Continuity in Undergraduate Medical Education: Mission Not Accomplished

Area of Science:

• Medical Education
• Clinical Training
• Healthcare Professions Education

Background:

• Traditional block clerkships present educational limitations.
• Longitudinal clerkships offer enhanced continuity and patient-centered learning.
• Evidence supports longitudinal models for improved student outcomes and patient care.

Purpose of the Study:

• To summarize the evidence supporting longitudinal clerkships.
• To analyze longitudinal clerkships through the Kirkpatrick model.
• To highlight the synergy between longitudinal clerkships and Entrustable Professional Activities (EPAs).

Main Methods:

• Review of existing educational and outcome studies on longitudinal clerkships.
• Analysis of evidence across Kirkpatrick levels (reactions, learning, behavior, results).
• Exploration of the integration of longitudinal clerkships with EPA evaluation.

Main Results:

• Longitudinal clerkships improve patient-centeredness, feedback fidelity, and student autonomy.
• These programs show potential for positive patient care outcomes.
• Despite benefits, adoption of longitudinal clerkships remains limited.

Conclusions:

• Longitudinal clerkships provide significant educational and clinical advantages.
• They offer a framework for effective EPA evaluation.
• Mandating continuity-focused experiences is recommended for medical graduates.