BMJ  2004;329:834 (9 October), doi:10.1136/bmj.329.7470.834

Learning in practice

What can experience add to early medical education? Consensus survey

¹ Hope Hospital, Salford, Manchester M6 8HD, ² University of Manchester Medical School, Manchester M13 9PL

Abstract

Objective To provide a rationale for integrating experience into early medical education ("early experience").

Design Small group discussions to obtain stakeholders' views. Grounded theory analysis with respondent, internal, and external validation.

Setting Problem based, undergraduate medical curriculum that is not vertically integrated.

Participants A purposive sample of 64 students, staff, and curriculum leaders from three university medical schools in the United Kingdom.

Results Without early experience, the curriculum was socially isolating and divorced from clinical practice. The abruptness of students' transition to the clinical environment in year 3 generated positive and negative emotions. The rationale for early experience would be to ease the transition; orientate the curriculum towards the social context of practice; make students more confident to approach patients; motivate them; increase their awareness of themselves and others; strengthen, deepen, and contextualise their theoretical knowledge; teach intellectual skills; strengthen learning of behavioural and social sciences; and teach them about the role of health professionals.

Conclusion A rationale for early experience would be to strengthen and deepen cognitively, broaden affectively, contextualise, and integrate medical education. This is partly a process of professional socialisation that should start earlier to avoid an abrupt transition. "Experience" can be defined as "authentic human contact in a social or clinical context that enhances learning of health, illness or disease, and the role of the health professional."

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