Engagement and opportunity in clinical learning: Findings from a case study in primary care

Pearson, David; Lucas, Beverley

doi:10.3109/0142159x.2011.611402

Cited by 21 publications

(38 citation statements)

References 22 publications

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“…The students' reflections suggest this was successful. Our findings are in keeping with previous research about the LE (Hutchinson 2003;Kendall et al 2005;Pearson and Lucas 2011). What our research adds are key features of a safe LE which students identified that can be deliberately incorporated into a LE.…”

Section: Discussionsupporting

confidence: 89%

“…Given the constraints of the clinical workplace, research into the contexts, volume and timing of observation and feedback is needed. Simulations are a useful step towards work-based learning and clinical practice because it is easier to control the LE for variables such as feedback and support (Dornan et al 2007;Pearson and Lucas 2011).…”

Section: Discussionmentioning

confidence: 99%

“…Clinical learning is maximised when opportunities for meaningful and authentic patient interactions are available and students feel engaged, recognised and respected (Pearson and Lucas 2011). Pearson and Lucas also noted that learning ensued when emotion, often feelings of being challenged, was stimulated.…”

Section: Introductionmentioning

confidence: 98%

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Students’ reflections on the relationships between safe learning environments, learning challenge and positive experiences of learning in a simulated GP clinic

Young

Williamson

Egan

2015

Adv in Health Sci Educ

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Learning environments are a significant determinant of student behaviour, achievement and satisfaction. In this article we use students' reflective essays to identify key features of the learning environment that contributed to positive and transformative learning experiences. We explore the relationships between these features, the students' sense of safety in the learning environment (LE), the resulting learning challenge with which they could cope and their positive reports of the experience itself. Our students worked in a unique simulation of General Practice, the Safe and Effective Clinical Outcomes clinic, where they consistently reported positive experiences of learning. We analysed 77 essays from 2011 and 2012 using an immersion/crystallisation framework. Half of the students referred to the safety of the learning environment spontaneously. Students described deep learning experiences in their simulated consultations. Students valued features of the LE which contributed to a psychologically safe environment. Together with the provision of constructive support and immediate, individualised feedback this feeling of safety assisted students to find their own way through clinical dilemmas. These factors combine to make students feel relaxed and able to take on challenges that otherwise would have been overwhelming. Errors became learning opportunities and students could practice purposefully. We draw on literature from medical education, educational psychology and sociology to interpret our findings. Our results demonstrate relationships between safe learning environments, learning challenge and powerful learning experiences, justifying close attention to the construction of learning environments to promote student learning, confidence and motivation.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Students’ reflections on the relationships between safe learning environments, learning challenge and positive experiences of learning in a simulated GP clinic

Young

Williamson

Egan

2015

Adv in Health Sci Educ

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“…Engagement in learning appears to be developed through four essential elements: recognition, respect, relevance, and emotion. Clinical Opportunities include the availability of patient encounters [1]. It is well documented that medical students receive their best training when this is done in PHCCS, due to many factors such as small group sessions [1, 2] and the presence of real patients for hands-on training which includes the development of effective patient interactions along with understanding chronic diseases [2].…”

Section: Introductionmentioning

confidence: 99%

“…Clinical Opportunities include the availability of patient encounters [1]. It is well documented that medical students receive their best training when this is done in PHCCS, due to many factors such as small group sessions [1, 2] and the presence of real patients for hands-on training which includes the development of effective patient interactions along with understanding chronic diseases [2]. It is reported that students in family medicine (FM) conduct physical examination more frequently and gain experience in both the breadth and depth of primary care (PC) [3].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Training in Primary Health Care Centers on Medical Students’ Clinical Skills

Alnasir

Jaradat

2013

ISRN Family Medicine

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Medical students' effective clinical skills training are an important goal of any medical school. When adequate, graduate doctors will have sufficient skills to consult a patient by taking proper history and conducting appropriate physical examination. The question under scrutiny is the optimal place for providing such training. Since the aim is to graduate general physicians, many literatures highlighted the importance of implementing such training in the primary health care centers. A special clinical skills training program was developed for the Year 4 pre-clerkship medical students of the Arabian Gulf University during the academic year 2011-2012. It was important for these students to acquire certain skills before transferring to the clerkship phase where they deal directly with patients. For the 130 students involved in this study, a self-assessment and clinical exam were conducted at the beginning and end of the program. The study showed that students benefited greatly from this training program with significant differences between their preexisting known skills and clinical skills acquired by the end of the program. Primary care centers are ideal places for optimal training because of small group training setting that is one tutor to two students and of the advantage that students face real patient environment.

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Ad hoc supervision of general practice registrars as a ‘community of practice’: analysis, interpretation and re-presentation

Clement

Brown

Morrison

et al. 2015

Adv in Health Sci Educ

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General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also provide an opportunity for learning and teaching. Wenger's (Communities of practice: learning, meaning, and identity. Cambridge University Press, New York, 1998) social theory of learning ('communities of practice') guided a secondary analysis of audio-recordings of ad hoc encounters. Data from one encounter is re-presented as an extended sequence to maintain congruence with the theoretical perspective and enhance vicariousness. An interpretive commentary communicates key features of Wenger's theory and highlights the researchers' interpretations. We argue that one encounter can reveal universal understandings of clinical supervision and that the process of naturalistic generalisation allows readers to transfer others' experiences to their own contexts. The paper raises significant analytic, interpretive, and representational issues. We highlight that report writing is an important, but infrequently discussed, part of research design. We discuss the challenges of supporting the learning and teaching that arises from adopting a socio-cultural lens and argue that such a perspective importantly captures the complex range of issues that work-based practitioners have to grapple with. This offers a challenge to how we research and seek to influence work-based learning and teaching in health care settings.

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Engagement and opportunity in clinical learning: Findings from a case study in primary care

Cited by 21 publications

References 22 publications

Students’ reflections on the relationships between safe learning environments, learning challenge and positive experiences of learning in a simulated GP clinic

Students’ reflections on the relationships between safe learning environments, learning challenge and positive experiences of learning in a simulated GP clinic

The Effect of Training in Primary Health Care Centers on Medical Students’ Clinical Skills

Ad hoc supervision of general practice registrars as a ‘community of practice’: analysis, interpretation and re-presentation

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