Effect of longitudinal clerkship model and preceptor continuity on student learning and skills in obstetrics and gynecology

Abstract

Background: Longitudinal and amalgamative clerkship models enhance medical education through faculty continuity, mentorship, and targeted feedback. A United States allopathic medical school piloted a 16-week longitudinal clerkship (PIONEER), including one half-day of obstetrics and gynecology (OB/GYN) clinic per week. This study assessed the impact of preceptor continuity on student knowledge and procedural experience during the OB/GYN portion of PIONEER. Methods: This cross-sectional study (August 2023–July 2024) surveyed PIONEER students on OB/GYN knowledge, procedural experience, and preceptor continuity. Students were categorized into “high” or “low” continuity experiences based on Likert responses. Outcomes included changes in knowledge and procedural exposure, with secondary analyses comparing procedural opportunities across the academic year and to the OB/GYN traditional block clerkship. Results: Among 83 respondents (76.1% response rate), 71.1% reported low continuity with OB/GYN preceptors. Knowledge and procedural experience did not differ between continuity groups (all p>0.05). PIONEER students’ procedural opportunities remained consistent across the year and exceeded those of traditional clerkship students (e.g., 25.7-fold increase in students performing >10 breast exams; 1.6-fold increase for pelvic exams). Discussion: These exploratory findings suggest that meaningful educational experiences can occur in OB/GYN amalgamative longitudinal clerkships even with variable preceptor continuity. Importantly, PIONEER preserved a core benefit of longitudinal models—greater procedural exposure—while highlighting the need for future research to more comprehensively evaluate the contributions of preceptor, patient, and location continuity to student learning.