Dundee's Longitudinal Integrated Clerkship: drivers, implementation and early evaluation.

Dundee University School of Medicine established a pilot for a 40 week long comprehensive Longitudinal Integrated Clerkship (LIC) in 2016. Ten places for year 4 students are available which are shared between two regions of Scotland which are largely rural areas by UK definitions. This paper describes the drivers for the pilot, its implementation and early evaluation. For the evaluation, data were collected using focus groups and semi-structured interviews from the first cohort of seven students, four health service employed staff (two with leadership roles and two with regional student facing roles), 21 General Practitioner tutors, and from reflective audio-diaries kept by all students. Analysis was thematic, the themes being identified from the data. Summative assessment data were collated. Students reported positive learning experiences though access to secondary care learning linked to their patients was sometimes problematic. GP tutors were positive and enthusiastic about the programme and could see the potential benefits on recruitment to GP careers. Pre-existing workload pressures were a challenge. Summative assessment results were encouraging. The Dundee LIC is successful in delivering Dundee's year 4 curriculum. Ongoing development has been focused on improving awareness of the programme in secondary care services.

Teaching wilderness and outdoor medicine in a city.

BACKGROUND: Teaching medical students wilderness medicine helps students learn how to apply skills such as leadership, teamwork and managing medical emergencies. The literature contains papers that describe methods for delivering this type of teaching, but they use specialised centres and a significant number of tutors. This paper describes a course delivered within the university and a nearby outdoor centre. METHODS: A course that covered outdoor emergency skills, and expedition and leadership skills, was delivered to third-year medical students. The usefulness of the course was assessed using student and tutor evaluations and the end-of-course assessment results. Practical scenarios were used to stimulate learning and the course finished with a camping trip, during which the students had to manage injuries in the field. RESULTS: The course was successfully delivered using only two tutors. The results of the evaluations indicated that the students had gained a good knowledge of the areas covered; they enjoyed the course and were able to apply first-aid skills to the outdoor situation. The students especially liked the approach of using practical scenarios to help them apply the principles that they had learned in the course. DISCUSSION: The course was successful because of the use of scenarios that encouraged the students to actively manage casualties and work as a team. We were able to deliver the course at a reasonable cost by using the facilities of a local outdoor camping centre.