Abstract
Abstract
Background
Longitudinal community-based education may help health-professions students connect clinical learning with people’s social circumstances, prevention, primary-care services and relationships over time. However, evidence concerning how Physician Associate students in India interpret such education in relation to preparedness for primary healthcare is limited. This study explored final-year students’ experiences of a structured longitudinal community-based programme and the educational conditions they considered important for meaningful preparation.
Methods
A qualitative interview study was conducted with 13 final-year Physician Associate students in one programme in Kerala, India. Individual face-to-face semi-structured interviews were conducted in English and audio-recorded. Data were analysed using Braun and Clarke’s reflexive thematic analysis, informed by an experiential orientation within a contextualist framework. Participants’ accounts were treated as situated interpretations of learning and perceived preparedness, not as measures of competence.
Results
Five interrelated themes were developed: (1) Seeing health differently—from disease episodes to people, places, populations and systems; (2) Learning to enter and engage—from uncertainty to adaptive communication; (3) Recognising care as relational—trust, listening and emotional presence; (4) Envisioning a collaborative PA role while recognising the limits of readiness; and (5) Making longitudinal learning consequential—continuity, participation and reciprocity. Students described a layered reorientation in what they noticed about health, how they approached community encounters, what they understood as care and where they imagined PAs might contribute. Perceived preparedness was uneven and task-specific, with stronger confidence for repeatedly practised activities and continuing uncertainty about complex management and independent decisions. Students valued connected encounters and supervised participation. Two participants raised reciprocity-related concerns about survey-centred encounters.
Conclusions
Students described contextual, relational and bounded readiness for primary healthcare. Their accounts are consistent with the educational value of continuity and supervised participation and raise questions about reciprocity in community learning. These findings do not establish clinical competence, autonomous readiness, professional scope, causality or community benefit; direct assessment and wider stakeholder evidence are needed.