Students' hopes and fears about early patient contact: Lessons to be learned about preparing and supporting students during the first year

Background: Medical students increasingly have contact with real patients ('early patient contact', EPC) from the beginning of their first year. Little is known about their expectations of meeting patients at this time. Understanding their hopes and fears might usefully influence the design and delivery of EPC. Aim: To explore students' views of EPC before arrival at medical school and the impact of EPC on them after 1 year. Methods: A two-part study comprising a pre-registration questionnaire, with open-ended questions, sent to the complete year group, and four focus groups conducted after 1 year with randomly selected students. Results: Students anticipated benefits from EPC, especially in promoting personal and professional development. After 1 year most of their hopes were realized. They feared feeling inadequate and doing harm to patients or themselves. Fears were reinforced when students felt underprepared, were not made welcome on hospital wards and treated disrespectfully by some staff. Conclusion: Understanding how students anticipate meeting patients for the first time is crucial to maximize the educational potential of EPC. Students' preparation for EPC and the organization of these real patient encounters are of paramount importance in determining to what extent their hopes and fears are realized and their consequent learning.