title: Legitimate workplace roles and activities for early learners.
abstract: OBJECTIVE
  Given the calls for earlier student engagement in clinical experiences, educators are challenged to define roles for pre-clerkship students that enable legitimate participation in clinical practice. This study aimed to determine the student roles and activities, as well as the clinic characteristics, that allow early student engagement within a specific clinical experience.
  
  
  METHODS
  The authors conducted semi-structured interviews in December 2011 and January 2012 with a purposive sample of medical student and faculty volunteers at student-run clinics (SRCs). They were asked to discuss and compare student roles in SRCs with those in the core curriculum. An inductive approach and iterative process were used to analyse the interview transcripts. Themes identified from initial open coding were organised using the sensitising concepts of workplace learning and communities of practice and subsequently applied to code all transcripts.
  
  
  RESULTS
  A total of 22 medical students and four faculty advisors were interviewed. Thematic analysis revealed pre-clerkship student roles in direct patient care (patient triage, history and physical examinations, patient education, laboratory and immunisation procedures) and in clinic management (patient follow-up, staff management, quality improvement). Students took ownership of patients and occupied central roles in the function of the clinic, with faculty staff serving as peripheral resources. Clinic-related features supporting this degree of legitimate participation included defined scopes of practice, limited presenting illnesses, focused student training, and clear protocols and operations manuals.
  
  
  CONCLUSIONS
  Pre-clerkship students are capable of legitimately participating in patient care experiences to an extent not usually available to them. The SRC represents one example of how early clinical experiences in the core curriculum might be transformed through the provision of patient care activities of narrow scope.
authors: Department of Paediatrics, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors: H Carrie
authors: HC
authors: Chen
authors: Leslie
authors: L
authors: Sheu
authors: Patricia
authors: P
authors: O'Sullivan
authors: Olle
authors: O
authors: Ten Cate
authors: Arianne
authors: A
authors: Teherani
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration*; D002983:Clinical Competence; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005180:Faculty, Medical; D006297:Health Services Accessibility; D006801:Humans; D015279:Organizational Culture; D005791:Patient Care; D010817:Physician-Patient Relations; D018794:Problem-Based Learning / Q000458:organization & administration; D036301:Qualitative Research; D012380:Role; D013337:Students, Medical; D014838:Volunteers; D017132:Workplace / Q000458:organization & administration