Improving integration of clinical clerkship didactic curriculum

Curricular integration is a primary focus of many efforts to improve clinical education, but the practical realities of connecting content across discipline-based learning experience is a formidable challenge. This paper describes the construction of a third-year clinical clerkship curriculum featuring integrated didactics, purposeful sequencing, linkage to clinical context and introduction of competency-based learning activities. We describe the organization of our curriculum, the methods by which we integrated our didactic curriculum, and the results of curricular evaluations. Over two years, we improved integration and reduced fragmented learning experiences in a longitudinal integrated clerkship. Individual lectures were highly rated with a mean overall score of 4.29 (SD=0.78) (1=poor, 5= excellent)(N=23). Integrated didactic sessions and competency-based learning activities, including a quality improvement curriculum and reflection sessions, were also highly rated. Purposeful integration of clinical content, sequencing of didactics across the academic year, linking didactic content to a clinical context and creating new competency-based learning activities were highly rated and feasible ways to combine didactics across disciplines in the core clerkship year. Similar integrated curricula may be used with students in longitudinal integrated clerkships or in a traditional third-year clerkship model.