This document evaluates the Longitudinal Integrated Flinders Training (LIFT) program, which places students in longitudinal half-year placements at Flinders Medical Centre. The evaluation found that students in the LIFT program showed a significant increase in their scores on a clinical reasoning test from pre-to-post, and the LIFT students significantly increased their class ranking by the end of the program. Clinicians provided feedback that the longitudinal nature of the program allowed them to better monitor student progress and assess clinical abilities, though noted weaknesses included a lack of inpatient exposure and not enough clinician preceptors across all disciplines.

1. Evaluation of LIFT
Longitudinal Integrated Flinders
Training
Gayle Roberton

2. Presenter Disclosure
• Faculty: Gayle Roberton
• I have no conflict of interest to disclose

3. Rationale
• All other Year 3 placements at Flinders
consist of half-year or full year
longitudinal placements and have been
shown to be educationally sound
• Based on 2 programs in USA that have
done longitudinal placements in urban
teaching hospitals
• Will these models work at FMC or will
we have to adapt?

4. LIFT 2013
• Pilot of 8 students at FMC, 4 in Alice
Springs
• Longitudinal – panel of patients followed
for the whole year
• 50-100 patients hoped for
• Integrated – all disciplines at the same
time

5. Preceptors
• Each student had one preceptor in each
discipline
• Medicine, surgery, paediatrics,
psychiatry, obstetrics and gynaecology
–once per fortnight in outpatient clinic
• Emergency department – weekly
• GP – weekly for 6 months

6. Students
• Follow patients in their panel to:
– Other outpatient appointments
– Inpatient wards and visit daily
– GP appointments if possible
• Meet new patients in:
– Outpatients with preceptors
– ED

7. LIFT Evaluations
• Assessment of Learning by Roberton,
Heddle, Schuwirth
• Feedback from Clinicians
• Feedback from Students
• End of year Exams and consequent
place in class

8. The Clinical Reasoning Test
• 10 Scenarios
• For example: Jennifer James is 38 years old and
presents to ED with a severe headache that started
suddenly 6 hours ago. She has vomited twice in that
time and says that the light hurts her eyes. BP is
150/80, HR is 105, RR is 22 and temperature is
38.8C

9. Test Analysis
Pre-Test Post-Test
LIFT Mean score: 59.00
(SD=16.71)
Within LIFT
students between
post and pre-test
(p=0.004)
Mean score: 71.69
(SD=8.53)
Within Pre-Test
Comparison of LIFT and
NON-LIFT students
(p=0.659)
Within Post-Test
comparison of LIFT
and NON-LIFT
students (p=0.659)
NON
LIFT
Mean score: 59.70
(SD=11.59)
Within NON-LIFT
students between
post and pre-test
(p=0.018)
Mean score: 70.93
(SD=6.34)

10. Change in Class Ranking

11. Clinician Comments
• Strengths
– Relationship with the student
– Ability to monitor the student’s progress
– Most said they were confident in their
ability to assess the student’s clinical ability
and professional behaviour

12. Clinician Comments
• Weaknesses
– Outpatients only with no inpatient contact
– Not enough clinicians in all disciplines for
70 students
– Consultant teaching only with no
involvement of Junior Medical Staff in the
teaching

13. Summary
• Clinical Reasoning Test showed no
significant difference
• Significant increase in class rank for
LIFT students
• Clinician-student relationship valued