How can experience in clinical and community settings contribute to early medical education? A BEME systematic review
Medical TeacherPublished 1 January 2006
Tim Dornan, Sonia Littlewood, Simeón Margolis, Albert Scherpbier, John Spencer, Valmae Ypinazar
Citations473
SJR quartileQ1
SJR score1.25
SNIP2.36
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Early experience motivated and satisfied students of the health professions and helped them acclimatize to clinical environments, develop professionally, interact with patients with more confidence and less stress, develop self-reflection and appraisal skill, and develop a professional identity.
Abstract
Early experience helps medical students socialize to their chosen profession. It helps them acquire a range of subject matter and makes their learning more real and relevant. It has potential benefits for other stakeholders, notably teachers and patients. It can influence career choices.
Keywords
MedicineHealth Professions
Medical EducationEducational strategies in curriculum development: the SPICES model
770 Citations1984R. M. Harden, Susette Sowden +1 more
Six education strategies have been identified relating to the curriculum in a medical school and each issue can be represented as a spectrum or continuum: student‐centred/teacher‐Centred, problem‐based/information‐gathering, integrated/discipline‐based, community-based/hospital‐based and systematic/apprenticeship‐based.
Educational ResearcherTheme Issue: The Role of Design in Educational Research
265 Citations2003Anthony Kelly
BMJWhat can experience add to early medical education? Consensus survey
239 Citations2004Tim Dornan, Christine Bundy
A rationale for early experience would be to strengthen and deepen cognitively, broaden affectively, contextualise, and integrate medical education, which is partly a process of professional socialisation that should start earlier to avoid an abrupt transition.
Medical EducationMedical students' professional identity: self‐reflection during the preclinical years
213 Citations1997Pekka Niemi
The quality of professional self‐reflection and identity formation during the preclinical training are described on the basis of two qualitative materials – learning logs and identity status interviews.
QJMThe rise and fall of EBM
183 Citations1998Bruce G. Charlton, A. Miles
The rise of Evidence-based Medicine (EBM) has been were never properly addressed—nonetheless CE was widely regarded as a refreshing approach that blew one of the more remarkable phenomena of the British health scene during the 1990s.
Journal of the Royal Society of MedicineOsler, Flexner, apprenticeship and 'the new medical education'
131 Citations2005Tim Dornan
Archives of Internal MedicineTeaching medical interviewing. A basic course on interviewing and the physician-patient relationship
115 Citations1992Dennis H. Novack
Journal of the American Geriatrics SocietyAn Introduction to Geriatrics for First‐Year Medical Students
87 Citations2001Cynthia Alford, Toni P. Miles +2 more
This research aims to prepare medical students to better serve their older patients while raising awareness of geriatrics as a career choice.
Archives of Internal MedicineTeaching Medical Interviewing
76 Citations1992Dennis H. Novack
A first-semester, first-year medical student course that effectively teaches basic interviewing skills, suggests educational principles and standards for the teaching of medical interviewing, and educational research demonstrating significant gains in students' skills associated with improvement in standardized patient satisfaction is presented.
Academic MedicineRelationship between early clinical exposure and first-year studentsʼ attitudes toward medical education
58 Citations1998Arlien Johnson, Craig S. Scott
It is suggested that early clinical experience may contribute to students' satisfaction with medical education, regardless of their clinical exposures.
Medical EducationProviding early clinical experience in primary care
52 Citations1998A J Hampshire
This qualitative study evaluated the first two years of the new early clinical experience course at Nottingham by using interviews with 19 students and their GP tutors to show that basic clinical skills can be successfully taught to pre‐clinical students in primary care.
Journal of General Internal MedicineEducational and career outcomes of an internal medicine preceptorship for first-year medical students
44 Citations1999D. Michael Elnicki, Kevin Halbritter +2 more
The PIM course is an intervention, early in students’ careers, which appears to benefit them academically and increase their interest in internal medicine as a career.
Clinical MedicineMedical professionalism in the new millennium: a physicians' charter
43 Citations2002Linda Blank
This Charter on Medical Professionalism is intended to encourage dedication to the principles of professionalism and to promote an action agenda for the profession of medicine that is universal in scope and purpose.
