Factors affecting medical students' sense of belonging in a longitudinal integrated clerkship

Abstract

Background: Longitudinal integrated clerkships (LICs) have been shown to be effective educationally and may assist in promoting rural career choices when undertaken in rural communities. Despite these merits, some students find LICs challenging. This qualitative study investigated the experience of students undertaking a LIC from the perspective of 'belonging', in order to identify areas for improvement. Methods: Students from a regional medical school undertaking a LIC participated in semi-structured interviews. A template approach was used for analysis of the transcripts. Results: Thirteen students participated. Three major themes were identified: academic leadership, external (general practice) environment and intrinsic (student) factors. Optimally, a synergistic relationship between factors, facilitated by academic leadership, resulted in a sense of belonging. Discussion: Our findings support the concept that there is a highly dynamic interaction between factors determining the experience of students in the LIC. The individual nature of learners and the learning contexts require multi-level academic leadership.