1. Early clinical exposure in primary
care – an experience from Slovenia
Marija Petek Šter
Janko Kersnik
Department for family medicine
University of Ljubljana
Slovenia
Department for family medicine
University of Maribor
Slovenia
Corresponding author: marija.petek-ster@mf.uni-lj.si

2. Fieldwork
• Interview with nursing home residents:
• Six to eight nursing homes in a neighborhood of the
Medical faculty - contraction with Medical faculty
• Nursing home staff: rules of behavior, ethical
principals
• Students in pairs: one of the student performing a
semi-structured one-hour interview according to the
instructions and the second one is an observer
• After the first interview with the first patients, the
role with the second patient was changed (an
observer became an interviewer)

3. Clinical visit
• One day attachment in general practice
• General practices all over Slovenia (chosen by
the student, tutors trained in giving feedback)
• Student is an observer of GPs’ work and
communication
• Protocols for observation (20 consultations)

4. Assessment
• Students have to pass theoretical and
practical part of the exam. Each part
contributes 50% of final mark.
• Theoretical part: MCQ questions (60% of
points)
• Practical part: seminar and analysis of the
communication at office visit (written, oral),
criteria for evaluation was prepared in
advance

5. Students feedback
• During the curriculum: we appreciated
students’ oral feedback
• At the end of the curriculum: students’
written feedback with the evaluation of the
overall curricula and parts of the curricula
using evaluation form (Likert scale from 1 to
5)
• Students’ feedback is of most importance for
future improvement of the curriculum

6. Students’ feedback and assessment of
the curriculum – overall
• Students’ assessed ECE as of outmost
important for their personal and professional
development
• They found that good relationship is
important part of treatment
• They would like to have more practical work
and opportunity for communication

7. Students’ feedback and assessment of
the curricula – interview with nursing
home residents
• Fears that their skills of communication is
inadequate (welcome and respect by the staff
and patients)
• Emphatic relationship with the elderly
• They found that elderly people are much
more positive and more vital in their mind
that they thought before
• An opportunity to learn from life experiences
of elderly people

8. Students’ feedback and assessment of
the curricula – office visit
• White coat – they observed themselves as
future physicians
• They found that the physicians’ work is
complex with many dilemmas
• Motivation for future study
• Confirmed that decision to become physician
is appropriate

9. Teachers’ and tutors’ experiences
Positive experiences:
• feasible to organize: enthusiasm of the staff in
nursing homes and offices
• acceptable to patients: most of the patients find
the ECE as important and participate in the
curriculum,
• educationally effective: students greatelly valid
their extensive contact with patients
Evaluation: subjective in assessing of practical part
of the curricula

10. Dilemmas
• Inadequate knowledge and experiences in
communication
• Personal immaturity: problems with
acceptance of professional and ethical norms
• Interview with elderly nursing home residents
is too demanding (no knowledge about the
characteristics of residents, problem with
empathy, dealing with emotional reactions,
ethical issues)