Reflecting on the Advantages of Longitudinal Integrated Clerkships and COVID-19

Abstract

The emergence of Coronavirus Disease 2019 (COVID-19) has dramatically changed the landscape of medical education. The global pandemic highlighted advantages of specific curricular frameworks. Longitudinal, integrated approaches may avoid some of the educational consequences seen in traditional models. This viewpoint highlights the advantages of a longitudinal integrated clerkship during the COVID-19 outbreak. These advantages include a relatively even exposure to multiple specialties, discipline specific assessment information despite an early truncation of clinical activity, and a seamless transition to ongoing integrated online learning, as a single integrated virtual clerkship model for an entire class. Notably, the longitudinal integrated clerkship avoided consequences seen in traditional clerkships such as missing entire rotations positioned in March-June 2020 and therefore, clerkship grades. The longitudinal clerkship allowed for students to receive discipline specific grades in all core specialties based on assessment of individual skills (direct observation and assessment of skills such as physical exam and history) versus discipline specific knowledge (subject exams). In addition, there are advantages of pre-existing relationships with preceptors and patients that could facilitate engagement in ongoing contact during virtual clerkships and opportunistic clinical experiences when it is safe for students to re-engage in clinical activities.