Optimizing student learning at the Regional Medical Campus

ABSTRACT: INTRODUCTION:         Both benefits and challenges are associated with training medical students in a community-based setting at a Regional Medical Campus (RMC).  At the RMC, close relationships between learner and teaching faculty can truly be fostered. However, those volunteer teaching faculty are frequently conflicted due to time-constraints and practice productivity requirements that may run counter to maximizing learner involvement.  Longitudinal integrated clerkships (LICs) have been studied and promoted as clinical clerkship structures that, through taking full advantage of the on-going relationship between learner, teacher, patients, and practices, optimize the learning environment for medical students on clinical rotations.  In our resource-limited environment, we wished to create longitudinal educational relationships for all UPRC students with preceptors, practices and patients that would achieve the educational benefits of a true LIC yet not overwhelm the limited resources of this small community. METHODS:                  We created an amalgamative LIC clerkship model that provided a year-long Family Medicine experience integrated within OB-GYN, Surgery and Pediatrics ½-year longitudinal clerkships and three 1-week inpatient adult medicine mini-immersions spaced over the course of ½-year.  Neurology, Psychiatry and Underserved/Rural Medicine (4-weeks each) and subspecialty/elective rotations (2-weeks each) remained in traditional self-contained blocks interspersed within longitudinal experiences.   At 6 and 12 months, we administered a 5-point Likert-type survey to both medical students and teaching faculty asking their perceptions of the educational value and resource requirements for our clinical rotation structure.  Descriptive averages of the ordinal values were reported. RESULTS:                     There were 11/12 students (92.7%) and 11/21 faculty (52.4%) who responded to the survey.   Both students and faculty believed that some of the longitudinal benefits of the amalgamative structure were achieved.  The students especially noted that attending feedback was beneficial due to the longer interaction and that they had a greater ability to interact with patients.  All told, the faculty teachers found the Amalgamative LIC to be slightly less satisfying than the students. CONCLUSIONS:                       While logistical limitations necessitated our unique rotation design, some optimization of education was achieved.  Faculty concerns toward adopting this new structure should be considered for other programs structuring LICs in a similar sparsely resourced environment such as a Regional Medical Campus.