Abstract

BackgroundExposure to a broad spectrum of patient cases is a mainstay of undergraduate medical education. This study aimed to assess how many primary care-specific clinical pictures final-year medical students in traditional block rotations had encountered, and how this changed after a curricular change that included the implementation of a four-year longitudinal clerkship in primary care.MethodsFinal-year students before, and after, implementation of the clerkship were asked which of the clinical pictures most relevant to primary care they had seen. We compared the overall proportions of clinical pictures seen by the two cohorts.ResultsIn the first cohort, 96 (66%) students responded, and 94 (65%) in the second. Before the curricular change, students had encountered a mean of 26.3 of the 34 primary care-specific clinical pictures (77.2%). After implementation of the longitudinal clerkship, this increased by 1.1 (4.2%, P = 0.038).Among the eight clinical pictures seen the least by students in the first cohort, we found a significant increase in the proportion of students seeing polymalgia rheumatica, frozen shoulder, epicondylitis and Dupuytren’s contracture after the clerkship’s implementation.ConclusionThe undergraduate longitudinal clerkship in primary care broadened the spectrum of clinical pictures seen by medical students, to include more clinical pictures commonly seen in primary care.

Highlights

  • Exposure to a broad spectrum of patient cases is a mainstay of undergraduate medical education

  • Significantly more medical students in the pre-longitudinal clerkship cohort reported that they had taken up the option of additional general practitioner (GP) training (49.0% in the 2009 cohort, 14.9% in the 2012 cohort, P < 0.001)

  • After the implementation of the longitudinal clerkships in general practice, students saw a mean of 27.4 primary care-specific clinical pictures (80.7%), an increase of 1.1 (4.2%) over the previous cohort (P = 0.038)

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Summary

Introduction

Exposure to a broad spectrum of patient cases is a mainstay of undergraduate medical education. The mixture of clinical conditions experienced in this setting is positively linked to positive learning experiences [2] This is taken into account by the Swiss Catalogue of Learning Objectives for Undergraduate Medical Training (SCLO), a document that gives a list of the 1220 clinical pictures Various undergraduate medical curricula have implemented longitudinal clerkships in general practice to broaden the educational spectrum for students [8]. This follows the 1988 Edinburgh Declaration of the World Federation for Medical Education, which advocated a substantial transfer of education from teaching hospitals to community settings [9]. In a longitudinal clerkship the continuity of contact with supervising doctors has been found to provide students with career mentorship and personal support, and students are more likely to report learning about chronic illness and communication skills, as well as receiving help in developing their clinical skills [12]

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