Educational Impact of Generalist-Specialist Collaborative Outpatient Training for Medical Students: A Qualitative Study.

Background: Despite the recognized benefits of specialty outpatient training for medical students, such settings present educational challenges. To address these, our university incorporated generalist support into specialty outpatient education. The present study aimed to explore what medical students learned from this program. Methods: Fifth- and sixth-year medical students who selected orthopedics or cardiology for their clinical clerkships were enrolled. During training at specialty outpatient clinics, the students conducted preliminary interviews with new patients under generalist supervision and received immediate feedback from the generalists. They then presented the cases to specialists and observed the subsequent examinations, receiving additional feedback. Afterward, they completed a reflection sheet. Text data from the reflections were analyzed thematically using open coding. Results: Sixty-four medical students participated. Four categories were generated based on learning from generalists: Efficient information gathering through the synergistic use of open and closed questions; understanding the psychosocial background of the patient and their family through the interpretive model; communication skills to build rapport with the patient; and awareness of the difficulty and importance of balancing patient interviews and chart documentation. From orthopedic specialists, two categories emerged: Proactive approaches emphasizing interviewing and physical examination rather than relying solely on referrals, and insights gained from actual clinical examinations and consideration for patients. From cardiology specialists, two categories were generated: Proactive interviewing and professional perspectives independent of referrals; and explanations that foster patient understanding and co-creation of treatment plans. Conclusion: Medical students gained distinct learning experiences from generalists and specialists through generalist-supported outpatient training.