Continuity through the LIC Model
Shanta Zimmer, MD, Senior
Associate Dean for Education
What is an LIC in the Trek Curriculum?
The International Consortium of Longitudinal Integrated Clerkships defines an LIC as a clinical curriculum in which students participate in comprehensive care of patients over time, engage in continuity relationships with preceptors and evaluators, and meet core clinical competencies across multiple disciplines simultaneously.
In order to adapt to the changes in medicine and the way in which it is taught, the University of Colorado School of Medicine has instituted a transition to a fully LIC model in the Trek Curriculum. Longitudinal Integrated Clerkships allow students to interleave and space their specialty specific knowledge and experiences over time and see the same concept or skill reflected in a variety of different specialties. The LIC model allows students to develop longitudinal relationships with not only their teachers and facilitators, but also their peer group, a healthcare system, and a panel of patients – all leading to a deeper understanding of how their clinical experiences correlates throughout their medical career.
The CU School of Medicine currently has a variety of LIC and hybrid LIC programs that will help to guide and inform the development of more Trek LIC programs in the future. The Colorado Community LIC (C-CLIC, formerly ILMC) primarily places students in rural communities and focuses on rural community health. COSMIC or Colorado Springs Mentored Integrated Curriculum is a program that is located at the Colorado Springs Branch where students focus on clinical and community leadership opportunities. The Denver Health LIC focuses on urban underserved care, social justice, and health equity. The VA Sequential Training (VAST) Program is a LIC hybrid program where third year students spend their time caring for Veterans here at the Rocky Mountain Regional VA Medical Center. The Northern Colorado LIC will open its doors to CU students in Spring, 2020 and will be based at the Fort Collins Branch with a focus on health care as it impacts all areas of life including people, animals and the environment. These programs provide outstanding and diverse learning experiences for CU medical students and are the foundation for curriculum reform in the clinical clerkships.
Why an LIC?
Moving to an LIC model will address challenges with the current educational systems and encourage the facilitation of authentic and longitudinal roles between students and patients and health care teams. In these models, students develop a broad, patient-centered perspective of disease and health care systems, experience progressively more patient care responsibilities, and can provide value to a preceptor’s practice. LICs have been shown to produce high levels of patient-centeredness in students, high satisfaction and retention of preceptors, and potential enhancements to a patient’s experience. The CUSOM LICs will all deliberately integrate the pillars of leadership, curiosity and commitment into their experiences in a manner that is relevant to their specific patient care context. CUSOM is proud to offer this outstanding learning model to all students in the Trek curriculum.
References: Walters, et al. Outcomes of longitudinal integrated clinical placements for students, clinicians and society. Med Educ 2012; 46: 1028-1041 Poncelet, et al. Development of a longitudinal integrated clerkship at an academic medical center. Med Educ Online 2011; 16: 5939. Teherani, et al. Outcomes of Different Clerkship Models: Longitudinal Integrated, Hybrid and Block. Acad Med 2013; 88: 1-9 Poncelet, et al. Med Teach 2013 Flick R, Adams JE. Academic Medicine. In Press.
Recent Website Questions:
How many hours per week do they have of required time?
In the preclinical, foundational curriculum, students will have between 24-28 hours of required class and clinical time.
What does it mean to take step 1 later?
Students in the Trek curriculum will take step one after the foundational clinical and science years. This will place the timing at the beginning of the third year of medical school.
How quickly do some of these changes occur/what is the level of fluctuation?
Roll out of the full Trek curriculum will being with the class entering in 2021. A number of pilots and changes toward the new curriculum are happening now. Some examples of these early changes include the plan to move our step one to later in the curriculum, introduction of specialty specific preparation for residency courses, implementation of new integrated science electives and enhanced work around our assessment strategies and exam questions.