title: Development of a longitudinal integrated clerkship at an academic medical center.
abstract: In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.
authors.affiliation: Department of Neurology, University of California, San Francisco, CA 94143-0348, USA. ann.poncelet@ucsf.edu
authors.forename: Ann
authors.initials: A
authors.lastname: Poncelet
authors.forename: Seth
authors.initials: S
authors.lastname: Bokser
authors.forename: Brook
authors.initials: B
authors.lastname: Calton
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hauer
authors.forename: Heidi
authors.initials: H
authors.lastname: Kirsch
authors.forename: Tracey
authors.initials: T
authors.lastname: Jones
authors.forename: Cindy J
authors.initials: CJ
authors.lastname: Lai
authors.forename: Lindsay
authors.initials: L
authors.lastname: Mazotti
authors.forename: William
authors.initials: W
authors.lastname: Shore
authors.forename: Arianne
authors.initials: A
authors.lastname: Teherani
authors.forename: Lowell
authors.initials: L
authors.lastname: Tong
authors.forename: Maria
authors.initials: M
authors.lastname: Wamsley
authors.forename: Patricia
authors.initials: P
authors.lastname: Robertson
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000704:Analysis of Variance; D002982:Clinical Clerkship; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods; D004522:Educational Status; D004635:Emergency Medicine / Q000193:education*; D005180:Faculty, Medical; D005260:Female; D017144:Focus Groups; D006801:Humans; D007297:Inpatients; D007858:Learning; D008137:Longitudinal Studies; D008297:Male; D018802:Patient-Centered Care; D016730:Program Development; D015397:Program Evaluation; D036301:Qualitative Research; D012495:San Francisco