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Virtual patients (VPs) have traditionally been utilized in clinical education rather than in preclinical instruction. However, limited research has evaluated the effectiveness of VP-based sessions in enhancing early clinical exposure (ECE) during the preclinical years. To assess the impact of VP-based tutorials in supplementing the Clinical Skills module for second-year medical students. In this prospective study, the effectiveness of VP-based tutorials was compared to conventional lecture-based teaching within the Clinical Skills module. All second-year medical students enrolled during the 2022/2023 and 2023/2024 academic years were included. The 2022/2023 cohort (Group 1) received traditional lectures, while the 2023/2024 cohort (Group 2) participated in VP-based tutorials. Student performance was evaluated using pre- and post-module tests and formative Objective Structured Clinical Examination (OSCE) scores. Baseline performance showed no significant difference in pre-module test scores between Group 1 (26.55 ± 22.45%) and Group 2 (27.13 ± 26.21%) (p = 0.681). Both groups demonstrated significant improvements in post-module scores (Group 1: 73.88 ± 15.11%; Group 2: 75.01 ± 10.09%, p<0.0001 for both), with no significant difference between the two (p = 0.129). However, Group 2 achieved significantly higher OSCE scores compared to Group 1 (82.62 ± 11.03% vs 75.80 ± 14.38%, p<0.0001). This study highlights the value of incorporating virtual patients into preclinical education. VP-based tutorials significantly enhance clinical skill development and facilitate early clinical exposure, offering a promising adjunct to traditional teaching methods in preclinical curricula.

Background The critical transition from preclinical theory to clinical practice in medical education is often hampered by a crisis of student confidence. Self-efficacy – belief in one’s capabilities – is paramount for effective patient interaction, yet how longitudinal, early community-based experiences during the preclinical phase foster this self-efficacy remains underexplored. This study investigated the impact of an early, longitudinal community-based education program, CFHC, which provides patient interaction from the first to seventh semester, on medical students’ self-efficacy for clinical clerkships. Methods A descriptive qualitative study was conducted with seven first-semester clinical clerkship students (3 females, 4 males) at Universitas Gadjah Mada, Indonesia, who had participated in the longitudinal CFHC program. Data were collected via semistructured interviews, guided by the Social Cognitive Theory, and subjected to inductive thematic analysis. Rigor was ensured through peer coding, technical and peer review of the analysis, expert consultation, and member checking, with achievement of data saturation. Results The analysis of student experiences yielded ten main themes and thirty subthemes, revealing a significant positive impact of the CFHC program on students’ self-efficacy. These themes were synthesized into four developmental variables (early exposure as a catalyst, adaptive communication as an enabler, reflective practice as a mediator, and professional growth as a transformational outcome). Two novel conceptual models were developed: the Longitudinal Clinical Immersion (LCI) framework, which maps the four key stages of student’s development from initial exposure to professional growth, and the Self-Efficacy Infinity Loop (SEIL) model, which explains the core psychological mechanism of how students convert experience into confidence through a reinforcing cycle of action and reflection. Conclusions Early, longitudinal community-based education which provides patient interaction is a promising strategy for cultivating medical student self-efficacy. The LCI framework and SEIL model provide valuable conceptual tools for understanding and designing educational experiences that foster not only clinical skills but also the robust self-efficacy essentials for competent, compassionate, and adaptive future physicians. Integrating such programs is a valuable component of effective medical education.

Early clinical exposure (ECE) is a teaching-learning methodology which fosters the exposure of medical students to the patients as early as the first year of medical college. A worldwide number of research studies investigated the outcome of ECE and found, ECE sessions motivate the medical student in various ways making their academic strength, improve clinical skills, and improve communication skills and making them more confident. In the medical curriculum, ECE makes an overall impact on student's performance and confidence. Planning of ECE in real-time practices can be done in different settings with the use of appropriate resources such as logbook, textbooks, notes, instruments, learning material, case record sheets, and computers. Herewith, we reviewed the scientific base responsible for these outcomes and discussed different ECE settings and their outcome. The Medical Council of India in new educational reforms made ECE sessions compulsory from 2019 in undergraduate medical curriculum. In conclusion, the challenge for health professions education is to look for ways to improve the quality of clinical education by comparing students' understanding and modifying practices of clinical education in new circumstances. Early clinical experience will definitely play a crucial role in this context, only if proper strategies are implemented. This systemic review article highlights ECE settings and scientific basis in a theoretical way helpful for medical faculties during its implementation in regular teaching.