Medical EducationEarly patient contact in primary care: a new challenge
42 Citations2001Ann-Christin Haffling, Anders Håkansson +1 more
An early patient contact course, including training in communication and examination skills, is introduced at the Medical School of Lund University, Sweden, with general practitioner participation gradually increasing.
Academic MedicineA Primary Care Preceptorship for First-year Medical Students Coordinated by an Area Health Education Center Program
39 Citations2001Larry G. Rooks, Robert T. Watson +1 more
After six years, this preceptorship has been demonstrated to have a positive and meaningful impact on medical student education and development.
Academic MedicineAn active-learning approach to basic clinical skills
39 Citations1996Raymond H. Curry, Gregory Makoul
Preliminary data suggest that the overall attitudes, knowledge, and clinical proficiency of students completing this curriculum compare favorably with those of students who progressed through the preclinical curriculum before the active-learning approach was introduced.
Academic MedicineIntegrating early clinical experience curricula at two medical schools
36 Citations1999Christine C. Matson, John A. Ullian +1 more
It is concluded that early clinical experience with generalist physicians is an important element of generalist curriculum reform and improves student satisfaction with the first two years' experience and provides a structure for teaching patient-centered, integrated clinical medicine.
Academic MedicineHospital-based versus community-based clinical education
34 Citations1993Leon Satran, Ilene Harris +4 more
That the hospital-based and community-based students performed comparably on the OSCE and gave similar evaluations of their pediatrics rotations supports the use of community practitioners to provide students with their initial clinical training.
Medical EducationA communication skills course for preclinical students: evaluation of general practice based teaching using group methods
30 Citations1993Tony Kendrick, P Freeling
The aims, objectives and methods of the preclinical communications skills course at St George's Hospital Medical School are described, which teaches preclinical medical students about doctor‐patient communication.
Medical TeacherTeaching medical decision making and students' clinical problem solving skills
29 Citations1991John Rogers, David E. Swee +1 more
A 15 hour course covering decision making topics was presented during a preclinical elective preceptorship for 5 years and the results suggest that this approach to teaching decision making requires further development and testing.
Teaching and Learning in MedicineStudent Perspectives on Primary Care Preceptorships: Enhancing the Medical Student Preceptorship Learning Environment
29 Citations2001Douglas H. Fernald, Amie Staudenmaier +4 more
Key themes are active teaching, active learning, a trusting relationship, sufficient time, and a shared understanding of preceptorship objectives that describe important features of what makes the preceptorship work for students.
Journal of General Internal MedicineImpact of a first-year primary care experience on residency choice
27 Citations2001Martha S. Grayson, Martin Klein +1 more
The community-based primary care experience was positively associated with students’ selection of generalist residencies and had a 40% higher odds of selecting a generalist residency than those who wanted to take IPC.
Academic MedicineThe impact of early clinical training in medical education
26 Citations1999Patricia A. Carney, Miriam Bar-on +12 more
Academic MedicineEarly clinical experience enhances third-year pediatrics clerkship performance
25 Citations1999Eric H. Kossoff, Thomas W. Hubbard +1 more
Students who had participated in a mentorship program that provided early clinical experience demonstrated significantly improved clinical skills in the pediatrics clerkship early in the academic year.
American Journal of Pharmaceutical EducationUsing Actual Patients in the Classroom to Develop Positive Student Attitudes Toward Pharmaceutical Care
24 Citations1999Marie A. Chisholm, William E. Wade
Results of the study document that a course that involved actual patients positively influenced students’ pharmaceutical care attitudes.
Medical EducationAn evaluation of early patient contact for medical students
22 Citations1993Janet Cade
The introduction of early patient contact for first‐year medical students in the form of talking with a patient at an out‐patient clinic was evaluated to give students an insight into the patient's view of the illness and treatment, and the effect of the condition on his or her lifestyle.
Academic MedicineThe impact of early clinical training in medical education
21 Citations1999Patricia A. Carney, M E Bar-on +12 more
Each program used cross-sectional evaluation, and the analysis methods included descriptive statistics, chi-square, t-tests, analysis of variance, and generalized linear models.
