 LIC prior to the implementation of hybrid inpatient experiences and again in December 2024 for students enrolled in the 2024-2025 hybrid LIC.

Results: In 2022, many students (82%) were satisfied with the standard LIC schedule. However, 38% of these students (N=52) reported dissatisfaction with patient continuity. After the implementation of inpatient experiences into the LIC, students in 2024 (N=50) reported 64% satisfaction with the schedule of the hybrid model. Amongst this cohort, 36% were dissatisfied with patient continuity in the hybrid LIC model. Of note, 70% of these students were satisfied with faculty continuity. When questioned about preferred curriculum model, 64% of students in 2024 prefer the hybrid LIC over traditional block schedule.

Conclusion: Initial findings show that the implementation of inpatient clinical experiences in the LIC curriculum has decreased student satisfaction with scheduling and minimally improved satisfaction with patient continuity. Results also show that students prefer the hybrid LIC over a traditional block model.