A Light at the End of the Tunnel: The Impact of Early Clinical Experiences on Medical Students.

This paper describes the impact of early clinical contact (ECC) on medical students. The concepts emerged from a grounded theory analysis of interviews with students and faculty in the ECC program at Ohio University College of Osteopathic Medicine, which places first-year and second-year students in a variety of clinical settings in ambulatory clinics, private offices, and community settings. Program goals are broadly stated; neither explicit objectives nor formal feedback to students is provided. To assess the program, interviews were conducted with 8 faculty and 19 students, covering the length, timing, and structure of the experiences provided; impact of the program; and relationship to the didactic curriculum. Results indicated that students value opportunities to become acclimated to clinical settings before they are thrust into clerkships. Students were especially interested in: observing how physicians interacted with patients and managed their time, understanding how physicians approach clinical problems and make decisions; and recognizing that there is more to medicine than just the textbook. Though ECC programs are often developed to encourage students to enter primary care, students do not report much relationship between ECCs and their career choices. The study concludes that ECC can begin to train students to think like doctors while it initiates them into a community of practice. (Contains 14 references.) (JDD)