Challenges in transformation of the "traditional block rotation" medical student clinical education into a longitudinal integrated clerkship model.

BACKGROUND: Longitudinal integrated clerkships (LIC) in the first major clinical year in medical student training have been demonstrated to be at least equivalent to and in some areas superior to the "traditional block rotation" (TBR). Flinders University School of Medicine is starting a pilot changing the traditional teaching at the major Academic Medical Centre from TBR to LIC (50% of students in other locations in the medical school already have a partial or full LIC programme). METHODS: This paper summarises the expected challenges presented at the "Rendez-Vous" Conference in October 2012: (a) creating urgency, (b) training to be a clinician rather than imparting knowledge, (c) resistance to change. RESULTS: We discuss the unexpected challenges that have evolved since then: (a) difficulty finalising the precise schedule, (b) underestimating time requirements, (c) managing the change process inclusively. DISCUSSION: Transformation of a "block rotation" to "LIC" medical student education in a tertiary academic teaching hospital has many challenges, many of which can be anticipated, but some are unexpected.

The revised 'Early Learning in Medicine' curriculum at the University of Otago--focusing on students, patients, and community.

This article describes recent changes to years 2 and 3 of undergraduate medical education at the University of Otago, now termed 'Early Learning in Medicine'. These changes focus on learning that is contextually relevant, student centred, horizontally and vertically integrated, and community based. Three new programmes have been introduced to the course; Integrated Cases, Clinical Skills, and Healthcare in the Community. Innovative teaching and learning activities have been implemented to prepare students for a greater level of interaction with patients, carers, health professionals, and community organisations. This curriculum also aims to increase the relevance of their theoretical learning within and across years, and foster an early appreciation of professional responsibilities. Challenges to facilitating this direction are described and framed by an evolutionary approach that builds upon the strong features of the previous course.