title: Outcomes of different clerkship models:  longitudinal integrated, hybrid, and block.
abstract: OBJECTIVE
  To examine student perceptions and learning outcomes of three different third-year clerkship models: a yearlong, longitudinal, integrated clerkship (LIC); six-month clerkships with continuity (hybrid); and traditional, discipline-specific block clerkships (BCs).
  
  
  METHODS
  The authors compared the perceptions regarding the clerkship year and the hidden curriculum, as well as the pre- and postclerkship academic performance, of third-year medical students participating in LIC, hybrid, and BC models between 2006 and 2010.
  
  
  RESULTS
  Generally, LIC students rated the following clerkship experiences higher than did the hybrid and BC students: faculty teaching, faculty observation of clinical skills, feedback, and the clerkship overall. Students in the LIC observed more positive role-modeling behaviors and had more patient-centered experiences than BC students. All students preferred to see patients more than once, work within a consistent site or system, and work with a stable group of peers and faculty mentors over time. Whereas students in both the LIC and the hybrid models outperformed their BC counterparts in clinical skills, student performance on the U.S. Medical Licensing Exam Step 2 (clinical knowledge) was equivalent across models.
  
  
  CONCLUSIONS
  Key differences in student experiences and outcomes between the continuity clerkship models (LIC and hybrid) and BCs reinforce the literature and the educational framework for continuity in clinical learning. The benefits to student outcomes seem to increase with greater opportunities for continuity.
authors.affiliation: Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California 94107-1751, USA. Teherani@medsch.ucsf.edu
authors.forename: Arianne
authors.initials: A
authors.lastname: Teherani
authors.forename: David M
authors.initials: DM
authors.lastname: Irby
authors.forename: Helen
authors.initials: H
authors.lastname: Loeser
mesh_terms: D000046:Academic Medical Centers; D002982:Clinical Clerkship / Q000458:organization & administration*; D002983:Clinical Competence; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D004521:Educational Measurement; D005180:Faculty, Medical; D017144:Focus Groups; D006801:Humans; D008611:Mentors; D017145:Models, Educational; D018802:Patient-Centered Care / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation; D012495:San Francisco; D013337:Students, Medical / Q000523:psychology; D011795:Surveys and Questionnaires