Advances in Health Sciences EducationAn Early Preceptorship and Medical Students' Beliefs, Values, and Career Choices
21 Citations1997Sharon A. Dobie, Jan D. Carline +1 more
R/UOP supports preexisting beliefs and positive attitudes towards rural underserved primary care careers and is more likely to select primary care residencies, compared with nonparticipants.
Medical TeacherThe patient's experience of being interviewed by first-year medical students
21 Citations1999JANET PALMER HAFLER ERIC J. THOMAS
To understand hospitalized patients' experiences of being interviewed by first-year medical students learning to take a medical history, qualitative research methods were used and participating patients were interviewed.
Medical TeacherStructured clinical teaching strategy
20 Citations1991Sharon Allen, Carole J. Bland +5 more
It was found that assuring at least one structured clinical experience for a specific common problem seen in ambulatory care did not enhance student ability to select and use specific history or physical exam skills for that problem as assessed by an OSCE, as compared with students who did not have this experience.
Education for HealthThe Role of the Community in Educating Medical Students: Initial Impressions from a New Program
20 Citations2000Rhondda Waddell
The experience of the first-year medical students' home visits, which were developed to foster health promotion and disease prevention, are described.
Teaching and Learning in MedicineInterim Evaluation of the Rural Health Scholars Program
18 Citations2001D C Lynch, Sari Teplin +5 more
The Rural Health Scholars Program is meeting some interim objectives conducive to its long-term goal of developing physicians who will practice primary care medicine in rural, underserved areas of North Carolina.
PubMedQuality of a family medicine preceptorship is significantly associated with matching into family practice.
18 Citations2001Barcey T. Levy, Arthur J. Hartz +2 more
A number of student characteristics and preferences, early clinical experiences, and the perceived quality of a required family medicine preceptorship were significantly and independently associated with students matching into family practice.
Academic MedicineThe use of questionnaires to assess achievement of course goals in medical studentsʼ longitudinal community-based clinical experiences
17 Citations1999Erica I. Lubetkin, Sharon K. Krackov +1 more
It is suggested that questionnaires assessing students' and preceptors' perceptions of students' achievement of specific goals should be independently verified before making decisions to modify objectives and activities in these kinds of courses.
Academic MedicineTeaching clinical reasoning to second-year medical students
16 Citations1996John Goss
A series of exercises developed and implemented in this three years as a clinical tutor for second-year medical students in an introduction to clinical medicine course are described, designed to accelerate the student's understanding of diagnostic reasoning, thereby better preparing them for the requirements of the third-year clerkship.
Medical EducationBehavioural sciences and the real world: report of a community interview scheme for medical students
16 Citations1993Sheina Orbell, Chandran Abraham
It is suggested that the scheme might be further developed by using feedback from interviewees to provide students with evidence of both their own skill development and the benefits of self‐disclosure to the patients involved.
Medical EducationUndergraduate education in rural primary health care: evaluation of a first‐year field attachment programme
15 Citations1992Rafael Sittoni Vaz, O D Gona
Contrary to previous opinions of some individuals, students whose homes are in rural areas benefited from the rural field attachment programme and found it of value, even though they were dissatisfied with aspects of the programme.
Academic MedicineApplying Practical Preventive Skills in a Preclinical Preceptorship
15 Citations2001Linda Z. Nieman, Lewis E. Foxhall +2 more
The authors relate their experiences with implementing a voluntary, preventive diabetic foot-care program within the Texas Statewide Family Practice Preceptorship Program (TSFPPP) and are developing a smoking-cessation module.
Medical TeacherCommunity-orientated medical education: extending the boundaries
14 Citations2001Helen Cooper, Trevor Gibbs +1 more
The course is described, the advantages and disadvantages perceived by the students are described, potential outcomes are identified and future improvements are highlighted.
Academic MedicineThe Interdisciplinary Generalist Project at the University of Nebraska Medical Center
14 Citations2001David Steele, Jeff Susman +4 more
The Interdisciplinary Generalist Curriculum Project at the University of Nebraska College of Medicine had three goals: to increase first- and second-year students' exposure to primary care practice in the community, to develop specific educational programs introducing these students to the principles and practices of primary care medicine, and to establish a generalist coordinating council.