Background The idea of early clinical exposure in Ethiopian medical schools is a young concept. Old and newly established universities across the nation are shifting towards incorporation of early clinical exposure (ECE) in their curricula. Debre Tabor University introduced ECE in undergraduate medical education from inception. This study generated evidence on students’ experience and academic leaders’ reflection on early clinical exposure implementation. Objective This study was carried out to investigate medical students’ perception towards early clinical exposure and its implementation process by instructors in undergraduate medical education at Debre Tabor University. Method A cross-sectional survey design that combines quantitative and qualitative methods was conducted in 2021. We asked fifth year medical students (42) to complete a self-administered questionnaire on 5-point Likert scale. The data were supplemented by semi-structured interview with 6 purposively selected academic leaders on the factors that facilitate or impede early clinical exposure implementation. The quantitative data were entered and analyzed using SPSS 20 to compute frequency, median and interquartile range. The qualitative data were analyzed thematically. Results The study findings suggest that early clinical exposure (ECE) has a positive impact on the development of students’ professional knowledge, problem-solving skills, motivation, active learning, and community orientation. Specifically, 64.3% of the surveyed students believed that ECE was effective in constructing their professional knowledge, while 52.4% felt that it improved their problem-solving skills and facilitated constructive/active learning. Additionally, 57.1% of students reported that ECE improved their motivation and 50% noted that it facilitated community orientation. The study also identified several barriers to the implementation of ECE, with the heavy workload being the most commonly mentioned (78.6%). Other challenges included a loose linkage between academic and healthcare institutions (59.5%) and a lack of orientation on the implementation process (35.7%). Academic leaders reflected that ECE was beneficial in familiarizing students with the clinical environment, but staff commitment was crucial for its successful implementation. The study also found that heavy workload, lack of assessment dedicated to ECE on the curriculum, and poorly oriented staff about the program impeded its implementation. Conclusion and recommendations The findings of this study suggest that early clinical exposure was beneficial learning method. Teachers’ commitment to their roles with adequate preparation, and the contribution of curriculum in providing the learning objective and cases for each session were factors that facilitate effective implementation of ECE. Heavy workload and poor orientation about the program could impede ECE implementation.

Background Medical education has predominantly adhered to a process-based education model. Recently, outcome-based education (OBE) has emerged as a dominant pedagogical framework, facilitating simultaneous acquisition of theoretical knowledge, practical skills, and clinical experience. In 2020, our medical school implemented a new curriculum designed to integrate clinical skills training and experiential learning with foundational knowledge from the first year. Herein, we evaluated whether the clinical competencies of New Curriculum Students (NCS) are superior to the clinical competencies of Traditional Curriculum Students (TCS). Specifically, we clarified how self-assessment scores related to competencies in “Professional practice skills” evolved over time, and analyzed the longitudinal trends in self-assessment scores. Methods We included TCS enrolled between 2016 and 2019, and NCS enrolled between 2020 and 2023. Self-assessment of students’ competencies in “Professional practice skills,” a core component of our institution’s competency framework, was conducted by online survey. Competency levels were categorized into Levels A, B, and C. Results The self-assessment scores of NCS were significantly higher than those of TCS across most competency domains of “Professional practice skills.” The “Medical interview and physical examination” competency revealed that first-year NCS achieved scores equivalent to those of fourth-year TCS. These scores were either maintained or improved as students progressed in years. In the “Clinical skills” competency, NCS outperformed TCS at all levels from the first to the third year, and at Level A in the fourth year. In the “Medical record charting” competency, NCS achieved significantly higher scores than TCS across all levels during the first and second years. Discussion The early acquisition of clinical skills and exposure to clinical practice enabled students to consistently maintain high self-assessment scores. A curriculum design aligned with OBE appears to foster a heightened sense of self-efficacy among students. This approach is anticipated to facilitate a seamless transition into clinical responsibilities as future physicians.

