Early Clinical Experience (ECE)
The 24 week Early Clinical Experience (ECE), which includes HM552 and HM553 serves as the first year of a student’s medical school journey. Both courses are Pass/Fail to allow students to focus on learning rather than grades. By integrating basic science, clinical experiences and social sciences, the ECE provides students with the foundational attitudes, skills and knowledge needed to begin to explore clinical practice and to find success in medical school. The Early Clinical Experience (ECE) places students in ambulatory settings, learning with medical assistants, nurses and physicians starting early in the third month medical school. Preparation for clinical work – which emphasizes and enables student and patient safety in clinical settings – begins in the first week of the ECE.
Typically, students spend two half days in a primary care clinic. Students participate in patient care activities along with medical assistants after demonstrating the knowledge and skills necessary to safely enter a patient care environment. They then participate in the care management and population health activities of the practice and begin to perform more focused data gathering on patients with common presenting conditions. Students learn about basic communication and clinical skills, ethics, the social context of clinical decisions, and the biological science behind clinical findings and apply their knowledge to their clinical work throughout the ECE. The exception to this longitudinal clinical experience is students involved in the Leadership in Rural Medicine Certificate program, who instead have an option to complete a 2-week immersion experience at a clinical site in a rural community.
When not engaged in clinical activities, students are provided with weekly learning objectives and learning resources on Just in Time Medicine (JIT). Learning objectives for each week are delivered using a combination of student-centered methodologies which take place in large group activities (LGA) and small groups called Post Clinic Groups (PCGs) that meet twice a week. Post Clinic Groups provide students with an opportunity to work closely with a small group of peers, a lead fellow, and basic science faculty, to unpack cases in an integrated manner and to debrief their clinical experiences. Students also engage in Integrated Biomedical Lab (IBL) which focuses on the relevant histology, pathology, genetics and microbiology for the week. Finally, students continue to engage weekly in Simulation lab and Gross Anatomy Lab, as well as guided independent learning. Throughout this time in ECE, the focus is on allowing patient care to drive learning, and on creating interactive, integrated learning experiences for students.
Assessment
Like all of the college's curriculum, the ECE is a competency-based curriculum. Students’ work is aligned with the SCRIPT competencies. In the ECE, major assessments include progress suite testing, reflection such as End of Semester Self-Assessment (ESSA) and personal goal setting, the scholarly project, feedback from clinical and non-clinical preceptors and anatomy capstones. The progress suite includes a necessary science exam which prepares students for the USMLE Step 1 exam and a Progress Clinical Skills Exam (PCSE) to monitor progression in their development of clinical skills. In addition to these more summative measures, students receive a wide variety of formative feedback.
A typical “Week in the Life” of a student during the Early Clinical Experience might look like this:
