Eddings Stacy K, Brown Laura L, Godin Steven
Dean's Office, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, United States.
Department of Pediatrics, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, United States.
J Med Educ Curric Dev. 2023 Dec 15;10:23821205231217894. doi: 10.1177/23821205231217894. eCollection 2023 Jan-Dec.
Medical schools considering longitudinal integrated clerkships (LICs) have access to literature that provides recommendations for planning, implementation, and sustainability. However, LIC development and implementation remain notoriously challenging. University of Utah's LIC development process was informed by the documented experiences of long-established LIC programs. A literature gap was identified pertaining to more recently implemented LICs. The aim of this study was to explore the experiences of faculty in the early stages of LIC development.
Thirteen representatives from eight LICs implemented after 2015 participated in 2 Zoom focus groups (5 participated in the first and the other 8 participated in the second). Participants were asked questions to assess key supports, barriers, and recommendations. Following the focus groups, participants were asked to rank the responses based on their level of importance.
Highest ranked supports included stakeholder and partner involvement; a dedicated coordinator or team; and strong, committed leadership. Highest ranked barriers included difficulty recruiting preceptors and clinical sites; underestimation of the amount of work required to coordinate the LIC; and challenges in providing the needed faculty development. Top recommendations for new LICs included investing in the needs of clinical partners; staffing or assigning a dedicated coordinator early in the development and implementation process; and frequent communication with all stakeholders.
Despite variation among the types of new LICs represented, there was consensus among participants on the importance of key supports, barriers, and recommendations. Knowledge of these factors can help new schools plan and allocate resources during their LIC development process. Participants found the focus group process and follow-up discussions useful and have formed an ongoing workgroup which meets quarterly.
考虑开展纵向整合式临床实习（LICs）的医学院校可以获取相关文献，这些文献为规划、实施和可持续性提供了建议。然而，LIC的开发和实施仍然极具挑战性。犹他大学的LIC开发过程参考了长期设立的LIC项目的记录经验。研究发现，关于最近实施的LICs存在文献空白。本研究的目的是探索LIC开发早期阶段教师的经验。
来自2015年后实施的8个LIC的13名代表参加了2次Zoom焦点小组讨论（5人参加第一次，另外8人参加第二次）。向参与者提问，以评估关键支持因素、障碍和建议。焦点小组讨论后，要求参与者根据重要程度对回答进行排序。
排名最高的支持因素包括利益相关者和合作伙伴的参与；专职协调员或团队；以及强有力、有决心的领导。排名最高的障碍包括难以招募带教教师和临床实习点；低估协调LIC所需的工作量；以及在提供所需的教师发展方面存在挑战。对新LIC的首要建议包括满足临床合作伙伴的需求；在开发和实施过程早期配备或指定一名专职协调员；以及与所有利益相关者进行频繁沟通。
尽管所代表的新LIC类型存在差异，但参与者在关键支持因素、障碍和建议的重要性方面达成了共识。了解这些因素有助于新学校在LIC开发过程中规划和分配资源。参与者认为焦点小组讨论过程和后续讨论很有用，并成立了一个每季度开会的常设工作组。
