Comparison of student learning in the out-patient clinic and ward round

Davis, Margery H.; Dent, John A.

doi:10.1111/j.1365-2923.1994.tb02700.x

Cited by 25 publications

(25 citation statements)

References 6 publications

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“…Based on studies, students tend to learn better and even more in outpatient environments than in wards, but these are never a good replacement. [35]…”

Section: Discussionmentioning

confidence: 99%

Medical academia clinical experiences of Ward Round Teaching curriculum

et al. 2014

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Background:Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members’ experience on Ward Round Teaching content.Methods and Materials:This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9). Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation. Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability) were employed (Guba and Lincoln).Results:Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1) tangible teachings (analytic intelligence, technical intelligence, legal duties) and (2) implied teachings (professionalism, professional discipline, professional difficulties).Conclusion:Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

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“…Based on studies, students tend to learn better and even more in outpatient environments than in wards, but these are never a good replacement. [35]…”

Section: Discussionmentioning

confidence: 99%

Medical academia clinical experiences of Ward Round Teaching curriculum

et al. 2014

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“…Third, the definition of effective teaching in most studies is the learners’ perceptions of what is effective, even though this may relate poorly to specific goals of the curriculum. For example, medical students often rank their outpatient experience better than their inpatient one, although formal testing reveals no difference in acquired knowledge between the two areas 10–14 …”

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confidence: 99%

Teaching in the outpatient clinic

1997

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For teachers of medicine, the outpatient clinic promises many unique educational opportunities including more complete observation of chronic diseases, closer relationships between teachers and learners, and a more appropriate forum for teaching preventive medicine, medical interviewing, and psychosocial aspects of disease.Despite these educational benefits, teachers face many challenges in the clinics. Not only do most teachers feel there is inadequate time to teach, 1 they also have little control over the distribution and organization of this time. Unlike teachers in hospital wards, who often focus on only two or three patients during teaching rounds, outpatient teachers must address the concerns of each patient while the patient is still in the clinic, leaving little or no time for more elaborate instruction (typically 1 minute or less per case). 2 Furthermore, teaching about a single well-defined complaint often fails in the ambulatory setting because many problems occur simultaneously, organic findings are intertwined with psychosocial issues, and diagnostic questions are settled more often by observation or empiric treatment than by laboratory testing.In a recent, comprehensive review of educational research on ambulatory education, 3 four important points were made. First, the environmental variables of a particular outpatient clinic-case mix of clinic, pace of workload, structured time for teaching, space for teachinghave little if any impact on the overall ratings of teaching effectiveness. 4,5 Second, the behavior of teachers strongly influences the perceived success of the ambulatory experience. [6][7][8] Effective teachers ask questions, show interest, define goals, demonstrate competence, and, most importantly, spend time with the learner. 9,10 Third, the definition of effective teaching in most studies is the learners' perceptions of what is effective, even though this may relate poorly to specific goals of the curriculum. For example, medical students often rank their outpatient experience better than their inpatient one, although formal testing reveals no difference in acquired knowledge between the two areas. [10][11][12][13][14] Finally, role modeling clearly influences learners. In one study, there were striking similarities between what teachers wanted to transmit to their students, what these teachers cherished about their own instructors, and what the students admired during the rotation and wanted to emulate subsequently. 15 However, when residents were assigned to a teacher who demonstrated deficient charting practices and made fewer psychosocial diagnoses, the residents' own practices began to suffer from identical deficiencies. 16 The challenge for the clinician-educator, therefore, is to create opportunity and space for meaningful dialogue with one or more learners in the midst of a busy outpatient clinic full of vague and indolent patient problems. Based upon the literature just cited and years of experience teaching and observing medical students and house officers in a variety of a...

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“…In general, residents take more responsibilities in teaching and supervising students than staff members do (Van Der Hem-Stokroos et al, 2001;Busari et al, 2002), but between residents a considerable variation in their supervision activities can be demonstrated, in our study as well as in others (Jolly, 1994;Remmen et al, 2000; This has been demonstrated elsewhere also for the learning content: students only recognized symptoms, problems or diseases that were familiar to them. They need support to recognize all learning opportunities (Davis & Dent, 1994;Raghoebar-Krieger, 2002). Most likely the differences in estimated observation time should be accounted for by both explanations.…”

Section: Discussionmentioning

confidence: 99%

Starting learning in medical practice: an evaluation of a new Introductory clerkship

et al. 2005

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The transition from undergraduate medical education to learning in clinical clerkships can be difficult for students. Learning in clinical practice requires awareness of learning opportunities and goals, active elaboration and reflection. Staff should provide students with guidance to learn from their experiences. A new Introductory Clerkship was designed to facilitate the start of goal-oriented, active and reflective work-based learning. This four-week clerkship is a result of the cooperation of six major specialties in the university hospital. The innovations included explicitly formulated goals, a description of the student's activities in daily practice and of the staff's role, group meetings, a logbook, a halfway formative interview and a final summative interview. The aim of this study was to investigate to what extent the innovations of the new Introductory Clerkship were implemented and how students and residents valued them. Two questionnaires were constructed: one was administered to students (n = 54) and the other to residents (n = 27). Students considered participation in daily practice very instructive, although more observations of history taking and physical examination are wanted. The interviews and group meetings promote students' learning. Use of the logbook needs improvement. Residents perceived a shortage of time and would appreciate more participation of staff members, as well as a better preparation for supervising tasks. Overall, the study demonstrates that it is possible to introduce innovations in clinical clerkships to improve the learning environment of work-based learning.

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Comparison of student learning in the out-patient clinic and ward round

Cited by 25 publications

References 6 publications

Medical academia clinical experiences of Ward Round Teaching curriculum

Medical academia clinical experiences of Ward Round Teaching curriculum

Teaching in the outpatient clinic

Starting learning in medical practice: an evaluation of a new Introductory clerkship

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