Exploring reflections of first-year medical students following the inaugural early clinical exposure program: a qualitative study

The Faculty of Medicine, University of Ruhuna introduced Early Clinical Exposure (ECE) into Phase 1 of its revised curriculum starting in 2025. This program provides structured patient encounters to contextualize preclinical learning and ease the transition into clinical practice. Students complete reflective writing exercises as part of ECE, and this study analyzed their initial reflections following the first session of the programme to explore early perceptions, emotional responses, and learning insights. This study adopted a qualitative, descriptive research design utilizing thematic analysis to explore first-year medical students’ reflective narratives. All first-year students who submitted reflective narratives were included for this study. Thematic analysis was used to identify and interpret patterns within the reflective writings. A total of 290 students participated in the first ECE session, of whom 139 submitted reflective writings. After excluding submissions that were not aligned with the reflective writing prompt, 134 reflections (46%) were included in the analysis. Thematic analysis identified five major themes: (1) compassion and commitment to patient wellbeing (2), motivation and purpose for learning (3), familiarization with patient-based clinical learning (4), concerns about performance and (5) dissatisfaction with limited exposure. Reflections from first-year medical students following the inaugural early clinical exposure program revealed that it provided a meaningful bridge between preclinical learning and clinical experiences by enhancing motivation for learning, sensitizing students to core professional values such as compassion and patient-centeredness, and fostering an early appreciation of clinical competencies including communication and teamwork.