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Introduction Early medical school education has historically focused on teaching basic medical sciences. More recently, medical schools are encouraged to incorporate health systems science (HSS) into early curricula. Addressing all of these components in an overcrowded curriculum remains challenging. Methods We report on the Student Navigator Project (SNaP), a pre-clinical experience where students engage longitudinally with medically and socially complex patients. SNaP is built on a foundation of trust, responsibility, and ownership in the studentpatient relationship. Early learners take an active role in navigating, advocating, and coaching for their patients. In addition, students are integrated as medical assistants into a primary care clinic; complete a mentored, team-based quality improvement project; and engage in evidence-based medicine, teaching, and handoff activities. Results As a result of these activities, students learn firsthand about HSS, contribute meaningfully to their patients' care, and are immersed in a systems-based practice approach early in their medical school education. Preliminary outcomes (2016)(2017)(2018)(2019) show satisfaction with the program and knowledge of program focus areas. Conclusions The authors are engaged in improvement cycles to modify program structure and curriculum in order to promote dissemination in diverse clinical settings. Ultimately, we plan to measure longer-term outcomes, including clerkship and residency preparation, career choice, and practice setting.

Background:The purpose of this study was to investigate the impact of early longitudinal preceptorship experiences on the evolution of general self-efficacy and patient-centeredness self-efficacy through medical school.Methods: Validated surveys for general self-efficacy and patient-centeredness self-efficacy were administered in an allopathic medical school at three timepoints. These data were stratified by traditional and longitudinal preceptorship groups and analyzed using Generalized Estimating Equations. Qualitative analysis of narrative medicine essays by the same cohort during their preceptorship experiences was also performed.Results: While general self-efficacy remained largely unchanged over time, patient-centeredness self-efficacy measures increased throughout medical school in the whole cohort (N=157). The longitudinal preceptorship group had higher gains in patient-centeredness self-efficacy, especially in the domain of exploring patient perspectives (p<0.05). The qualitative analysis of narrative medicine essays showed those in longitudinal preceptorships were more likely to discuss health care systems issues, consider psychosocial factors, and perceive themselves as active members of the care team.Discussion: Our study indicates greater patient-centeredness attitudes over time among students who have early longitudinal experiences, perhaps due to the self-efficacy building nature of these experiences. Our research suggest that medical school programs should consider incorporating opportunities for early longitudinal clinical experiences for their students.