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Perm J. 2014 Spring;18(2):50-6. doi: 10.7812/TPP/13-137.

Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

Author information

Professor of Neurology, the Rowe Endowed Chair for Teaching in Neurology, and the Longitudinal Integrated Clerkship and Structured Clerkship Program Director at the University of California, San Francisco.
Assistant Professor of Clinical Medicine at the University of California, San Francisco and an Internist at the Oakland Medical Center in CA.
Director of Graduate Medical Education for Kaiser Permanente Northern California.
Professor of Clinical Medicine at the University of California, San Francisco.
Clinical Professor of Internal Medicine at the University of California, Davis and an Internist at the Sacramento Medical Center in CA.
Professor of Clinical Family and Community Medicine at the University of California, San Francisco and the Permanente Medical Group Teaching Chair for Primary Care.


The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills.Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment.Success factors include continued support and investment from both organizations' leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers.

[Indexed for MEDLINE]
Free PMC Article

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