What do medical students learn from early clinical experiences (ECE)?

Abstract

What are the common learning themes perceived by medical students during ECE with varying practice settings and patient profiles? Retrospective qualitative and quantitative analyses of structured descriptive reports completed by one class (n = 92) for 895 observed patient encounters identified common learning themes. Identified themes were examined by practice setting and patient characteristics. Student response rates were 85 to 94% across settings. Fifty-five percent of ECE were in outpatient settings. Chief complaints were predominantly medical (67%); only 20% represented psychosocial and 8% preventive care, respectively (5% were ambiguous). The five most common learning themes (out of 13 themes coded) were communication (>50%), procedures/time management, cross-cultural issues, feeling useful as a student, and presenting medical problems. Cross-cultural issues were addressed mainly in community settings. Negative learning occurred only rarely (<3%). Student observations from ECE can be used by course managers to design effective early clinical exposures to address specific course learning objectives.

Additional information

Notes on contributors

Désirée Lie

DÉSIRÉE LIE, MD, MSED, is Clinical Professor, Department of Family Medicine, Irvine School of Medicine, CA.

John Boker

JOHN BOKER, PhD, is Clinical Professor, Family Medicine and Director, Research in Medical Education, Irvine School of Medicine, CA.

David Gutierrez

DAVID GUTIERREZ is an undergraduate biological science major.

Michael Prislin

MICHAEL PRISLIN, MD, is Associate Dean for Student Affairs and Vice Chair for Education, Irvine School of Medicine, CA.