Angela S. Punnett,,Toronto,Ontario,Ra . Han,,Toronto,ON,Stacey . Bernstein,,Toronto,Ontario,Karen . Weyman,,Toronto,Ontario
Background: Longitudinal integrated clerkships (LICs) provide an alternative means of learning core clinical skills across disciplines in a continuity experience. We recently introduced a pilot LIC option in third year. This abstract describes the process mapping and planning for the LIC including the Pediatric experience.
Methods: Internal and external consultation began two years prior to the start date of the LIC pilot. Internal consultation included a faculty retreat to promote engagement and brainstorm barriers/facilitators. External consultation with mature LIC programs, a national needs assessment and literature review provided necessary background. The LIC concept was presented to Clinical Chairs and University and Hospital Education Committees. A central LIC Committee was formed with diverse representation including students, residents, faculty, administrators, and researchers.
Results: Eight working groups were established to develop the LIC program: Admissions, Curriculum, Evaluation, Patient Panel, Faculty Development, Communications, IT, and Research. Currently, 7 students are enrolled in the program. For the Pediatric integrated rotation they are paired with one preceptor in an urban ambulatory clinic for one half day per week (38 total over the year). Students follow patients longitudinally according to requirements collaboratively set in a Patient Panel. There are 34 core patients on the panel including 3 newborns; a well infant aged 6-9 months; a child with a chronic disease; a child with a developmental and/or mental health issue. Identification of a Pediatrics site lead and consultation with supervising Pediatricians were critical to the formulation of the local experience and identified unique opportunities for students in that context (nursery, community advocacy). Students attend LIC School- one half day per week of interactive seminars; six are devoted to Pediatrics. Evaluation involves iterative, real-time qualitative assessments: Tri-annual Focus groups and quarterly 1:1 site lead meetings. Student examination performance is monitored for non-inferiority. Faculty development includes formal solicitation of feedback on the pilot.
Conclusion: Detailed process mapping is essential for faculty engagement and environmental readiness for curricular change. The LIC pilot was successfully launched; ongoing evaluation will support further development and expansion to 24 students in the next academic year.