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College of Osteopathic Medicine of the Pacific

Longitudinal Chronic Care Course (LC3)

Image of the LC3 logo of patient and doctor with careOn the Pomona campus, the LC3 experience begins with the pairing of a patient being evaluated in the Western Diabetes Institute with a health professions student. This pairing is designed to promote a partnership to last for the entire four years of the student’s undergraduate professional education. Students function as an essential part of the patient’s core care team, to help serve as health coaches and to more deeply understand the myriad challenges posed by chronic disease. Students are expected to engage their paired patient in every aspect of their lives. This longitudinal engagement aids the patient with improved medication adherence and lifestyle changes and enhances the student’s understanding of the patient’s real world and how one lives with chronic disease and pursues a state of wellness.

Group picture of LC3 students with Dr. Barnes

LC3 consists of monthly meetings for training in cultural awareness; healthy patient communication skills; social factors affecting patients; protected health information; and research. Students existentially learn the importance of healthy living and how nutrition and exercise are essential components. The skills that students gain during this course will be sustainable and invaluable.


Picture of LC3 student and staff

Traditionally, medical education has overwhelmingly focused on the preparation of clinicians for the diagnosis and management of acute disease. And for good reason. The American health care delivery system itself was organized in the late 1800s primarily to diagnose and treat acute, and often untreatable, life-threatening diseases. The remarkable advances in medical science and the astonishing successes of the 20th century have led to the control or eradication of many acute and lethal childhood diseases. Ironically, while Americans are living longer lives today than ever before, longevity’s price is often a lifetime struggle with one or more chronic and progressive diseases.
In fact, today 90 million Americans have a chronic disease of which 30 million have diabetes.

Students of the health professions are still primarily educated and trained in acute-care hospitals and clinics where hands-on experience is brief and episodic. There is inadequate opportunity to learn about the natural history of chronic, progressive disease; the continuum of care and its cost effectiveness; the impact of chronic disease on the patient and their family. Ideally, longitudinal contact provides health professions students with real opportunities to establish effective long-term relationships with people living with one or more chronic diseases as well as with their families. Accessing direct exposure across the full care cycle of chronic disease offers students an appreciation of the unique and individualized temporal courses as well as of the impact of education and lifestyle change that is needed for such patients to achieve and maintain wellness.

LC3 Students Engage In:

  • Multi-disciplinary Care
  • Healthcare Coaching Skills
  • Health IT Literacy
  • Longitudinal View of Chronic Disease
  • Pairing with a patient to gain empathy for patient perspectives
Student examines feet of patient who is lying on examination table

Meet some of our LC3 Track Students

 

Portrait of future DO Chin hugging a patient

My LC3 patient turns to her two friends and says, “I can’t believe she’s mine for the next 4 years! Can you believe it? She’s mine!” That’s when it hit me that a lot of our future patients just want to know that someone out there genuinely cares about them.

Picture of future DO Mohammadi with a patient sitting

What struck me when I first met my LC3 patient is how similar we both were. Both of us were highly ambitious Asian American women in our mid-twenties and self-professed science geeks…. I really did not expect to be so emotionally involved with a patient, but I think seeing someone like me in many ways, but living a completely different life, really shook me.

 


It is essential that we prepare our students to one day provide “21st century health care”. We have partnered with the Western Diabetes Institute’s integrated practice unit (IPU) that provides an ideal setting for students to learn the skills that will be necessary for them to deliver high-value care to people with diabetes and other chronic diseases on the Pomona campus. We have also partnered with the Veterans Home on the Lebanon campus There are essential competencies (see table below) in which students need to become proficient. Students need real-life experiences that prepare them to provide whole-person care; arrange care with other professionals; integrate technology into the care of their patients; measure clinical outcomes; and how to manage patients with chronic conditions across the total care cycle, including acute care, disease prevention, and end-of-life. These immersion experiences provide training in professionalism, accountability and empathy.

lc3 chart


LC3 Faculty

Portrait of Edward Barnes
Edward V. Barnes II, MD, FACP
Assistant Dean of Longitudinal and Experiential Learning
Associate Professor of Internal Medicine
Chief, Division of Nephrology and Hypertension
COMP – Pomona
ebarnes@westernu.edu

Portrait of Derrick Sorweide, DO
Derrick Sorweide, DO
Assistant Professor of Family Medicine
COMP-Northwest
Kirksville College of Osteopathic Medicine, Kirksville, MO, 1996
dsorweide@westernu.edu