Medical Students Experience Early Patient Contact in General Practice:<i>A Description and Evaluation of a New Course in the Medical Curriculum</i>

Lassen, Lars Chr.; Larsen, Jan-Helge; Almind, G; Backer, P

doi:10.3109/02813438909103672

Cited by 13 publications

(8 citation statements)

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“…Presently, medical schools in several countries integrate training in communication skills into the medical curriculum, and provide medical students with the opportunity to meet patients in a real primary health care setting during the early stages of their studies [5,6]. Pre-clinical familiarisation of medical students with general practice considerably improves students' communication skills and understanding of patients' perceptions, helps students understand patients as human beings, and helps them recognise the importance of the doctor-patient relationship [7-9]. There is also much international documentation concerning the importance of role models in making good doctors [10].…”

Section: Introductionmentioning

confidence: 99%

Doctor-patient interaction in Finnish primary health care as perceived by first year medical students

2005

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BackgroundIn Finland, public health care is the responsibility of primary health care centres, which render a wide range of community level preventive, curative and rehabilitative medical care. Since 1990's, medical studies have involved early familiarization of medical students with general practice from the beginning of the studies, as this pre-clinical familiarisation helps medical students understand patients as human beings, recognise the importance of the doctor-patient relationship and identify practicing general practitioners (GPs) as role models for their professional development. Focused on doctor-patient relationship, we analysed the reports of 2002 first year medical students in the University of Kuopio. The students observed GPs' work during their 2-day visit to primary health care centres.MethodsWe analysed systematically the texts of 127 written reports of 2002, which represents 95.5% of the 133 first year pre-clinical medical students reports. The reports of 2003 (N = 118) and 2004 (N = 130) were used as reference material.ResultsMajority of the students reported GPs as positive role models. Some students reported GPs' poor attitudes, which they, however, regarded as a learning opportunity. Students generally observed a great variety of responsibilities in general practice, and expressed admiration for the skills and abilities required. They appreciated the GPs' interest in patients concerns. GPs' communication styles were found to vary considerably. Students reported some factors disturbing the consultation session, such as the GP staring at the computer screen and other team members entering the room. Working with marginalized groups, the chronically and terminally ill, and dying patients was seen as an area for development in the busy Finnish primary health care centres.ConclusionDuring the analysis, we discovered that medical students' perceptions in this study are in line with the previous findings about the importance of role model (good or bad) in making good doctors. Therefore, medical students' pre-clinical primary health care centre visits may influence their attitudes towards primary health care work and the doctor-patient relationship. We welcome more European studies on the role of early pre-clinical general practice exposure on medical students' primary care specialty choice.

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Section: Introductionmentioning

confidence: 99%

Doctor-patient interaction in Finnish primary health care as perceived by first year medical students

2005

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“…Evidence suggests that early patient contact can be difficult and troubling, yet provides motivation and relevance to medical studies and helps students acclimatize to clinical environments, 11–17 develop self-reflection skills, 18 and interact confidently with ill people. 19–22 Medical students have described early patient contact as “the most exciting and exhilarating and also definitely the most frightening thing.” 11 Some students experience tension with others’ corporeality, helplessness in front of death, guilt for using patients selfishly for learning purposes, shame related to intimacy, 23 and confusion in front of a young attractive person.…”

Section: Introductionmentioning

confidence: 99%

Stretching the Comfort Zone: Using Early Clinical Contact to Influence Professional Identity Formation in Medical Students

Schei

Knoop

Gismervik

et al. 2019

Journal of Medical Education and Curricular Development

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Purpose: To explore first-year medical students’ affective reactions to intimate encounters with severely sick patients in their homes, within a curricular innovation targeting the development of a patient-centered professional identity. Background: Early patient encounters create complex emotional challenges and constitute fertile ground for professional identity formation. The literature indicates that students often learn, largely through the hidden curriculum, to avoid and suppress emotion. This can culminate in mental health problems and loss of empathy. Method: A qualitative descriptive analysis of 28 randomly selected, mandatory, reflective essays focused on a home visit to a previously unknown patient, in an unsupervised group of 4 students, within the context of a structured course called Patient Contact—PASKON. Results: Students described a wide range of affect-laden responses, positive and negative, elicited by the home visits. The observations were typically related to loss of control, struggles to behave “professionally,” and the unmasking of stereotypes and prejudices. Conclusions: Medical students’ initial clinical encounters elicit emotional responses that have the potential to serve as triggers for the development of emotional maturity, relational skills, and patient-centered attitudes. Conversely, they can foreground uncertainty and lead to defensive distancing from patients’ existential concerns. The findings point to a role for structured educational strategies and supervision to assist students in the emotion work necessary in the transition from a “lay” to a “medical” identity.

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“…Different universities have developed teaching models in which patient contact already takes place during the first semesters. (2, 3) The Scandinavian countries have the most experience in conducting and applying these teaching methods (4–6). In contrast, such models and concepts are rare in the pre‐clinical stage of dental studies, particularly in Germany.…”

Section: Introductionmentioning

confidence: 99%

Early patient contact in undergraduate dental education in Germany –‘The Greifswald Model’

Ratzmann

Wiesmann

Gedrange

et al. 2007

Eur J Dental Education

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Revised regulations in Germany have allowed new curricular concepts to be introduced into the undergraduate dental curriculum. In the first 2 years of the dental curriculum at the University of Greifswald, a new teaching concept which is based on the interactions between Community Medicine and Dentistry has been introduced. It emphasises the importance of early patient contact in providing experience for students. The course consists of three principal elements: student-patient contacts in the patient's home; problem-based learning tutorials to discuss patient cases; and special training in communication skills. The aim of the course is to give students an insight into the patient's view of the illness and treatment, and the effect of their condition on his or her lifestyle. The students also learn about the communal perspective (health survey, intervention planning and implementation in a community). The first four courses were evaluated by questionnaires from the students before and after the 2-year course to assess the concept from the students' perspective. The results indicate that it is possible to provide considerable improvement of the medical/dental education as regards communication skills and understanding of the patients' perceptions, by letting the student establish contact with patients at the very beginning of the curriculum.

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Medical Students Experience Early Patient Contact in General Practice:A Description and Evaluation of a New Course in the Medical Curriculum

Cited by 13 publications

References 0 publications

Doctor-patient interaction in Finnish primary health care as perceived by first year medical students

Doctor-patient interaction in Finnish primary health care as perceived by first year medical students

Stretching the Comfort Zone: Using Early Clinical Contact to Influence Professional Identity Formation in Medical Students

Early patient contact in undergraduate dental education in Germany –‘The Greifswald Model’

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