Outside an exam room at Carilion Clinic Family Medicine in Vinton, Va., Mark Watts, M.D. and Virginia Tech Carilion School of Medicine student Jarred Hicks look at the chart of a patient who is waiting behind the door. With a knock on the door, Jarred and Watts enter the room. Jarred has practiced his interview skills in the classroom many times, but today is the real deal. While he handles it with ease, Watts is there to give guidance as needed. The Longitudinal Ambulatory Care Experience (LACE) is one of the many educational experiences that Virginia Tech Carilion School of Medicine students will have outside of the classroom. The LACE experience incorporates skills learned in the classroom into a clinical setting.
LACE is an important component of the Virginia Tech Carilion School of Medicine curriculum designed to provide medical students with a longitudinal, clinical experience that emphasizes clinical skills development throughout the first two years of medical school. Each student is paired with a Carilion Clinic physician to encourage positive physician role-modeling and emphasize the importance of interprofessional health care relationship building. The students spend two afternoons a block with their clinical preceptor shadowing and interacting with patients, while learning the skills essential to become a successful physician.
Participation in this program by Carilion Clinic physicians is voluntary and open to any physician who is willing to teach in a clinical setting. The LACE preceptor will serve as a mentor for the student and will also offer guidance in years two through four by serving on their research advisory committee. For Watts, the choice to become a preceptor was easy. “I think this has reinvigorated me at this point in my career. Teaching always makes you appreciate the things that you do on a daily basis that you sometimes take for granted. I feel like I have knowledge that I can pass on to others.” He continues by saying, “I really like that this is longitudinal and we can get to know each other over the long-haul.”
Each LACE experience is broken into two parts. In the first portion, the student spends time interacting with the clinical preceptor and their patients. The physician guides and oversees the student as they conduct interviews and practice the skills that they have learned in the classroom. The second portion of the afternoon is designed to introduce the student to specific components in the practice of medicine, such as charting or medical billing.
The benefits of the LACE experience are wide and varied but for Jarred, the early patient interaction means the most. “This experience has given me the perspective on issues that are facing patients, and issues that doctors have to face from the very beginning, and I’m starting to think about those now, rather than years down the road,” he said. When asked about how he has applied what he learned in the classroom to this experience, Jarred noted, “I am starting to understand the medicine behind what Dr. Watts is doing, why he is performing an exam, or why he is prescribing a certain medication.”
The emphasis the Virginia Tech Carilion School of Medicine has placed on patient-centered learning is amplified in this experience. “I think the reaction from the patients has been very positive,” said Jarred. “I think a lot of them feel like they are part of my education, which they are, and I think they really enjoy that part of the experience.” Watts added, “The patients love it and Jarred has been so polite and interacts with them so well, that they absolutely love him.” While at the clinic, Jarred not only learns from Watts, but also from the patients as well. Jarred added, “Everybody has an anecdote for you and something that they want to make sure that you do as a physician.”
A unique feature of the LACE program is the aspect of mentorship and the longitudinal nature of the relationship. For Jarred, the mentorship piece has been one of the most rewarding aspects of the experience. “As a result of this experience, I have a mentor over the next four years. If I have questions about interacting with patients or need career advice, I have a mentor who can answer some of those questions for me.” He continued by saying, “The fact that we get to develop that relationship is one of the most invaluable pieces of this and I am very grateful to have this opportunity.”
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