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Teaching Medical Students About Cancer Impact Through a Longitudinal Surgical Experience
*Arundhati Ghosh, *David Hirsh, *Barbara Ogur, Steven D Schwaitzberg
Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
Undergraduate medical cancer education has many deficiencies. Students have piece-meal exposure to cancer patients. Teaching is fragmented across disciplines. Our objective was to design a curriculum that would provide comprehensive understanding of the illness and its impact on the patient.
Design: Retrospective review.
Setting: Academic Community Hospital
The Harvard Medical School Cambridge Integrated clerkship is a complete redesign of the third year. Traditional block rotations in core disciplines are replaced by a single integrated year-long experience. The cancer component of the curriculum requires students to follow a patient with newly-diagnosed breast cancer and a patient with newly-diagnosed gastro-intestinal cancer across all specialties, throughout the year. All “meaningful” encounters are logged. An entire in-patient hospitalisation counts as one encounter, differentiating true longitudinal care from prolonged inpatient stay.
Main Outcome Measures:
Objective data on the number, duration, variety and quality of patient contact and subjective evaluation of the program from year-end student and faculty surveys.
29 of 34 medical students, 2007 to 2009, responded to the survey. Over 85% of students were present at the time of diagnosis and for the surgeries, 100% students were present for subsequent clinic visits. On an average, students followed each patient for seven months, attended five different specialist clinics and had twelve separate meaningful encounters with each patient. All students felt the multidisciplinary experience facilitated their understanding of cancer in a way not feasible in a traditional clerkship model.
Medical Students and faculty value this program. They perceive that this longitudinal model of education and patient exposure improves students’ integration of the surgical, medical, scientific, emotional and social issues of cancer in afflicted patients.
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