Patient perceptions of innovative longitudinal integrated clerkships based in regional, rural and remote primary care: a qualitative study

BMC Family Practice

Research Article

Kathryn M Weston¹  Patricia J Knight¹  Judith N Hudson² 

[1] Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia;School of Rural Medicine, University of New England, 2351, Armidale, NSW, Australia;

关键词: Rural medical education;    Longitudinal integrated clerkships;    Patient-centredness;    Patients as stakeholders;   

DOI  :  10.1186/1471-2296-13-72

 received in 2012-02-02, accepted in 2012-07-11,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundMedical students at the University of Wollongong experience continuity of patient care and clinical supervision during an innovative year-long integrated (community and hospital) clinical clerkship. In this model of clinical education, students are based in a general practice ‘teaching microsystem’ and participate in patient care as part of this community of practice (CoP). This study evaluates patients’ perceptions of the clerkship initiative, and their perspectives on this approach to training ‘much-needed’ doctors in their community.MethodsSemi-structured, face-to-face, interviews with patients provided data on the clerkship model in three contexts: regional, rural and remote health care settings in Australia. Two researchers independently thematically analysed transcribed data and organised emergent categories into themes.ResultsThe twelve categories that emerged from the analysis of transcribed data were clustered into four themes: learning as doing; learning as shared experience; learning as belonging to a community; and learning as ‘becoming’. Patients viewed the clerkship learning environment as patient- and student-centred, emphasising that the patient-student-doctor relationship triad was important in facilitating active participation by patients as well as students. Patients believed that students became central, rather than peripheral, members of the CoP during an extended placement, value-adding and improving access to patient care.ConclusionsRegional, rural and remote patients valued the long-term engagement of senior medical students in their health care team(s). A supportive CoP such as the general practice ‘teaching microsystem’ allowed student and patient to experience increasing participation and identity transformation over time. The extended student-patient-doctor relationship was seen as influential in this progression. Patients revealed unique insights into the longitudinal clerkship model, and believed they have an important contribution to make to medical education and new strategies addressing mal-distribution in the medical workforce.

【 授权许可】

CC BY   
© Hudson et al.; licensee BioMed Central Ltd. 2012