Creating a learning environment in your practice or facility

Abstract

Family physicians are expected to build the capacity of the primary care team and to provide clinical training to students, but often lack the educational expertise and a supportive learning environment. This article aims to outline the competencies needed to fulfil these expectations and to assist with professional development in this area. The organisational environment has a profound effect on the success of learning and issues such as adequate infrastructure, optimal staff numbers and mix, appropriate patient mix, quality of care, supportive management and organisational culture are all important. Within this organisational culture learning is often dependent on an effective clinical trainer. Clinical trainers impact learning through role modelling, facilitation of learning and providing up to date information. They need educational competencies to embed brief and effective training into clinical practice, to provide effective feedback and to engage with small group teaching and assessment. The family physician can lead the entire team and practice through developing themselves as a clinical trainer, creating supportive relationships and transforming policies and processes to support innovation and learning.

Re-imagining health professions education in the coronavirus disease 2019 era: Perspectives from South Africa

“…Existing relationships between health institutions and the clinical service platform that have developed over many years have been invaluable in rapidly adapting the clinical environment to the global pandemic. 16 This emphasises the need for health professions education to continue training in practical settings at grassroots level, close to people and communities. These new circumstances have highlighted the value of providing opportunities for students to be exposed to practical integrated healthcare and to engage with a much broader scope of platforms offered by, for example, non-governmental organisations (NGOs) and community-based organisations (CBOs).…”

Strengthening African health systems through outreach and support and values-driven leadership

“…Family physicians and health managers who live according to the principles of FM have enabled traditional hierarchical and mechanistic organisational culture to slowly transform. 7,13 These processes made people more aware of alignment between their personal values and behaviour and organisational values and behaviour (processes, rules and procedures). Dilemmas were resolved by being clearer about alignment or non-alignment with values that were more clearly articulated, and therefore were easier to solve.…”

Perceptions of postgraduate family medicine supervision at decentralised training sites, South Africa

“…According to registrars and FPs, FP supervisors had good clinical trainer and supervisor attributes or acted as good role models with excellent communication and organisational skills, openness, honesty, willingness to teach and teamwork, as found in previous studies. 12,24,25,58 In some districts, FP supervisors worked as a team when challenged because of their multiple roles or level of experience in training by sharing their responsibilities. Teamwork is essential for professional satisfaction, as described in the UK medical education system.…”

“…Another constraint affecting the quality of supervision was the training environment itself. An enabling training environment in DCT depends not only on the FP training abilities but also on the workplace infrastructure, organisational structure, equipment, optimum supervisor-to-trainee ratio and appropriate patient mix, 3,58 which was a limitation at most sites. Contextual health system factors, such as workload, work patterns and distribution, were major system factors that influenced learning interactions between supervisors and registrars, as identified in previous studies.…”