The LIC students’ patient logs listed 57 longitudinal care patients who met the study’s two inclusion criteria. All patients were invited to be interviewed. The final study sample consisted of 20 patients. These patients comprised 25 interviewees: 16 patient interviewees and 9 family members (Table 1). Respondents under 18 years old were interviewed with or substituted by at least one parent or guardian. Patients in the final sample included recruits from all 12 students. All interviews were conducted face-to-face. The average length of interviews was 50 minutes (range 43 minutes to 68 minutes). Twenty-two patients turned down the interview invitation; 12 could not be reached by telephone, and 3 passed away. Of the 25 interviewees, 18 (72%) were female, and 7 (28%) were male. There was no significant difference in the proportion of females between participants (patients or their participating family members) and patients not interviewed (P > .05 for each comparison). The interviewees had an average age of 41.6 years; the youngest was 13 years old and the eldest 73 years old. There was no significant difference in the distribution of age between participants (patients or their participating family members) and patients not interviewed (P > .05 for each comparison). Other than sex and age, we did not collect information from patients who declined to participate.
We identified 3 themes from the patient interviews: care facilitation, companionship, and empathy (figure 1); we present themes and representative quotations for each theme. We summarize the findings below:
The interviewees recognize the student as a resource, connecting patients to their attending and improving patients’ access to the healthcare system. They mentioned their interactions with LIC students during hospitalization periods or at outpatient clinic sessions. The medical students kept in contact with the patients with telephone or instant messaging app. They reminded and confirmed the appointment date with patients, tracking their response to treatment, provided health education, and facilitated their care.
“The medical student will LINE (a chat app) me and confirm the date of visit.” (P018)
“We chatted on the LINE. The students taught me how to control my diet in order to lower my blood sugar.” (P014)
The interviewees described their student as a sort of consultant alongside the attending physician. The student not only provided consulting information but also offered them additional information about the hospital.
“I will ask him (the medical student) which pediatrician is better at allergy or what. He is quite clear. He knows what the expertise of each doctor is.” (P002)
“In addition to the attending physician, you have the option of consulting other people, so you get the feeling of having a consultant team.” (P003).
They expressed that LIC students strengthened the bridge between the attending physician and the patient. When patients would raise questions, the students provided answers directly or facilitated connection to the attending physician.
“It is not easy to find my doctor. I can ask them [students] to help me ask. It may take some time, but I always get solutions to my problems.” (P005)
“They pass the message on to my attending physician. The physician then examines the situation and gives instructions.” (P001-1)
The interviewees perceive the students’ presence. The students visited them daily while they stayed in the hospital, met them while they came back to the outpatient clinic, and kept in contact with them by telephone or communication apps when they were home. Numerous interviewees revealed that the LIC students were like a companion with professional knowledge and skills. They noted that students spent considerable time accompanying patients.
“If I come to the hospital or clinic, he [the medical student] will come to see me, as long as I come to the hospital, he will look after me.” (P015)
“When we have a problem, we first think of him (medical student). Because we can only see the doctor at a certain time, but we can contact him (medical student) anytime.” (P011-1)
Interviewees shared that the students cared about their wellbeing and shared relevant knowledge with them. With the students’ company and assistance, they would be less worried and feel at ease. Sometimes, the patients described students like friends they can talk to.
“I feel like [the medical student] is a good friend, a very good friend. She is very caring and gave me a caring feeling.” (P001-2)
“Sometimes, there are things you don't want to talk to your family, […] don't want to talk to the doctor. Medical students are more like friends, and sometimes you want to talk to friends about something.” (P012-1)
Some interviewees expressed that they expected to see the students when they went back to outpatient visits, and like meeting a friend, the connection offered benefit.
“It likes that when my son was going to see a doctor, he seemed going to have an appointment with his friends. He will feel a little happier because friends will come to see him in the waiting room.” (P009-2)
The interviewees perceive the students’ attend to the patients’ feelings. Some interviewees explained that through longitudinal care, the LIC students could more deeply consider the patients’ experiences of being sick and patients’ experience of the treatment process. They expressed that they valued students’ displays of empathy.
“They probably have a better understanding of the stress of having a chronic disease after they have gained experience of such contact with us [patients or family members]. They will be more empathetic.” (P011-2)
“They have a sense of empathy; they know the physical and emotional discomfort we are facing, so they comfort us in their own ways and help us snap out of our bad moods.” (P006)
The interviewees also shared that students could better learn the families’ experiences about caring for these patients. They noted that medical students could understand their distress and support them in hard times.
“She [the medical student] is not only focusing on my son [the patient] but also concerning my feelings. I feel being looking after.” (P020)
“In the process of communicating with medical students, you gradually know their professional abilities, and then they also understand your suffering and your blind spots.” (P010)
The interviewees expressed that they received sincere concern from the students that were beyond the standard clinical diagnosis and treatment process.
“They don't make me think that I am a patient. They can chat with me and make me feel like a friend. Because they may be about the same age, they can understand my thoughts well”. (P014)
“I was discharged from the hospital, but my baby has not been discharged yet. The medical student promised me to see my baby every day and report to me my baby's condition.” (P008)