Qualitative analysis of a health systems science (HSS) course incorporating early clinical exposure

Health systems science (HSS) is increasingly recognized as a core component of contemporary medical education. Although early clinical exposure (ECE) has been shown to enhance students' understanding of clinical practice, evidence regarding its role in shaping HSS-related perspectives in Korean medicine (KM) education remains limited. This study explored how participation in an HSS-based ECE program influenced KM students' perceptions and learning experiences. Between 2023 and 2025, a qualitative study was conducted with 65 third-year students enrolled in a KM college. Following HSS-oriented lectures and case-based discussions, the students participated in a 4-week observational ECE program in community-based KM clinics. Data were collected from reflective journals and analyzed using conventional qualitative content analysis with inductive coding. The derived codes were organized into themes and subsequently interpreted in relation to the core functional and foundational domains of HSS. Four overarching themes were identified: clinical practice competency, patient-centered care, health care systems, and professional competency. A total of 35 codes across 11 subcategories were derived. Students demonstrated an increased awareness of clinical processes, patient-centered approaches, and the broader health care system, including the influence of policies, organizational structures, and social determinants of health. Ethical considerations and professional responsibility were also prominently reflected in students' experiences. Participation in the HSS-based ECE program was associated with an expanded understanding of clinical practice within broader health care contexts among KM students. These findings suggest that early experiential learning facilitates the development of systems-oriented perspectives and professional awareness. These results provide preliminary evidence that supports the integration of HSS-informed educational approaches into KM curricula.