Abstract
BackgroundDespite increasing attention to providing preclinical medical students with early patient experiences, little is known about associated outcomes for students. The authors compared three early patient experiences at a large American medical school where all preclinical students complete preceptorships and weekly bedside clinical-skills training and about half complete clinical, community-based summer immersion experiences. The authors asked, what are the relative outcomes and important educational components for students?MethodsMedical students completed surveys at end of second year 2009–2011. In 2009, students compared/contrasted two of three approaches; responses framed later survey questions. In 2010 and 2011, students rated all three experiences in relevant areas (e.g., developing comfort in clinical setting). Investigators performed qualitative and quantitative analyses.ResultsStudents rated bedside training more highly for developing comfort with clinical settings, one-on-one clinical-skills training, feedback, active clinical experience, quality of clinical training, and learning to be part of a team. They rated community clinical immersion and preceptorships more highly for understanding the life/practice of a physician and career/specialty decisions.ConclusionsPreclinical students received different benefits from the different experiences. Medical schools should define objectives of early clinical experiences and offer options accordingly. A combination of experiences may help students achieve clinical and team comfort, clinical skills, an understanding of physicians’ lives/practices, and broad exposure for career decisions.
Highlights
Despite increasing attention to providing preclinical medical students with early patient experiences, little is known about associated outcomes for students
The medical education community has increasingly emphasized the value of early patient contact experiences for preclinical medical students
We found that students received different benefits from the different types of experiences
Summary
Despite increasing attention to providing preclinical medical students with early patient experiences, little is known about associated outcomes for students. The authors compared three early patient experiences at a large American medical school where all preclinical students complete preceptorships and weekly bedside clinicalskills training and about half complete clinical, community-based summer immersion experiences. The medical education community has increasingly emphasized the value of early patient contact experiences for preclinical medical students. In the influential volume Educating Physicians from the Carnegie Foundation, the authors called for early clinical immersion to help integrate skills and knowledge in preparation for practice [1]. Dornan defined early clinical experience as preclerkship experiences with authentic patient contact in a clinical context that enhances learning [2]. These experiences frequently take the form of community-based preceptorships. Yardley’s follow-up study suggests that early experiences help students understand and align with patient and community perspectives [7]
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