title: What has changed in the evidence for early experience? Update of a BEME systematic review.
abstract: 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.
authors.affiliation: Keele Medical School, Keele University, Staffs., UK. s.j.yardley@ipchs.keele.ac.uk
authors.forename: Sarah
authors.initials: S
authors.lastname: Yardley
authors.forename: Sonia
authors.initials: S
authors.lastname: Littlewood
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Margolis
authors.forename: Albert
authors.initials: A
authors.lastname: Scherpbier
authors.forename: John
authors.initials: J
authors.lastname: Spencer
authors.forename: Valmae
authors.initials: V
authors.lastname: Ypinazar
authors.forename: Tim
authors.initials: T
authors.lastname: Dornan
mesh_terms: 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