What has changed in the evidence for early experience? Update of a BEME systematic review.
BACKGROUND
We previously reviewed evidence published from 1992 to 2001 concerning early experience for healthcare undergraduates (Dornan T, Littlewood S, Margolis S, Scherpbier A, Spencer J, Ypinazar V. 2006. How can experience in clinical and community settings contribute to early medical education? A BEME systematic review. Med Teach 28:3-18). This subsequent study reviews evidence published from 2002 to 2008.


OBJECTIVE
Identify changes in the evidence base; determine the value of re-reviewing; set a future research agenda.


METHODS
The same search strategy as in the original review was repeated. Newly identified publications were critically appraised against the same benchmarks of strength and educational importance.


RESULTS
Twenty-four new empirical studies of early authentic experience in education of health professionals met our inclusion criteria, yielding 96 outcomes. Sixty five outcomes (from 22 studies) were both educationally important and based on strong evidence. A new significant theme was found: the use of early experience to help students understand and align themselves with patient and community perspectives on illness and healthcare. More publications were now from outside Europe and North America.


CONCLUSIONS
In addition to supporting the findings of our original review, this update shows an expansion in research sources, and a shift in research content focus. There are still questions, however, about how early authentic experience leads to particular learning outcomes and what will make it most educationally effective.
Yardley
Sarah
S
Keele Medical School, Keele University, Staffs., UK. s.j.yardley@ipchs.keele.ac.uk
Littlewood
Sonia
S
Margolis
Stephen A
SA
Scherpbier
Albert
A
Spencer
John
J
Ypinazar
Valmae
V
Dornan
Tim
T
D002321:Career Choice; D002982:Clinical Clerkship; D002983:Clinical Competence; D003142:Communication; D055317:Evidence-Based Practice / Q000639:trends; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010819:Physician's Role; D010817:Physician-Patient Relations; D018794:Problem-Based Learning