Dr Bethan Stephens & Dr Katie Webb - Longitudinal Integrated Clerkships in Wales

Dr Bethan Setphens, a GP and Director of Community Learning at Cardiff university, and Dr Katie Webb, a psychologist, and a Professor of Medical Sducation at the University of Cardiff, tell us about Longitudinal Integrated Clerckships in Wales and the upcoming CLIC conference.

Episode summary: 

01.30  Katie and Bethan tell us about their professional background and how they became involved with medical education.

04.26  What is a Longitudinal Integrated Clerkship?

08.22  How were LIC introduced in Wales?

11.29  What were the challenges of establishing this new approach to medical education?

15.43  What are some important features of LIC and how do they enhance medical education for students?

21.15  How are communities involved in LIC? What role do they play in the student’s education?

23.55  What is social accountability and what role does it have in LIC?

26.53  What impact have LICs had on student’s future career choices?

34.15  Are there benefits for the GP practices that engage with LICs?

49.45  What is the Consortium for Longitudinal Integrated Clerkships? What is CLIC 2025?

56.11  What are the topics and themes for the CLIC 2025 conference?

01.05.00  What are their hopes for outcomes from CLIC 2025? How do they see LICs developing in Wales?

Key messages:

Longitudinal Integrated Clerkships (LIC): Consists of comprehensive care of patients over time while based in one community. Students that are involved have continuing learning relationships with patients, clinicians, and they meet most of their academic clinical competencies across multiple disciplines simultaneously through these experiences. 

A number of universities in the UK have started offering longitudinal Integrated clerkships.

In Wales the government supported the establishment of LIC, it first started in Aberystwyth and Bangor.  Cardiff University has been running the program since 2018.  Their students are mostly based in primary care.  They develop longitudinal relationships with supervisors, the community and patients. They started as a way to try to tackle challenges with recruitment and retention of GPs in rural areas. 

Getting initial buy-in from staff and students can be a challenge.  However, the learning outcomes for students have been found to be the same as for those on the standard curriculum.  

Features of the LIC:  students spend a whole year in one practice and in one community, social learning, having access to a team of professionals not just one mentor, continuous learning which improves the learning cycle, builds confidence and students become more independent and they develop a deeper understanding of the social and health system context. 

Students develop a sense of belonging during their time in the community.  This can lead to a feeling of responsibility for the community.  Many of them choose to help during COVID with patient care and vaccination programs.  

Students live and work in the area for the year and join different community activities.  They work on a student selected project, this project often looks at providing a new service or evaluating an existing service.  

Social accountability in LIC means that the student thinks about how to co-produce things with the community, gets them thinking about what the community needs and how to meet those needs through working with the community.  

There have been around 30 graduates to date from their program.  Around half of those have opted during their time to stay in Wales.  They have expressed interest in staying in the same area or working in another rural area, others have changed their career preference towards general practice.  Indications at this early stage are positive.

Information about CLIC 2025: https://www.cardiff.ac.uk/community/events/view/2871539-consortium-of-longitudinal-integrated-clerkships-clic-conference-2025

 

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