title: Systems-based practice learning opportunities in student-run clinics: a qualitative analysis of student experiences.
abstract: OBJECTIVE
  Student-run clinics (SRCs) provide preclerkship medical students with systems-based practice (SBP) experiences as they engage in patient care and manage clinic operations. This study explored the types and context of SBP activities students participate in at SRCs.
  
  
  METHODS
  Between November 2011 and February 2012, the authors conducted in-depth, semistructured interviews with a purposive sample of medical students who served as volunteers and coordinators (student leadership role) at four independently run SRCs within the University of California, San Francisco, School of Medicine. They also interviewed SRC faculty advisors. Interviews focused on student roles in SRCs, SBP learning opportunities in SRCs, and comparisons of SBP experiences in SRCs with those in the formal preclerkship curriculum. The authors used thematic analysis techniques to code and synthesize data.
  
  
  RESULTS
  Data from interviews with 8 volunteers, 14 coordinators, and 4 faculty suggested six major domains related to SBP learning opportunities in SRCs: interprofessional roles and collaboration; clinic organization; patient factors affecting access to care; awareness of the larger health care system and continuity of care; resource acquisition and allocation; and systems improvement. Coordinators, who managed SRCs, demonstrated greater depth of SBP understanding than volunteers, who provided patient care. Students and faculty agreed that SRCs provided students with SBP learning opportunities beyond those available in the formal curriculum.
  
  
  CONCLUSIONS
  Preclerkship students' participation in SRCs provides opportunities for in-depth learning of SBP, particularly among students who take on leadership roles. SRCs may model ways to effectively introduce key components of SBP to early medical learners.
authors.affiliation: University of California, San Francisco, School of Medicine, Department of Medicine and Office of Medical Education, San Francisco, California 94143, USA. leslie.sheu@ucsf.edu
authors.forename: Leslie
authors.initials: L
authors.lastname: Sheu
authors.forename: Bridget
authors.initials: B
authors.lastname: O'Brien
authors.forename: Patricia S
authors.initials: PS
authors.lastname: O'Sullivan
authors.forename: Austin
authors.initials: A
authors.lastname: Kwong
authors.forename: Cindy J
authors.initials: CJ
authors.lastname: Lai
mesh_terms: D000328:Adult; D002140:California; D004501:Education, Medical / Q000379:methods*; D005069:Evaluation Studies as Topic; D055317:Evidence-Based Practice; D005260:Female; D006268:Health Facilities; D006801:Humans; D008297:Male; D013337:Students, Medical