A multicenter study: how do medical students perceive clinical learning climate?

Abstract

BackgroundThe relationship between students and instructors is of crucial importance for the development of a positive learning climate. Learning climate is a multifaceted concept, and its measurement is a complicated process. The aim of this cross-sectional study was to determine medical students’ perceptions about the clinical learning climate and to investigate differences in their perceptions in terms of various variables.MethodsMedical students studying at six medical schools in Turkey were recruited for the study. All students who completed clinical rotations, which lasted for 3 or more weeks, were included in the study (n=3,097). Data were collected using the Clinical Learning Climate Scale (CLCS). The CLCS (36 items) includes three subscales: clinical environment, emotion, and motivation. Each item is scored using a 5-point Likert scale (1: strongly disagree to 5: strongly agree).ResultsThe response rate for the trainees was 69.67% (n=1,519), and for the interns it was 51.47% (n=917). The mean total CLCS score was 117.20±17.19. The rotation during which the clinical learning climate was perceived most favorably was the Physical Therapy and Rehabilitation rotation (mean score: 137.77). The most negatively perceived rotation was the General Internal Medicine rotation (mean score: 104.31). There were significant differences between mean total scores in terms of trainee/intern characteristics, internal medicine/surgical medicine rotations, and perception of success.ConclusionThe results of this study drew attention to certain aspects of the clinical learning climate in medical schools. Clinical teacher/instructor/supervisor, clinical training programs, students’ interactions in clinical settings, self-realization, mood, students’ intrinsic motivation, and institutional commitment are important components of the clinical learning climate. For this reason, the aforementioned components should be taken into consideration in studies aiming to improve clinical learning climate.

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

“…Further the transition from college to university life, especially in a health care program, is a high‐risk period during which young people are exposed to a myriad of psychological challenges (Burgess et al, ; Yilmaz et al, ; Tackett et al, ). This includes new social relationships (Blomberg et al, ; Castaldelli‐Maia et al, ), greater academic pressure (Read et al, ; Cusimano et al, ), and stress during exams (Sun et al, ; Greene et al, ).…”

“…Often educators tend to intervene only as rescuers in uncomfortable client–clinician situations (Junod Perron et al, ; Gonzalo et al, ), and expect students to reproduce desirable behaviors and skills simply by observing their educators (Cianciolo et al, ; Lamba et al, ). Another underlying reason for this attitude among educators is that many do not feel confident enough to instruct students in skills that they have not yet mastered (Yilmaz et al, ; Christensen et al, ; Lysak et al, ). Additionally the teaching of client communications skills is not often considered a priority, as the first mandate is to always address the health needs of clients (Augustyniak et al, ; Igde and Sahin, ; Oommen et al, ; Valero‐Chillerón et al, ).…”

“…Feedback offers students an insight into their actions (Dingwall, and Allen, ; Ezell et al, ), and highlights the differences between intended and actual results (Bradley et al, ; Alrebish, ). It thereby provides an impetus for change (Yilmaz et al, ), and also conveys to students an attitude of concern by their educators about their academic progress (Younan, ; Everson et al, ) and professional development (Dornan et al, ; Brass et al, ), and not just as an analysis of their examination grades (Jacobs et al, ; Rothmaler et al, ).…”

“…They often remain longer in health care practice to be able to teach and share their knowledge and skills with younger generations (Joshi et al, 2017;Keister et al, 2017;Pape et al, 2018), and tend to focus on the process of education rather than its direct outcomes (Evans and Cuffe, 2009;Abdel Meguid and Khalil, 2017). Although most Traditionalists have now retired (Fleming and Baume, 2006), a significant number are still employed in health care as active clinicians and health policymakers (Ezell et al, 2013;Christensen et al, 2018), and many are founders of modern academic departments (Yilmaz et al, 2016). Since Traditionalists value formality and hierarchy, they are more rigid in their views (Burgess et al, 2015;Tackett et al, 2018) and succeeding generations find them most challenging to work with (Mohr et al, 2011;Christensen et al, 2018;Yang and Shanks, 2018).…”

“…Educators have long recognized the importance of enhancing IM in students toward improving their educational experience (Everly et al, 1994;Deci and Ryan, 2012;Ramirez et al, 2018), since it has been demonstrated to be associated with deep learning (Sinclair et al, 2015) and improved academic performance (Desy et al, 2018). Reports have also indicated that students who were intrinsically motivated had higher self-esteem (Yilmaz et al, 2016), greater personal control of their lives (Pandey et al, 2018), and exhibited psychological well-being (Cook and Artino, 2016;Raza et al, 2018). It is universally acknowledged that the non-fulfillment of these needs is one of the major reasons for dropouts (Tai et al, 2016;Rothmaler et al, 2017;Mabel and Britton, 2018), or considerations of discontinuation of training among health care students (Jacobs et al, 2015;Brass et al, 2017).…”