Patient outcomes in a Longitudinal Integrated Clerkship: A systematic literature review.

Autor: Dodsworth A; Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.; Northumbria General Practice Training Programme, Health Education England North East and Cumbria, Newcastle upon Tyne, UK., Munro K; School of Medicine, Newcastle University, Newcastle upon Tyne, UK., Alberti H; School of Medicine, Newcastle University, Newcastle upon Tyne, UK., Hirsh DA; Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.; Massachusetts Cambridge Health Alliance, Cambridge, Massachusetts, USA., Paes P; School of Medicine, Newcastle University, Newcastle upon Tyne, UK., Illing J; School of Medicine, Newcastle University, Newcastle upon Tyne, UK.; RCSI University of Medicine Health Sciences, Dublin, Ireland.
Jazyk: angličtina
Zdroj: Medical education [Med Educ] 2023 Sep; Vol. 57 (9), pp. 820-832. Date of Electronic Publication: 2023 Jan 09.
DOI: 10.1111/medu.15013
Abstrakt: Context: Patient-student relationships are at the heart of Longitudinal Integrated Clerkships (LICs). Outcomes for students and preceptors are beneficial, but patient outcomes remain unclear. This systematic literature review explored the current evidence base of patient outcomes in an LIC. Patient outcomes were defined as issues related to patient safety, clinical effectiveness or patient experience.
Methods: Seven bibliographic databases were searched. A wider search strategy included a hand search of three medical education journals' previous issues and backward/forward citation searching of included studies and of a relevant systematic review. Included studies were quality appraised and assessed for their strength and level of evidence. A qualitative data synthesis was performed.
Results: Databases searches identified 7237 titles. Following the removal of duplicates, titles and abstracts were reviewed against the inclusion criteria. Forty-eight studies had a full-text review. Nineteen met the inclusion criteria. Seven studies were included from the wider search strategy. From the 26 included studies, two major themes were identified. (1) 'A trusting patient-student relationship' contains the sub-themes: 'care and compassion', 'patient education and empowerment' and 'the loss of the student as 'my' doctor'. (2) 'The student acts as an agent of change for the patient' contains the sub-themes: 'patient advocacy', 'supporting the patient to navigate the healthcare system', 'communication between patient and healthcare professional' and 'enhancement of preceptors' care, healthcare services and communities'.
Conclusions: LICs provide educational continuity allowing the creation of a trusting patient-student relationship. This relationship leads to students becoming agents of change for patients by enhancing patient outcomes. This review provides further evidence on the benefits of having an LIC as part of the medical education curricula and implications for its successful delivery. Further research is needed to explore educationally induced benefits for patients and look at objective assessments of patient health outcomes.
(© 2023 The Authors. Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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