Introduction The benefits of Early Clinical Exposure (ECE) in medical education are often stated but there is limited evidence on how to effectively maximize its learning value. The challenge for medical educators lies in finding ways to enhance the quality of ECE in alignment with students’ feedback, while realizing the learning outcomes. The purpose of this study is to investigate undergraduate medical students’ perception of an innovative ECE intervention in Dubai, United Arab Emirates, developed using design-based research in alignment with adult, experiential learning theories. Methods A convergent mixed methods study design was utilized. The data was collected using a tailormade survey to solicit both quantitative and qualitative feedback. Quantitative data was analyzed using SPSS. Qualitative data analysis was inductive based on constructivist epistemology. Following the conclusion of the independent data analyses of the quantitative and qualitative datasets, the primary inferences were integrated using the iterative joint display analysis process. Results Out of the 68 students who attended the ECE, 54 responded. The percentage of the total extent of agreement that the ECE: familiarized them with learning in the clinical environment and brought forth the institutional values were 79.60% and 86.43%, respectively. The extent of active engagement and self-directed learning, with a mean of 6.80(2.42), was significantly associated with how much the learners reaped from the learning experience (P < 0.05). A novel conceptual model, namely: ‘Early Clinical Exposure Added Value’, with five interconnected themes, was developed from the qualitative analysis. Integration of findings led to six meta-inferences: Embeddedness in context of learning, System perspective, Patient-centricity, Theory–practice link, Resilience, and Proactiveness. Conclusion The more medical students engage in their learning, the more ECE contributes to building their academic resilience, and propels them in terms of clinical correlations, skills’ development, and values reinforcement. Securing engagement opportunities for the learners, when designing and planning for the ECE, is essential. Optimizing the ECE learning value can happen systematically through continuously developing the respective intervention in alignment with the principles of design-based research and anchoring it in constructivism experiential learning theories.

Background Due to COVID-19, face-to-face service activities in service-learning courses have become unfeasible. To address this challenge, this study aims to integrate project-based learning into medical education’s service-learning curriculum. This study also seeks to evaluate the effectiveness of this instructional approach and identify factors that influence its success. Methods A total of 135 first-year medical students enrolled in a mandatory 1-credit service-learning course were recruited. The course involved various service activities aligned with the needs of the local community. The students were organized into 12 groups, each working on different service-learning projects, such as raising health awareness or educating the public about specific diseases. Following the completion of the course, a questionnaire was distributed among the students to gather feedback on the course, and 122 (valid responses were collected, representing a response rate of 90.3%). Results The results indicated that the project-based service-learning course significantly improved students’ “interpersonal communication skills,“ their ability to “learn and grow from work,“ and their sense of “professionalism” (all p ≤ 0.037). Among the various aspects of service learning, the highest agreement was observed for “executing the project,“ followed by “group discussions and project formulation,“ “overall course review,“ “review of project outcomes,“ “outcome presentations,“ “teaching proposal writing and project brainstorming,“ “sharing of service-learning experiences by teachers,“ and “sharing of service-learning experiences by teaching assistants.“ Students also found certain factors to be beneficial in enhancing the learning effectiveness of service-learning courses, including “prize money for service-learning outcomes,“ “funding for service-learning activities,“ and “consultations from medical personnel” (all p ≤ 0.01). However, “course credit” and “photography software” did not show significant effects (both p > 0.05). The most preferred resources or activities for future service-learning courses were “course credit” and “face-to-face service-learning activities.“ Conclusions The project-based learning method improved the learning effectiveness in service-learning courses. Students perceived that the number of course credits reflects the course value and plays a pivotal role in enhancing the learning effectiveness in service-learning courses. During the epidemic, students still expect to have face-to-face service activities in service-learning courses. Therefore, without the impact of the epidemic, service learning courses should return to face-to-face service activities.

