Building Longitudinal Relationships Into a Traditional Block Clerkship Model: A Mixed-Methods Study

Area of Science:

• Medical Education
• Curriculum Development
• Patient-Centered Care

Background:

• Traditional block clerkships often lack continuity in patient care.
• Integrating longitudinal patient relationships is crucial for comprehensive medical training.
• The Longitudinal Clinical Experiences with Patients (LCEP) curriculum was developed to address this gap.

Purpose of the Study:

• To describe the implementation of the LCEP curriculum.
• To evaluate the feasibility, value, and impact of LCEP on medical students.
• To assess the integration of longitudinal patient relationships into a block clerkship model.

Main Methods:

• Mixed-methods study involving 54 Harvard Medical School students.
• Electronic surveys and confidential interviews were used to collect data.
• Content analysis framework was applied to analyze qualitative and quantitative data.

Main Results:

• Students successfully followed an average of 3.3 patients longitudinally.
• Most students (94%) followed at least two patients.
• Students reported enhanced understanding of patient experience, healthcare systems, and disease progression.
• Scheduling logistics and competing priorities were identified as key challenges.

Conclusions:

• The LCEP curriculum is feasible and effective in fostering longitudinal patient relationships within a block clerkship.
• Prioritizing in-depth experience with fewer patients may mitigate student-reported barriers.
• The hybrid program effectively promotes patient-centeredness in medical education.