On Doctoring: A Longitudinal Clinical Experience (LCE)
Terri L. Eastman, MEd, CHES
Cori Stebbins, BS
Description and Goal:
The mission of "On Doctoring: A Longitudinal Clinical Experience" (LCE) is to provide an understanding of the role of the physician in the clinical setting and in the community through longitudinal clinical and didactic experiences in the first two years of medical school. The course focuses on understanding the relationship between patient and doctor and how to use this relationship to improve patient outcomes and increase patient satisfaction. Because of the pairing of individual students with preceptors, "On Doctoring" relies on a large network of academic and community-based faculty, mostly in primary care disciplines. This two-year required course uses about 45-50 medical center based and 145-150 community-based faculty as facilitators and preceptors.
Students learn the fundamentals of:
- Patient Interviewing
- Physical Examination (Year one and two)
- Physical Diagnosis and Clinical Reasoning (Year 2 only)
The course meets weekly, alternating between the student experience in their preceptor's office and small group meetings of peers and their faculty facilitator. They learn from patients first-hand about the impact of illness on their lives and what their expectations are of their doctor. These experiences are brought back to the small groups where they have an opportunity to reflect on what it means to be a doctor. Small group learning is enhanced through the use of standardized patients and a new innovative program called a "Patient Bank". Through a "Patient Bank" students are able to observe, examine and interview patients who have various medical conditions. A "Patient Bank" creates opportunities to view abnormal physical findings that they may find in the subspecialty areas rather than in their primary clinical practices.