title: Educational outcomes of the Harvard Medical School-Cambridge integrated clerkship: a way forward for medical education.
abstract: OBJECTIVE
  The authors report data from the Harvard Medical School-Cambridge Integrated Clerkship (CIC), a model of medical education in which students' entire third year consists of a longitudinal, integrated curriculum. The authors compare the knowledge, skills, and attitudes of students completing the CIC with those of students completing traditional third-year clerkships.
  
  
  METHODS
  The authors compared 27 students completing the first three years of the CIC (2004-2007) with 45 students completing clerkships at other Harvard teaching hospitals during the same period. At baseline, no significant between-group differences existed (Medical College Admission Test and Step 1 scores, second-year objective structured clinical examination [OSCE] performance, attitudes toward patient-centered care, and plans for future practice) in any year. The authors compared students' National Board of Medical Examiners Subject and Step 2 Clinical Knowledge scores, OSCE performance, perceptions of the learning environment, and attitudes toward patient-centeredness.
  
  
  RESULTS
  CIC students performed as well as or better than their traditionally trained peers on measures of content knowledge and clinical skills. CIC students expressed higher satisfaction with the learning environment, more confidence in dealing with numerous domains of patient care, and a stronger sense of patient-centeredness.
  
  
  CONCLUSIONS
  CIC students are at least as well as and in several ways better prepared than their peers. CIC students also demonstrate richer perspectives on the course of illness, more insight into social determinants of illness and recovery, and increased commitment to patients. These data suggest that longitudinal integrated clerkships offer students important intellectual, professional, and personal benefits.
authors.affiliation: Department of Medicine, Harvard Medical School, Massachusetts, USA. david_hirsh@hms.harvard.edu.
authors.forename: David
authors.initials: D
authors.lastname: Hirsh
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gaufberg
authors.forename: Barbara
authors.initials: B
authors.lastname: Ogur
authors.forename: Pieter
authors.initials: P
authors.lastname: Cohen
authors.forename: Edward
authors.initials: E
authors.lastname: Krupat
authors.forename: Malcolm
authors.initials: M
authors.lastname: Cox
authors.forename: Stephen
authors.initials: S
authors.lastname: Pelletier
authors.forename: David
authors.initials: D
authors.lastname: Bor
mesh_terms: D002982:Clinical Clerkship / Q000639:trends*; D004504:Education, Medical, Undergraduate / Q000592:standards*; D004521:Educational Measurement / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008404:Massachusetts; D017145:Models, Educational; D015397:Program Evaluation; D012189:Retrospective Studies; D012577:Schools, Medical / Q000458:organization & administration*; D013337:Students, Medical