Integrated clinical learning: team teaching and team learning in primary care.

Developed in Northern Ontario, Canada, Integrated Clinical Learning (ICL) involves a team of clinical teachers from a range of health professions teaching a team of students and trainees together in common community and clinical settings. It is the balanced integration of educational strategies to develop healthcare providers and team-based competencies focused on improving the quality of care. Learning outcomes are developed with and in consideration of the goals of patients or the community through relational learning that mirrors patient-centred care. Implementing ICL requires a systematic approach that addresses the practical issues and enhances the quality of experience for all involved. These practicalities include academic institutions valuing ICL through the appointment and support of primary care clinicians as academic staff with protected time; the provision of physical space, as well as clinical and teaching equipment; and the appointment of local administrative coordinators. The team approach shares the teaching load with the multiple students actually teaching each other so that the load on individual clinicians is less than for one student at a time. Through ICL, students are learning from patients and developing a service-oriented professional identity. The patient and family centred nature of ICL helps bridge the primary care-secondary care divide as students follow their patients into and out of hospital services. This is positive for patients and specialists and provides authentic learning for students. ICL enhances the quality of care; the quality of learning; and the quality of professional satisfaction for primary care clinical teachers.