Initial community site development for first--and second-year medical students

Abstract

Background: Many medical schools are planning community-based experiences for preclinical students. As part of a generalist physician initiative, the University of Texas Medical Branch in Galveston placed all 200 first-year medical students in generalists' offices in a new course, called the "Community Continuity Experience."

Methods: Driven by significant time, class size, and geographic constraints, a process managed by the local Area Health Education Center was formulated for identifying and developing potential sites. The final process included identification of candidate generalist sites, departmental participation, and a detailed site assessment. The individual office nurses were the focus of site development activities.

Results: Feedback indicated that having office nurses serve as site facilitators was effective, and a key enabling strategy was having a nurse site coordinator serve as a single point of contact for all the sites. The students expressed positive views of the site experience and an interest in assignment, rather than student choice, for site allocation.

Conclusions: Important components of site development for such a new course are development of an accurate database of available generalist community faculty, a methodical site selection process, an early orientation for all involved, and consideration of nonphysician site facilitators during the start-up phase.