a Kaiser Permanente , Oakland , CA , USA.
b School of Medicine , University of California , San Francisco , CA , USA.
Med Teach. 2019 Mar;41(3):347-353. doi: 10.1080/0142159X.2018.1472369. Epub 2018 May 25.
Longitudinal integrated clerkships (LICs) are innovative educational models that emphasize medical student continuity with patients, preceptors, peers, and health systems. We characterize LIC growth in the US and interpret the growth using Rogers' Diffusion of Innovation Theory.
In 2015, we surveyed 123 US allopathic medical schools affiliated with Clerkship Directors in Internal Medicine (CDIM). The organization's annual survey was supplemented with questions aimed to quantify the number of current and planned LICs and to determine the intended purpose of starting LICs.
Of the 94 (out of 123 possible) schools which were responding, 35 (37%) have at least one LIC of six months or greater; of these 20 are year-long. Nineteen schools are engaged in planning a new LIC or increasing the number of students in an LIC. At least 45 (48%) responding schools will have LICs in future years. Respondents report implementing LICs to foster continuity of care, support patient-centeredness, advance inter-professional education, and address workforce shortages.
The number of LICs is increasing across the US. We considered the data through the lens of Diffusion of Innovation Theory, speculated that LIC growth has reached "critical mass," and considered why the LIC innovation may be self-sustaining.
纵向综合实习课程（LIC）是一种创新的教育模式，强调医学生与患者、导师、同学和医疗系统的连续性。我们描述了 LIC 在美国的发展，并使用罗杰斯的创新扩散理论对其发展进行了解释。
2015 年，我们调查了 123 所与内科住院医师指导协会（CDIM）有关的美国全科学医学院。该组织的年度调查补充了旨在量化当前和计划中的 LIC 数量以及确定开设 LIC 目的的问题。
在 94 所（总共 123 所可能的学校中）回应的学校中，有 35 所（37%）至少有一个为期六个月或更长时间的 LIC；其中 20 所为为期一年的 LIC。19 所学校正在计划开设新的 LIC 或增加 LIC 中的学生人数。至少有 45 所（48%）回应的学校将在未来几年开设 LIC。受访者报告实施 LIC 是为了促进医疗连续性、支持以患者为中心、推进跨专业教育以及解决劳动力短缺问题。
LIC 在美国的数量正在增加。我们通过创新扩散理论的视角考虑了这些数据，推测 LIC 的增长已经达到了“临界质量”，并考虑了为什么 LIC 的创新可能是自我维持的。
