First-year medical students' perspectives on continuity of care

The objective of this research was to obtain and describe medical students' perspectives about continuity of care while they are participating in a preclinical practice-based preceptorship.

Within the context of a preclinical preceptorship, students completed directed readings, conducted patient and physician interviews, and wrote reflections about continuity of care. Two coders independently analyzed a randomly selected subset of de-identified reflections (78 of 170) to describe predominant themes.

During preceptorship, students interacted with patients affected by wide-ranging diseases, from diabetes to multiple sclerosis, within primary care and specialty clinical settings located in geographically diverse regions. Drawing on personal experience and interviews with patients and physicians, students reported benefits of continuity of care for patients and physicians concordant with claims from the literature, including improved medical management, better interpersonal communication, increased patient compliance, and higher levels of trust. Students also offered perspectives regarding challenges of and impediments to providing continuity of care, including managed care and work hour constraints, lack of comprehensive coordinated services, and specialty-driven care.

Preclinical medical students are able to identify both benefits and barriers to continuity of care. These topics can provide a foundation for a future curriculum and may need to be explicitly addressed as students choose careers in medicine.