Evidence map›Paper›PMID 34100228›Full record

ArticleJournal of general internal medicine2022

From Passive Gatekeeper to Quarterback: Evolving Perceptions of Primary Care Among Medical Students in Longitudinal Outpatient Clerkships.

Bruce L Henschen, Sara Shaunfield, Blair P Golden, Lauren A Gard, Jennifer Bierman, Daniel B Evans, Diane B Wayne, Elizabeth R Ryan, Monica Yang, Kenzie A Cameron

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Bruce L HenschenDepartments of Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. b-henschen@northwestern.edu.ORCID 0000-0003-0994-9725
Sara ShaunfieldDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Blair P GoldenDepartment of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
Lauren A GardDepartments of Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Jennifer BiermanDepartments of Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Daniel B EvansDepartments of Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Diane B WayneDepartments of Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Elizabeth R RyanDepartment of Family Medicine, Indiana University School of Medicine - Northwest Campus, Gary, IN, USA.
Monica YangDepartment of Medicine, University of California-San Francisco, San Francisco, CA, USA.
Kenzie A CameronDepartments of Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Funding

HRSA HHS UH1HP29963
6 · The paper itself

Abstract

backgroundLongitudinal clerkships provide students with meaningful clinical care roles that promote learning and professional development. It remains unclear how longitudinal primary care clerkships inform students' perceptions of primary care.

objectiveTo explore perceptions of primary care among medical students enrolled in longitudinal primary care clerkships.

designQualitative, semi-structured interviews with medical students over 4 years.

participantsThirty-eight medical students participated at baseline; 35 participated in a 2-year follow-up interview; 24 participated at 4 years. Each student was enrolled in one of two longitudinal primary care clerkships: a team-based Education-Centered Medical Home (ECMH) or a one-on-one individual preceptorship (IP). APPROACH: De-identified interview transcripts were analyzed using a process of open and axial coding, followed by elaborative coding for longitudinal analysis. Codes were compiled into a set of themes and compared across time periods and between clerkships. KEY

resultsStudents reported that primary care serves as a first point of contact, emphasizing longitudinal care with a wide scope of practice and approaching patient care with a biopsychosocial perspective. Student perceptions of primary care greatly expanded over the course of 4 years: for instance, initial perceptions of primary care physicians evolved from "passive gatekeeper" to a more nuanced "quarterback." Students in ECMH, whose clerkship provided more opportunity for patient continuity, further reflected on the relationships they themselves developed with patients.

conclusionsRegardless of their eventual specialty choice, longitudinal experiences may aid all students in fostering a sense of the broad scope and importance of primary care. However, without numerous opportunities to witness continuity of care, students may perceive primary care as having limited scope and importance. Longitudinal clerkships, emphasizing continuity with patients and preceptors, may foster in students a broad and nuanced perspective of the scope of primary care as a field.

Indexed as

Clinical ClerkshipEducation, Medical, UndergraduateStudents, MedicalHumansOutpatientsPatient-Centered CarePreceptorshiplongitudinal clerkshipsprimary care educationqualitative methodsundergraduate medical education

Identifiers

PMID34100228
PMCPMC8858340

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.