The Columbia-Bronx VA amalgamative clerkship: an effective, 12-week, integrated, longitudinal clinical experience.
BACKGROUND
Many medical schools have adopted the longitudinal integrated clerkship (LIC) model in response to calls for increased continuity in clinical learning environments. However, because of implementation challenges, such programs are not feasible at some institutions or are limited to a small number of students.


OBJECTIVE
In January 2014, Columbia University College of Physicians and Surgeons (P&S) recognized the need to explore different LIC formats and began offering four, 12-week amalgamative clerkships (AC). Students within this curricular track experienced primary care, internal medicine 'away', orthopedic surgery, urology, and an elective in an integrated format.


METHODS
P&S developed the AC in partnership with the James J. Peters VA Medical Center in Bronx, NY (BVA). All patient care and educational conferences took place at the BVA during the 12-week experience. The learning objectives of the AC were aligned to the learning objectives of a 52-week20 LIC also offered at Columbia. An evaluation process was developed to determine studentlearning experiences and preliminary outcomes, including how well the LIC-related objectivescould be achieved in a shorter period of time.


RESULTS
In 2015, P&S collected AC evaluation data through three student feedback sessions. Students reported that the AC provided opportunity for patient continuity, patient-centered care approaches, meaningful roles for students, career development opportunities, and health systems awareness.


CONCLUSIONS
Early outcomes indicate that the BVA AC provides a degree of longitudinality that can influence student perceptions of patient care, career development, and health systems, consistent with the larger LIC. The team continues to gather additional data on students' experiences and investigate additional sites that have potential to serve as future AC learning environments.
a PGY1 in Internal Medicine , New York University Langone Medical Center , New York , NY , USA.
Jillian
J
Diuguid-Gerber
b PGY1 in Internal Medicine , University of Colorado-Denver Medical Center , Denver , CO , USA.
Samuel
S
Porter
c Center for Education Research and Evaluation , Columbia University Medical Center , New York , NY , USA.
Samuel C
SC
Quiah
d Department of Medicine , Columbia University College of Physicians and Surgeons , New York , NY , USA.
Katherine
K
Nickerson
d Department of Medicine , Columbia University College of Physicians and Surgeons , New York , NY , USA.
Deborah
D
Jones
e PGY3 in Pediatrics , Boston Children's Hospital , Boston , MA , USA.
Zeena
Z
Audi
f Medical Education Research and Scholarship , University of Utah School of Medicine , Salt Lake City , UT , USA.
Boyd F
BF
Richards
D002982:Clinical Clerkship / Q000379:methods* / Q000458:organization & administration; D003266:Continuity of Patient Care; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006784:Hospitals, Teaching; D006787:Hospitals, Veterans; D006801:Humans; D017145:Models, Educational; D018802:Patient-Centered Care; D010865:Pilot Projects; D024382:Professional Role; D013337:Students, Medical; D014505:Urban Population
Student; career; continuity; education; patient; systems; urban; veterans