Narratives, Sensemaking, and Didactic Relationships in Longitudinal Integrated Clerkship Education

Abstract

OBJECTIVE To understand what longitudinal integrated clerkship (LIC) participants found meaningful and valuable about their experiences while grounded in a communicated narrative sensemaking (CNSM) framework. METHODS Semi-structured interviews were conducted with a cohort of 3 LIC students and 7 of their 12 preceptors. Interviews were designed to elicit narratives ie time-ordered accounts of events, experiences, or reflections. Narratives were identified and coded to understand aspects of experiences. RESULTS Participants made sense of their experiences by narrating stories of LIC length allowing relationships to grow over time in a way that gave students a holistic perspective on patient care, built deep relationships between students and preceptors, and grew student confidence. CONCLUSION Participants value longitudinal integration in LICs because it allows for unique perspectives on patient care and builds deep meaningful mentor relationships with preceptors. Relationships in LICs must be managed carefully because much LIC learning is facilitated by relationships. The clerkship is a crucial aspect of medical education of which sense will be made by physicians during their whole lives.