Medical students’ responses to their first clinical experiences

Dear Sir

Medical students’ first clinical experiences evoke a broad variety of positive and negative emotions (Helmich et al. 2011). Little is known about students’ responses to these emotional experiences. To clarify this emotional learning process, we carried out a survey in all first-year medical students (N = 332) directed at their responses to emotional experiences during their first clinical placements.

Most students (53%), especially women (OR 2.4; 95% CI 1.4–4.1), talked with others about their experiences. Other responses included feeling content (35%), enjoying the situation (20%), and seeking connection with others in the workplace (17%). These positive feelings were less likely to be mentioned in hospitals than in nursing homes (OR 0.5; 95% CI 0.3–0.9). This leads to some important considerations.

First, the current medical education literature emphasizes difficult situations and needs and strategies to cope with these. Our study suggests the salience of other reaction patterns, such as explicitly enjoying the situation, seeking connection with others and feeling content. From the “broaden-and-build” theory (Fredrickson 2001), we know that positive feelings, such as joy, love and contentment, are important for the development of personal resources and relationship-building skills, and therefore should be fostered.

Second, our study revealed an important gender difference. Female students more often talked about their experiences than men did. Although most medical students are female (68%), we do have a substantial number of male students as well. Our findings pose the question if the needs of our male students are adequately met in an ongoing feminization of the curriculum and the medical workplace.

In conclusion, this study reveals many positive responses to emotional clinical experiences. Important implications for medical education are that (a) we should help students recognize and use these positive experiences, (b) the nursing home seems to be particularly suited as a learning environment for medical students, fostering contentment and team spirit, and (c) educators should be aware of gender differences.