Comparing the Performance in Family Medicine Residencies of Graduates From Longitudinal Integrated Clerkships and Rotation-Based Clerkships

Woloschuk, Wayne PhD; Myhre, Douglas MD; Jackson, Wesley MD; McLaughlin, Kevin MB ChB, PhD; Wright, Bruce MD

doi: 10.1097/ACM.0000000000000113
Research Reports

Purpose: In 2008, the University of Calgary implemented a longitudinal integrated clerkship (LIC) called the Rural Integrated Community Clerkship (RICC), which places students in a rural community for 32 weeks. Research indicates that LIC students perform academically as well as or better than students completing rotation-based clerkships (RBCs). However, little is known about how LIC graduates perform in residency. This study compared residency program director ratings of RICC and RBC graduates.

Method: The performance of RICC and RBC graduates (2009–2011) was assessed using a rating form mailed to family medicine residency program directors at the end of graduates’ first postgraduate year. Because of sample size and confounding effects of discipline, only the performance of graduates training in family medicine was examined. Data were analyzed using factor analysis, ANOVA, and chi-square.

Results: Three hundred sixteen of 399 (80.8%) rating forms were returned. The instrument contained two factors (clinical acumen and human sensitivity) of acceptable reliability (≥0.90) plus an overall rating of performance. Of 124 (31.7%) students who matched to family medicine, 101 (81.5%) rating forms (RICC = 22/25; RBC = 79/99) were returned. Program directors rated the performance of RICC graduates to be at least equivalent to their RBC peers on both dimensions. On overall performance, 16/22 (72.7%) RICC graduates and 43/79 (54.4%) RBC graduates were rated as “stronger” or “much stronger” than most residents in the program, P = .30.

Conclusions: The performance of RICC graduates was at least equivalent to the performance of their RBC peers.

Dr. Woloschuk is director of program evaluation, Office of Undergraduate Medical Education, University of Calgary, Calgary, Alberta, Canada.

Dr. Myhre is associate dean for distributed learning and rural initiatives, University of Calgary, Calgary, Alberta, Canada.

Dr. Jackson is director, Rural Integrated Community Clerkship, University of Calgary, Calgary, Alberta, Canada.

Dr. McLaughlin is assistant dean of undergraduate medical education, University of Calgary, Calgary, Alberta, Canada.

Dr. Wright is associate dean of undergraduate medical education, University of Calgary, Calgary, Alberta, Canada.

Editor’s Note: Commentaries by D.A. Hirsh, E.S. Holmboe, and O. ten Cate and by C.D. Stevens, L. Wilkerson, and S. Uijtdehaage appear on pages 201–204 and 205–207.

Funding/Support: The authors thank Alberta Health, Government of Alberta, for their financial support of the Rural Integrated Community Clerkship (RICC).

Other disclosures: Drs. Myhre and Jackson were administrators of the RICC during the time of this study.

Ethical approval: This study was carried out as part of the RICC three-year evaluation plan, which received approval from the conjoint health ethics board at the University of Calgary.

Correspondence should be addressed to Dr. Woloschuk, Health Sciences Centre, Room G701B, 3330 Hospital Dr. NW, Calgary, Alberta, Canada, T2N 4N1; telephone: (403) 220-4254; fax: (403) 270-2681; e-mail: woloschu@ucalgary.ca.

© 2014 by the Association of American Medical Colleges