How do longitudinal clerkships in general practice/primary care impact on student experience and career intention? A cross-sectional study of student experience

Abstract

Introduction: Internationally, the amount of time that medical students spend in community settings has increased in recent years. 'Longitudinal clerkships', which involve a prolonged exposure, are now common. In Ireland, medical education policy has promoted community-based education across medical schools, including one with a longitudinal clerkship of one semester duration.

Aims: To examine medical students' experience of a longitudinal clerkship in general practice/primary care, its impact on career preference and the factors which students find most important in supporting their learning.

Methods: Quantitative cross-sectional study of students who had recently completed a longitudinal clerkship at the Graduate-Entry Medical School at University of Limerick involving an online survey.

Results: Most students agreed the intended learning outcomes of the clerkship had been achieved. Activity such as two-way feedback with GP tutors, assisting with procedural skills and parallel consulting were rated as of greatest educational value. Students identified internet access, a safe/unthreatening learning environment, and feeling part of the clinical team as the practice attributes most important in supporting their learning. Twenty-six (41%) intended to pursue a career in general practice/primary care and 46 (72%) indicated they were more likely to pursue a career in general practice/primary care after the clerkship. The clerkship was a positive influence on career intentions, with 63% of those who indicated that general practice/primary care was not their current preferred career option reporting they were significantly more likely to pursue this option after the clerkship (χ(2) = 3.52, P < 0.05).

Conclusion: Our findings indicate that longitudinal clerkships are effective in helping students to achieve their intended learning outcomes and identify the student activity and practice attributes that are most important in promoting their learning.