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Presentation Description
PAIROJ BOONLUKSIRI1
TIPAPORN THONGMAK1
1 Hatyai Hospital
TIPAPORN THONGMAK1
1 Hatyai Hospital
Background:
The maldistribution of rural physicians is a persistent challenge that prompted the introduction of the Longitudinal Integrated Clerkship (LIC) as a potential solution. However, implementing LIC in rural hospitals is challenging. In Thailand, LIC was first launched in 2019 through the PSU-Hatyai-Yala medical network, involving a 16-week rotation in 13 rural hospitals. The first cohort of students completed the program in 2022. Objective: to assess the graduation rate and gather stakeholders' perspectives on the constraints associated with LIC.
The maldistribution of rural physicians is a persistent challenge that prompted the introduction of the Longitudinal Integrated Clerkship (LIC) as a potential solution. However, implementing LIC in rural hospitals is challenging. In Thailand, LIC was first launched in 2019 through the PSU-Hatyai-Yala medical network, involving a 16-week rotation in 13 rural hospitals. The first cohort of students completed the program in 2022. Objective: to assess the graduation rate and gather stakeholders' perspectives on the constraints associated with LIC.
Summary of work:
A questionnaire survey was conducted in 2023, involving 110 stakeholders directly associated with the program including students, faculty members, and rural staff.
A questionnaire survey was conducted in 2023, involving 110 stakeholders directly associated with the program including students, faculty members, and rural staff.
Results:
The program successfully achieved the nine learning outcomes specified in the curriculum, with high satisfaction in communication skills and social interaction. However, the LIC implementation had repercussions on the traditional clerkship structure, necessitating a significant program rearrangement. Approximately 30% of students expressed concerns about missing out on essential knowledge. Feedback was provided regarding the limited diversity of diseases encountered in hospitals of varying sizes compared to medical centers. Additionally, a considerable percentage of stakeholders disagreed with the 16-week rotation, considering it too long to yield immediate benefits. A small percentage of rural staff exhibited negative attitudes toward their roles, citing a lack of preparedness, stress, and unreadiness to fulfill teaching responsibilities.
The program successfully achieved the nine learning outcomes specified in the curriculum, with high satisfaction in communication skills and social interaction. However, the LIC implementation had repercussions on the traditional clerkship structure, necessitating a significant program rearrangement. Approximately 30% of students expressed concerns about missing out on essential knowledge. Feedback was provided regarding the limited diversity of diseases encountered in hospitals of varying sizes compared to medical centers. Additionally, a considerable percentage of stakeholders disagreed with the 16-week rotation, considering it too long to yield immediate benefits. A small percentage of rural staff exhibited negative attitudes toward their roles, citing a lack of preparedness, stress, and unreadiness to fulfill teaching responsibilities.
Discussion:
Despite meeting the learning outcomes, there are significant constraints. Feedback indicates a preference for an eight-week clerkship during the initial phase.
Despite meeting the learning outcomes, there are significant constraints. Feedback indicates a preference for an eight-week clerkship during the initial phase.
Conclusions:
While LIC achieved positive outcomes and high satisfaction in specific areas, there are constraints to be addressed, such as the impact on traditional clerkships, and dissatisfaction with the rotation length.
While LIC achieved positive outcomes and high satisfaction in specific areas, there are constraints to be addressed, such as the impact on traditional clerkships, and dissatisfaction with the rotation length.
Take-home messages:
LIC may not be entirely suitable for decentralized training due to infrastructure limitations and staff development challenges. Resolving these challenges is crucial for optimizing the program and enhancing training.
LIC may not be entirely suitable for decentralized training due to infrastructure limitations and staff development challenges. Resolving these challenges is crucial for optimizing the program and enhancing training.
References (maximum three)
1. EL Brown M, Anderson K, Finn GM. A Narrative Literature Review Considering the Development and Implementation of Longitudinal Integrated Clerkships, Including a Practical Guide for Application. Journal of Medical Education and Curricular Development. 2019; 6: 1-12. Available from: https://doi.org/10.1177/23821205198494092.
2. Poncelet AN, Mazotti LA, Blumberg B, Wamsley MA, Grennan T, Shore WB. Creating a Longitudinal Integrated Clerkship with Mutual Benefits for an Academic Medical Center and a Community Health System. Permanente Journal. 2014; 18(2): 50-56.
3. Chang YW, Hirsh DA, Fang WH, Li H, Tzeng WC, Kao S. Patient perceptions of students in a longitudinal integrated clerkship in Taiwan: a qualitative study. BMC Medical Education. 2021; 21:153. Available from: https://doi.org/10.1186/s12909-021-02553-7