Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 10;21(1):153.
doi: 10.1186/s12909-021-02553-7.

Patient perceptions of students in a longitudinal integrated clerkship in Taiwan: a qualitative study

Yaw-Wen Chang  1   2 , David A Hirsh  3   4 , Wen-Hui Fang  1 , Honghe Li  5 , Wen-Chii Tzeng  6 , Senyeong Kao  7
Affiliations

Patient perceptions of students in a longitudinal integrated clerkship in Taiwan: a qualitative study

Yaw-Wen Chang et al. BMC Med Educ. .

Abstract

Background: Longitudinal integrated clerkships (LICs) are a model of clinical education growing rapidly in Western contexts. LICs use educational continuity to benefits students' clinical learning and professional identity formation. Patient-centered care is a core component of medical professionalism in the West. To support patient-centered care, education leaders in Taiwan restructured clinical education and implemented the first longitudinal integrated clerkship in East Asia. We aimed to investigate patients' perceptions of longitudinal relationships with the LIC students within Taiwan's Confucian cultural and social context.

Methods: We invited patients or their family members who were cared for longitudinally by a LIC student to participate in the study. Participating patients or their family members undertook semi-structured interviews. We analyzed data qualitatively using a general inductive approach to identify themes in the patients' descriptions of their experiences interacting with the LIC students.

Results: Twenty-five patients and family members participated in interviews: 16 patients and 9 family members. Qualitative analysis of interview transcripts identified three themes from patients' experience receiving care from their LIC students: care facilitation, companionship, and empathy. To provide care facilitation, LIC students served as a bridge between the physicians and patients. Students served patients by reminding, consulting, tracking disease progression, and researching solutions for problems. To provide companionship, students accompanied patients interpersonally like a friend or confidant who listens and provides a presence for patients. To provide empathy, patients reported that students showed sincere concern for patients' experience, feelings, and mood.

Conclusion: In our study, Taiwanese patients' perspectives of LIC students suggested the value of care facilitation, companionship, and empathy. We discuss these themes within the context of Confucian culture and the Taiwanese context of care.

Keywords: Continuity; East Asia; Empathy; Longitudinal integrated clerkship; Medical student; Patient centered; Patient perception; Professionalism; Qualitative study; Relationship; Undergraduate medical education.

PubMed Disclaimer

Conflict of interest statement

Yaw-Wen Chang is director of TSGH’s longitudinal integrated clerkship. David A. Hirsh is co-founder and director of Harvard Medical School’s longitudinal integrated clerkship (the Cambridge Integrated Clerkship). Wen-Hui Fang is a preceptor the TSGH LIC. The authors alone are responsible for the content and writing of this article. All authors report no conflicts of interest and no financial disclosures.

Figures

Fig. 1
Fig. 1
Major themes from patients’ descriptions of students’ participation in their longitudinal clinical care
See this image and copyright information in PMC

References

    1. Hirsh D, Gaufberg E, Ogur B, Cohen P, Krupat E, Cox M, et al. Educational outcomes of the Harvard Medical School-Cambridge integrated clerkship: a way forward for medical education. Acad Med. 2012;87(5):643–650. doi: 10.1097/ACM.0b013e31824d9821. - DOI - PubMed
    1. Hirsh D. Longitudinal integrated clerkships: Embracing the hidden curriculum, stemming ethical erosion, transforming medical education. In: Hafferty FW, O’Donnell JF, editors. The hidden curriculum in health professional education. edn. Hanover, NH: Dartmouth College Press; 2014. pp. 193–202.
    1. Gaufberg E, Bor D, Dinardo P, Krupat E, Pine E, Ogur B, et al. In pursuit of educational integrity: professional identity formation in the Harvard Medical School Cambridge integrated clerkship. Perspect Biol Med. 2017;60(2):258–274. doi: 10.1353/pbm.2017.0032. - DOI - PubMed
    1. Hirsh DA, Walters LK. Learning in longitudinal integrated clerkships. In: Dent JA, Harden RM, Dan H, editors. A Practical Guide for Medical Teachers. 5th edn. Toronto: Elsevier; 2017. pp. 84–91.
    1. Alliance for Clinical Education . Longitudinal Integrated Clerkships : Principles, Outcomes, Practical Tools, and Future Directions, First edition. edn. North Syracuse: Gegensatz Press; 2016.

LinkOut - more resources