Academic MedicineAn innovative course in surgical critical care for second-year medical students
14 Citations1994Michael Lofaro, Charles M. Abernathy
That the students passed an examination at the level of the Additional Qualifications in Critical Care without completing a surgical residency, let alone a critical care fellowship, suggests that contextual learning would prove highly effective in medical education.
Medical EducationThe family study: a model for integrating the individual and community perspective in medical education
14 Citations1992D. P. Forster, Chris Drinkwater +2 more
Students learn that the collective epidemiological approach provided by the survey can guide the clinical impression gained from the observational study, yet each individual and family remains unique.
Medical EducationMedical students' reactions to a nursing attachment scheme
14 Citations1991Gerry Kent
Although the attachment had many positive consequences, including an increase in motivation to continue on the medical course and an increased appreciation of the individual needs of patients, it did raise issues which the students were unable to deal with or analyse adequately.
PubMedRequired first-year generalist clinical experience courses and their relationship to career choice: the critical effect of family medicine involvement.
14 Citations1996M B Mengel, Alan B. Davis
Family physicians are involved to some extent in the great majority of RFGCE courses, and such involvement is associated with an increase in the number of medical students selecting a family practice career upon graduation from medical school.
PubMedCan a 3-day preceptorship change first-year medical students' opinions about living and working in small towns?
14 Citations2000Lynch Dc, Willis Se
Brief exposure to rural medicine early in the curriculum appears to have little effect on variables that might precede practice location decisions.
Postgraduate Medical JournalTeaching medical undergraduates basic clinical skills in hospice—is it practical?
11 Citations2000Alison Franks
The venture was successful, stimulating, and practical for patients and students, and its impact on the nurses remains uncertain but it can be inferred tentatively that this was minimal.
Teaching and Learning in MedicineAn integrated curriculum for teaching preparatory clinical skills at a traditional medical school
11 Citations1996Daniel Frank, Richard Jones +7 more
This article describes such an effort at McGill University's Faculty of Medicine to integrate an integrated and longitudinal approach to curriculum design and a description of a medical school with the administrative and educational structure to implement one.
Academic MedicineWhat Did We Learn about the Impact on Studentsʼ Clinical Education?
10 Citations2001Gwyn Barley, Ann OʼBrien–Gonzales +1 more
The impact of curricular innovations at the IGC Project schools on students was immediate as they began to see patients early and continuously as part of their medical education, and a different kind of student arrived at the third year of clinical experiences in medical education.
Medical EducationTeaching clinical skills to new medical students: the Oman experience
10 Citations1992B. M. W. LINDER, Aishik Dipta Saha +1 more
The College of Medicine at the Sultan Qaboos University (SQU) in Oman took up the challenge of moving away from a didactic emphasis in the teaching of family and community health by actively involving students in health care, requiring some clinical skills, as early as possible.
Academic MedicineA longitudinal primary care program in an urban public medical school
10 Citations1995Joshua Freeman, C Cash +3 more
The experience of the University of Illinois at Chicago's College of Medicine with implementing a pilot generalist program focuses on institutionalization and management.
American Journal of Pharmaceutical EducationStudent Exposure to Actual Patients in the Classroom
10 Citations1997Marie A. Chisholm, Charles Y. McCall +2 more
Results of the study suggest that the use of actual patients in the classroom is effective in the education of first year pharmacy students.
PubMedAn elective primary care track in the preclinical years.
10 Citations1995Radecki Se, Abbott Av +1 more
Use of a primary care track in the preclinical years may help stem the decline in interest in primary care known to occur over the course of medical school.
Medical EducationTeaching patient wellness to first‐year medical students: the impact on future ability to perform the history of present illness
9 Citations2000Heather Madray, Carol Pfeiffer +1 more
It is unknown, however, if focusing on wellness detracts from students’ future ability to perform the history of present illness (HPI) which requires students to focus on disease processes.
Academic MedicineA collaborative approach to a primary care preclinical preceptorship for underserved settings
9 Citations1991K. F. Riley, Wayne Myers +4 more
A preliminary evaluation of the program indicated that the students were extremely satisfied with the program's ability to provide them with firsthand exposure to community medicine.
