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Keystone: Exploring Pediatric Residents' Experiences in a Longitudinal Integrated Block
Catherine D Michelson1, Kristina Dzara2, Subha Ramani3
1a Department of Pediatrics , Boston University School of Medicine , Boston , Massachusetts , USA.
Teaching and Learning in Medicine
|October 11, 2018
Summary
This study introduces the Keystone block, a novel longitudinal integrated training model for pediatric residents. It enhances professional relationships, patient-centeredness, and self-directed learning, addressing limitations of traditional rotations.
Area of Science:
- Medical Education
- Pediatric Residency Training
- Longitudinal Integrated Clerkships
Background:
- Traditional residency training often uses short, single-specialty rotations.
- This model faces challenges with patient continuity and team integration.
- Longitudinal integrated clerkships show promise but are rare in residency.
Purpose of the Study:
- To evaluate a novel 3-month longitudinal integrated block (Keystone) for pediatric residents.
- To explore resident perceptions of the block's impact on learning, relationships, and professional development.
- To assess the effectiveness of integrating developmental-behavioral pediatrics, advocacy, and emergency medicine.
Main Methods:
- A 3-month longitudinal integrated block (Keystone) was developed, combining three distinct rotations.
- Residents participated in weekly half-day sessions in primary care, a new continuity clinic, emergency department shifts, and advocacy activities.
- Qualitative methods, including interviews and a focus group, were used to gather resident feedback.
Main Results:
- The longitudinal design fostered professional relationships and entrustment.
- Integrated learning enhanced engagement and provided time for professional identity development.
- Flexibility supported work-life balance and self-directed learning, though schedule challenges were noted.
Conclusions:
- The Keystone block offers a novel structure for residency education.
- It successfully addresses educational goals such as enhancing relationships, entrustment, and patient-centeredness.
- The model emphasizes the value of self-directed learning within an integrated framework.