title: How do longitudinal clerkships in general practice/primary care impact on student experience and career intention? A cross-sectional study of student experience.
abstract: BACKGROUND
  Internationally, the amount of time that medical students spend in community settings has increased in recent years. 'Longitudinal clerkships', which involve a prolonged exposure, are now common. In Ireland, medical education policy has promoted community-based education across medical schools, including one with a longitudinal clerkship of one semester duration.
  
  
  OBJECTIVE
  To examine medical students' experience of a longitudinal clerkship in general practice/primary care, its impact on career preference and the factors which students find most important in supporting their learning.
  
  
  METHODS
  Quantitative cross-sectional study of students who had recently completed a longitudinal clerkship at the Graduate-Entry Medical School at University of Limerick involving an online survey.
  
  
  RESULTS
  Most students agreed the intended learning outcomes of the clerkship had been achieved. Activity such as two-way feedback with GP tutors, assisting with procedural skills and parallel consulting were rated as of greatest educational value. Students identified internet access, a safe/unthreatening learning environment, and feeling part of the clinical team as the practice attributes most important in supporting their learning. Twenty-six (41%) intended to pursue a career in general practice/primary care and 46 (72%) indicated they were more likely to pursue a career in general practice/primary care after the clerkship. The clerkship was a positive influence on career intentions, with 63% of those who indicated that general practice/primary care was not their current preferred career option reporting they were significantly more likely to pursue this option after the clerkship (χ(2) = 3.52, P < 0.05).
  
  
  CONCLUSIONS
  Our findings indicate that longitudinal clerkships are effective in helping students to achieve their intended learning outcomes and identify the student activity and practice attributes that are most important in promoting their learning.
authors.affiliation: General Practitioner and Clinical Teacher, Graduate Entry Medical School, University of Limerick, Limerick, Ireland and University of Notre Dame, Perth, Australia.
authors.forename: Sinead
authors.initials: S
authors.lastname: O'Donoghue
authors.affiliation: Director of Education, Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
authors.forename: Deidre
authors.initials: D
authors.lastname: McGrath
authors.affiliation: Professor of Urban General Practice, Graduate Entry Medical School, University of Limerick, Limerick, Ireland and School of Medicine & Medical Science, University College Dublin, UCD School of Medicine & Medical Science, Health Sciences, Belfield, Dublin 4, Ireland. walter.cullen@ucd.ie.
authors.forename: Walter
authors.initials: W
authors.lastname: Cullen
mesh_terms: D002321:Career Choice; D002982:Clinical Clerkship; D003430:Cross-Sectional Studies; D058006:General Practice / Q000193:education*; D006801:Humans; D033182:Intention; D007494:Ireland; D011320:Primary Health Care; D013337:Students, Medical / Q000523:psychology*