American Journal of Pharmaceutical EducationA Continuous Community Pharmacy Practice Experience: Design and Evaluation of Instructional Materials
9 Citations1996Selby Greer Thomas, Ann L. Janer +1 more
Though both students and preceptors perceived the learning experience as a valuable one, program modifications such as reevaluating program length, retooling modules, strengthening the role of the faculty advisor, and improving patient family selection are suggested to further enhance thelearning experience.
Academic MedicineEffect of Training Location on Studentsʼ Clinical Skills
8 Citations2001David M. Barclay, Danette McKinley +4 more
The clinical skills of second-year medical students trained in a hospital-based setting were compared with those of students training in a community setting using an objective structured clinical exam and no statistically significant difference was found.
PubMed[Early clinical exposure--an instant success. The new medical curriculum at the University of Aarhus].
8 Citations2001Berit Εika, H Mølgaard +2 more
It is concluded that early introduction to clinical practice is feasible and well received by the students and the evaluation of the hospital training was very positive.
Medical TeacherAdopt-A-Student: early mentoring in family medicine
7 Citations1995Patricia Meurer Quinby, Klara K. Papp
The background, development and results of this mentoring program, Adopt-A-Student, are described and survey responses of participating students and mentors indicate the value of the program early in medical education.
Academic MedicineCan First-year Students Master Clinical Skills?
6 Citations2001John Rogers, Joyce E. Dains
Performances on a clinical skills OSCE of first- and second-year students were compared to measure the success of a new interviewing and physical examination component of the first-year curriculum.
Academic MedicineLong-term follow-up of an alternative medical curriculum
6 Citations1994Elizabeth A. Foster
The Alternative Curriculum was successful in improving students' morale during the preclinical segment, preparing them for clerkships, and increasing their sensitivity to the patient as a whole and supports the view that curriculum content is not a major factor in students' choices of specialty.
PubMedDoes early clinical exposure enhance performance during third-year clerkship?
6 Citations1994Rubens J. Pamies, Arthur H. Herold +3 more
Positive findings might be explained in part by small sample size and the fact that the clinic is exclusively outpatient, while the third-year clerkship experience is inpatient, but subgroup findings indicate further study is warranted.
Academic MedicineRisks and benefits of early clinical exposure
5 Citations1999Erica I. Lubetkin, H Schmidt +1 more
Academic MedicineFirst-year medical students and longitudinal primary care
5 Citations1993Annette Yonke, M Lemon
Medical TeacherA first-year primary care experience for first-year medical students: is it a positive experience?
5 Citations1998STEVEN A. HAIST AMY V. BLUE JOHN F. WILSON
PubMedThe medical school without walls: who will be the faculty?
5 Citations1995Crump Wj, Levy Bj +1 more
The University of Texas Medical Branch at Galveston has implemented a comprehensive strategy for faculty to provide rural practice coverage technical assistance for practice management, a rural communications network, faculty development, and provider recruitment.
Medical TeacherEvolution of the second medical school in Nepal: a case study
5 Citations1999Chandra Shekhar Agrawal
The expectations and perceptions of health care professionals, medical graduates, teachers and employers regarding criteria for student selection, entrance examination pattern, curriculum, qualification of teachers and nature of graduates are presented.
Academic MedicineProviding clinical experience to first-year students
3 Citations1993Michelle Black, R M Fincher +1 more
Medical TeacherEarly patient contact for medical students: An exploration of GP teachers' perceptions
2 Citations1996Donald Mowat, Harriet Hudson
Students are enthusiastic about the courses and are seen as gaining motivation and direction in their studies, particularly in relation to patient care, and the recorded telephone interview is an effective survey technique where problems with questionnaires are anticipated.
Academic MedicineA program to provide early exposure to primary care role models
1 Citations1995John Kvasnicka, Ilene Harris +1 more
Academic MedicineEarly longitudinal assessment of clinical skills and performance in the basic sciences
1 Citations1995Scott A. Fields, Edward J. Keenan
Medical TeacherSchool visits: Medical students as teachers
1 Citations1996Mary Pat Mann, Pam Scholl +1 more
This experience documents that community education projects can be successfully incorporated into the preclinical curriculum, but outreach programs of this type need to focus on educational rather than promotional goals.
…