Bearing witness: a longitudinal integrated cancer care curriculum

Background: The Harvard Medical School Cambridge Integrated Clerkship longitudinal cancer curriculum directly facilitates students’ engagement with cancer patients to develop a comprehensive understanding of the disease and the patient's experience of illness. Third-year medical students follow newly diagnosed cancer patients over the course of a year, across all disciplines, and make formal presentations to a multidisciplinary forum at the end of the year. The aim of the study was to discover which aspects of longitudinal care were most meaningful to the students themselves. Method: Researchers performed a qualitative thematic analysis of students’ presentations. Basing the analysis on principles of grounded theory, researchers took an inductive approach using the constant comparative method to discover core themes and to cluster themes into encompassing domains. Result: Researchers identified 33 individual themes among 60 presentations, reflecting five major domains: clinical issues; patient characteristics; systems problems; psychosocial response to cancer; and existential decision making. Conclusions: In this qualitative study of students’ year-end final presentations after a year of cancer care experiences, two areas stood out: students perceived the complexities of medical decision making and students considered the impact of psychosocial factors on patients facing this disease over time. Which aspects of longitudinal care were most meaningful to the students(?).