Why longitudinal clerkships? VALUE of Patient/Family Engagement (PFE) in LIC PROGRAM :
For the Duke Medical School
Being at the forefront of a growing renaissance in medical practice of safety and PFE
The medical anthropological approach establishes empathy and understanding for the influences that impact patient/family health and illness: “As health becomes more broadly defined in a globalizing world with integrative approaches, new models are needed to improve quality patient/family care. Medicine is a single approach to health and illness that is at the forefront of science and technology in treatment of disease. However, definitions of health and illness have broadened in the last century to include not only physiological disease, but also social, political, cultural, and financial illness (among others). By utilizing anthropological models of illness identification and therapy, medical students will be able to create personalized and quality treatments for patient/families that include psycho-social, financial, and community resources. These models will also establish patient/family empathy and compassion through developing an understanding of patient/family health and illness influences.” – Team PFACT
The medical anthropological approach to medicine establishes quality patient/family centered care and empathy: “In the Western World, people usually do not make a distinction between illness and disease. These two terms seem to mean essentially the same thing and are often used interchangeably. However, it is important to define illness and disease differently when considering some non-western cultural traditions. Disease is an objectively measurable pathological condition of the body. Tooth decay, measles, or a broken bone are examples. In contrast, illness is a feeling of not being normal and healthy. Illness may, in fact, be due to a disease. However, it may also be due to a feeling of psychological or spiritual imbalance. By definition, perceptions of illness are highly culture related while disease usually is not. It is important for health professionals who treat people from other cultures to understand what their patients believe can cause them to be ill and what kind of curing methods they consider effective as well as acceptable.” -David O’Neill (http://anthro.palomar.edu/medical/med_1.htm)
For the Duke Medical Student:
Developing healthy emotional responses to difficult situations in healthcare, while cultivating more compassionate, effective treatment, potentially contributing to research, and/or potentially earning a dual degree with School of Divinity, or other offering at Duke.
For the Duke Medical Resident:
Potentially incorporating the LIC experience into a required quality improvement project.
For the Duke LIC Mentors:
a) Earning CME and stipend.
b) Learning cutting-edge ideas, maintaining resilience in dealing with stressful interactions while cultivating compassion and dissipating burnout.
c) Helping to shape the future physicians of the country.
How is the first year different from the standard Duke curriculum?
There are no differences for the first year students.
What does the second year look like?
In the first part of the year, LIC students complete two weeks of operating room orientation; two weeks of radiology covering 9 subspecialties; three weeks of inpatient psychiatry; four weeks of inpatient internal medicine; 2 weeks of inpatient neurology; 2 weeks of inpatient surgery; 2 weeks of OB/GYN +/- Centering; and two weeks of inpatient pediatrics. Following this, the students begin their longitudinal experiences in outpatient clinics for Medicine, Surgery, Neurology, Family Medicine, Pediatrics, and OB/GYN. Here, they will follow with the same preceptor for approximately six months, developing patient and faculty relationships. The students will develop a panel of patients whom they will follow throughout their care to help the student develop empathy as well as understanding of patient care and follow-through. The LIC is learner-centered to provide the optimal experience for our medical students.