Piece of work created by a medical student showing the progression in their learningWhy is it important?

Medical students require the training and skills to be able to address the key problems that we face in the 21st Century. With an ageing population and increasing medical, social and psychological multi-morbidity, there has been a need to rethink the traditional block rotational curricula of medical education. 

Longitudinal learning allows students to spend a longer time immersed within a clinical team, where they form meaningful relationships with patients, staff and their peers. Students take an active role with their patients, often advocating for them and guiding them through their healthcare journey. Clinical learning occurs in an authentic manner, synergistically with patient care. Key to longitudinal learning is the principle of continuity: continuity of care (students learning through patient care), continuity of curriculum (learning in an integrated fashion across disciplines) and continuity of supervision (meaningful relationships with supervisors and mentors).  (Hirsh et al, 2007)

MEdIC is committed to exploring how longitudinal learning can be incorporated within the undergraduate medical curriculum, alongside understanding what impact such curriculum design can have on student, patients, and communities.

Innovation and research

MEdIC has led nationally in the implementation and innovation of longitudinal integrated clerkships (LICs), a model of curriculum design using longitudinal learning. In 2016, MEdIC piloted an LIC entitled the “Integrated Clinical Apprenticeship” (ICA), where 24 Year 5 students spent a day a week placed in a local GP practice with their own caseload of patients. Students reviewed these patients regularly over the year and accompanied them to secondary care appointments, investigations and home visits. Students were able to advocate for their patients and contribute to decision making around management. 

MEdIC also launched a new and innovative LIC in July 2019 entitled “F-Zero”. F-Zero is a redesign of the current final year at Imperial College and integrates learning across primary and secondary care. Students were placed in a medical firm, surgical firm and GP practice throughout the academic year within a single geographical area. The students started to take the role and the responsibility of working as a foundation doctor, with close guidance, supervision and support. 

Following the experience and expertise gained from these courses, this model of longitudinal curricula design will begin to be rolled out to all Year 5 medical students starting in 2021 with the launch of the Longitudinal Community Clerkship (LCC). 

MEdIC is interested in conducting research associated with longitudinal learning from a variety of perspectives. We have explored the experiences of students using a mixture of research methodologies. Qualitatively, MEdIC has explored students’ experiences and roles in longitudinal courses and how this may affect their learning and development as a future doctor. Quantitatively, we have investigated whether such models of leaning can affect professional student attributes and assessment outcomes. 

MEdIC is also interested in understanding the theoretical educational underpinning of longitudinal learning and have explored areas including authenticity, communities of practice, transformational learning and student belonging. With the rapid transformation of the medical curriculum from the COVID-19 pandemic, MEdIC is exploring how key elements of longitudinal learning, such as service learning may be incorporated within more traditional clinical placements to support the healthcare system during this crisis and provide a unique learning experience for our students. 

MEdIC has founded UKLIC (UK think tank of LICs) bringing together UK institutions who are developing and interested in the principles of longitudinal learning to share experiences and learn from each other. MEdIC is proud to host the international CLIC (Consortium of Longitudinal Integrated Clerkships) conference in London in 2022.

Accordion

Current active projects

  • Exploring preparedness for practice of final year medical students using an innovative simulation design
  • Evaluating our F-Zero final year LIC model from perspectives of students and educators
  • Exploring whether there is a change in professional attributes through a longitudinal learning curriculum
  • Exploring the change in identity of LIC students using a novel “stepping stone” methodology

Selected publications

Learning through service: a qualitative study of a community-based placement in general practice
Tanna, S, Fyfe, M., Kumar, S.
Education for Primary Care 2020 May 14:1-6 doi: 10.1080/14739879.2020.1759459

UK longitudinal integrated clerkships: where are we now?
McKeown, A., Mollaney, J., Ahuja, N., Parekh, R., Kumar, S. 
Education for Primary Care 2019 Sep;30(5):270-274 doi: 10.1080/14739879.2019.1653228

Identifying central tenets needed in our education systems: Results from a pilot integrated clinical apprenticeship
Simpkin, A.L., McKeown, A., Parekh, R., Kumar, S., Tudor-Williams, G. 
Medical Teacher 2019 Jul;41(7):780-786. doi: 10.1080/0142159X.2019.1578874. Epub 2019 May 6. 

A novel Integrated Clinical Apprenticeship: transforming medical students into student doctors
Simpkin, A.L., McKeown, A.M., Parekh, R., Kumar, S., Tudor-Williams, G. 
Education for Primary Care 2017 Sep;28(5):288-290. doi: 10.1080/14739879.2017.1319745. Epub 2017 Apr 24.  

Longitudinal integrated clerkships in the community
McKeown, A., Parekh, R. 
Education for Primary Care 2017 May;28(3):185-187. doi: 10.1080/14739879.2017.1298976. Epub 2017 Mar 23. 

Selected presentations

Can Longitudinal Integrated Clerkships help protect against a decline in professional attributes in medical students? Evidence from a longitudinal cohort study
Parekh, R., McKeown, A., Ruzangi, J., Simpkin, A., Tudor-Williams, G., Kumar, S.
Association for Medical Education in Europe conference (AMEE) 2019 

Tackling a perceived misalignment between curriculum and assessment in a pilot LIC
Parekh, R., McKeown, A. (2019) 
Consortium of Longitudinal Integrated Clerkships Conference (CLIC) 2019 

“A bit of a doctor factory” What are medical students’ experiences of belonging in Longitudinal Integrated Clerkships? 
Parekh, R. (2019) 
Consortium of Longitudinal Integrated Clerkships Conference (CLIC) 2019 

The Trojan Horse: Medical students as the hidden army for the UK health service?
McKeown, A., Parekh, R., Kumar, S.
Global Community Engaged Medical Education Muster Conference 2018 

An Integrated Clinical Apprenticeship: Evaluation of a novel Longitudinal Integrated Clerkship at Imperial College 
McKeown, A., Parekh, R., Kumar, S. 
The Association for the Study of Medical Education (ASME)2018 

From Chrysalis to Butterfly: Using longitudinal learning to support the transformation from student to apprentice 
Kumar, S., McKeown, A., Parekh, R., Tanna, S.
Royal Society of Medicine (RSM), Medical Innovations Summit 2017