Background Early clinical exposure (ECE) represents one form of vertical integration that bridges the gap between the early theoretical years and the clinical practicing years in undergraduate medical education. In most medical colleges in China, the complex healthcare system and large-enrollment classes pose significant challenges for implementing ECE in a hospital setting. However, there is a paucity of data comprehensively demonstrating the effectiveness of a classroom-setting form of ECE with direct physician involvement in physiology education. Methods 181 sophomore clinical medicine students from Harbin Medical University were randomly divided into two groups: a control group ( n  = 91) and an experimental group ( n  = 90). The control group received traditional flipped classroom (FC) teaching, whereas the experimental group participated in ECE teaching, which featured a gastroenterology physician and real patient cases in their final class session. Upon completion of the classes, both groups took a posttest. At the end of the semester, both groups were assigned the task of writing an original science communication on any physiology-related topic. The effectiveness of ECE was assessed by comparing posttest scores, the frequency of online self-directed learning, and the number of science communications addressing the digestive system between the two groups. Additionally, a questionnaire was administered to assess the experimental group's perceptions of the ECE teaching method. Results The posttest scores and the rates of excellence for the two groups showed no statistical differences. Although no difference was found in the frequency of self-directed learning between the two groups during the gastrointestinal physiology classes, the experimental group exhibited a frequency of self-directed learning that was more than twice that of the control group on the day following the physician's lecture. Furthermore, the number of science communications focusing on the digestive system was significantly higher in the experimental group compared to the control group (17/73 vs. 8/83, P  < 0.05). In the questionnaire, more than 94% of the students expressed positive attitudes towards classroom-setting form of ECE with direct physician involvement and expressed a desire for this method to be applied in other chapters of physiology. Conclusions The classroom-setting form of ECE with direct physician involvement may not demonstrate immediate impact, but it encourages active learning, facilitates understanding of the subject's relevance, and enhances students' value output.

Objective: To examine the status of early clinical exposure (ECE) programs in Korean medical schools and to determine the educational needs for ECE in undergraduate medical education. Methods: In this cross-sectional study, 30 medical education experts and 65 professors from 30 medical schools across Korea were surveyed about the status of ECE programs in medical schools and the educational needs for ECE. This survey was conducted between January and March 2024 using Google Forms, and the collected data were analyzed using frequency analysis. Results: Out of the 30 participating medical schools, 70% had implemented ECE programs. In most schools, ECE programs were required courses and offered from the first year of pre-medical phase to the second year of medical phase. Among 95 respondents, 88.4% recognized the necessity of ECE programs. Most respondents considered “understanding the role of a doctor” an essential objective (70 out of 95, 73.7%) and outcome (73 out of 95, 76.8%) of ECE programs. Most respondents considered “observation/field trips” and “reflection journal” as essential teaching methods (69 out of 95, 72.6%) and assessment methods (68 out of 95, 71.6%) in ECE programs, respectively. Furthermore, most respondents (68 out of 95, 71.6%) considered the “lack of educational support personnel” a concern in implementing ECE programs in medical schools. Conclusions: This study sheds light on the status of ECE programs in Korean medical schools. Additionally, its results regarding the educational needs for ECE have implications for the future implementation of ECE programs in Korean medical schools. doi: https://doi.org/10.12669/pjms.41.2.10717 How to cite this: Kim S, Kyung SY, Park KH, Yune SJ. Current status and educational needs of early clinical exposure in Korean Medical Schools: A cross-sectional survey study. Pak J Med Sci. 2025;41(2):349-354. doi: https://doi.org/10.12669/pjms.41.2.10717 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background The transition between preclinical and clinical years during medical school has been shown to be challenging. Cooper Medical School of Rowan University (CMSRU) implements one required two-week-long shadowing program for first and one one-week-long shadowing program for second-year medical students called Week On the Wards (WOW). The goal of this study is to ascertain whether students who completed the WOW curriculum found it beneficial over the long-term. Specifically, we want to evaluate alumni’s impression of the program’s influence on career, specialty choice, professional development, personal development, and confidence. Methods To evaluate our program, we developed, validated, and distributed a survey via email in the autumn of 2023. Our population included alumni from the classes of 2019–2022, irrespective of race and gender. After following steps for survey development, it was validated via focus group using qualitative methods. The survey consisted of 19 questions answerable on a 5-point Likert scale, a “Yes/No/Unsure/Maybe” section, and an optional open-ended response question. Descriptive analysis was done to report the percent responses. Results The survey was emailed to 353 alumni, with 72 completed responses returned. Majority of respondents agreed or strongly agreed that the WOW program showcased the importance of teamwork in medicine (80.6%), helped them learn to apply medical knowledge (77.8%), influenced their decision regarding which residency/specialty they chose (72.2%), provided an example of how teamwork in medicine is necessary for patient safety and effective care (66.6%), and increased their confidence in their networking skills (66.6%). Alumni nearly unanimously agreed that the WOW program was a useful part of their medical school education (93.1%) and that it should be continued for future classes (94.4%). Conclusion Our results highlight the sustained importance of early preclinical exposure to clinical environments in students’ future career decisions, in their understanding of the clinical applications of learned preclinical topics, and the importance of teamwork in medicine.