A new clinical campus of Georgia Health Sciences University in Rome will focus on specific patients rather than blocks of exposure, an approach that a Harvard expert says will improve clinical medical education.
Research shows that this approach greatly improves students’ compassionate care and satisfaction while traditional programs might drive them in the other direction, said Dr. David Hirsh, the director and co-founder of Harvard Medical School’s Cambridge Integrated Clerkship.
Hirsh spoke Monday in Rome to those who will help found the clinical campus, set to open in 2013.
It will be the third clinical campus for GHSU outside Augusta, joining Albany and Savannah, but the new clinical program will be the first of its kind in Georgia.
There is also a branch of Medical College of Georgia in Athens in conjunction with the University of Georgia.
Called longitudinal integrated clerkships, the programs assign students to a specific number of patients with a range of conditions that are then followed throughout the year.
Students experience a greater continuum of care, sometimes beginning before diagnosis, and develop more meaningful relationships and better communication skills.
In a study published last month in Academic Medicine, Hirsh and others reported that students in the Cambridge program were more likely to feel they had made a difference in the patient’s life, felt better prepared to practice, and did as well as or better than other students on critical exams.
“It seems to me you can help them become more able learners of science, more skillful in clinical practice, and have core humanistic values (where) the patient is the center for you,” Hirsh said.
It also tends to reverse a disturbing trend among medical students in their clinical years, which typically begin in earnest in the third year, where many of those values decline in what has been called the “ethical erosion.”
“Typically the more morally developed people are the more competent people, so we just can’t write off moral development as some kind of side issue,” Hirsh said.
The integrated approach also lends itself to the modernizing of medical education, which is moving away from big lectures to small group “learning communities” and even things such as podcasts and taped lectures, he said.
“In the modern world, what we’re going to find in clinical education, I predict, is that we’re going to realize the student-patient work is the work,” Hirsh said. “And you don’t need to have a faculty person there for every, every, every moment of that. Close oversight for sure, but in theory it doesn’t need to be moment-to-moment oversight.”
In fact, it might not be a physician at all as medical schools move toward more emphasis on teamwork and working with other professionals, such as pharmacists and nurses and students in those disciplines, he said.
The approach is highly adaptable, and the program in Rome will be its own, Hirsh said.
“What is neat for Georgia is here there is a culture and a context and a climate and a community and you can create an education model that doesn’t just use those but contributes to those,” he said.