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They did just as well!
Academic performance of longitudinal integrated clerkship versus rotation based clerkship students: A matched-cohort study Mhyre DL et al. Academic Medicine 2014;89:292-295.
Reviewed by Srividya Naganathan

What was the study question?
Do students on a longitudinal integrated clerkship (LIC) have comparable academic performance to those on rotation based clerkship (RBC), when matched for prior academic performance?

How was the study done?
The study was done at the University of Calgary which has a three year medical school curriculum consisting of both traditional RBC and LIC streams. Each LIC student was matched with four RBC students from the same academic year who had similar pre-clerkship academic performance. Results of summative evaluation (which included multiple choice question [MCQ] exam and in-training evaluation report [ITER]) and clerkship objective structured clinical exam (OSCE) were compared between the two groups.

What were the results?
There was no significant difference between LIC and RBC students matched for pre-clerkship GPA in:

  • performance on MCQ exams (pooled effect size=0.019; 95% confidence interval= [-0.115,0.152]
  • ITER (pooled effect size=-0.15; confidence interval= [-0.157,0.127]
  • mean score on OSCE (67.9[SD=4.6] versus 68.6[SD=5.8], P=0.5)

What are the implications of these findings?
The study is unique in the aspect that it is a three year, prospective study and the matched cohort design mitigates potential selection bias. LIC and RBC students have comparable results on summative evaluation and clinical skills after matching on prior academic performance. Evidence suggests that LIC's increase continuity of care learning opportunities, improve team work and may bridge healthcare gaps (if trained at a rural setting). More medical schools should take the opportunity to explore the LIC curriculum, especially when studies have shown no difference in the academic performance when compared to traditional models.

Editor's note: For those schools considering adding an LIC to their program, this study will help in getting faculty and students to "buy in" to such a program (SLB).

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