Experience Based Learning (ExBL): Clinical teaching for the twenty-first century

Abstract

The problem: Clinical practice commonly presents new doctors with situations that they are incapable of managing safely. This harms patients and stresses the new doctors and other clinicians. Unpreparedness for practice remains a problem despite changes in curricula from apprenticeship to outcome-based designs. This is unsurprising because capability depends on learning from practical experience in supportive learning environments. To assure the care of patients and well-being of residents, the pedagogy of medical students' practice-based education is in urgent need of an overhaul. This Guide: Experience based learning (ExBL) is a 21 st century pedagogy of practice-based learning, derived from best current theory and evidence. ExBL specifies capabilities that medical students need to acquire from practical experience. It exemplifies how clinicians' behavior can help students gain experience. It explains how reflection converts real patient learning into capability and identity. It identifies desirable features of learning environments. This Guide advises clinicians, students, placement leads, faculty developers, and other stakeholders how to make new doctors as capable as possible. ExBL is a comprehensive model of medical students' practice-based learning, which complements competency-based education to prepare new doctors to deliver safe, effective, and compassionate care.

Finding your feet: student participation during initiation of international clinical placements: Student participation during initiation

“…The results of our study, moreover, confirm that students are likely to engage in practice once they have a clear position and supported role [6,7] and that they are less likely to contribute to patient care [12,25,26] and have a sense of belonging when facing difficulties in communication, time constraints, lack of practical guidelines and unfavourable supervisor and learner behaviours. This aligns with an article by Dornan and colleagues [27] who emphasise the importance of challenging students to step outside their comfort zones, supporting students' learning by organising the learning environment in a way that invites them to participate in practice.…”

Uncovering the ecology of clinical education: a dramaturgical study of informal learning in clinical teams

“…These shortcomings have been further highlighted by the widespread adoption of competency-based curriculums in graduate medical education (Ten Cate and Billett 2014). The perceived inefficiencies of graduate clinical education have led to increased calls for action, driven largely by enhanced scrutiny of clinical education by professional training and accreditation bodies (Dornan et al 2019).…”

Trenger medisinsk pedagogisk praksis en real overhaling?

“…Med dette som utgangspunkt har forfatterne utviklet en detaljert guide basert på pedagogisk teori fra erfaringsbasert laering (2). Erfaringsbasert laering er godt forankret empirisk.…”

“…I en nylig publisert artikkel hevder forfatterne at den konteksten arbeidsarenaen representerer, må tillegges større vekt underveis i utdanningsløpet, fordi opplaering og vurdering av studenter ikke er tilstrekkelig alene til å gjøre dem til dyktige klinikere (2). For å sikre trygge leger som gir god behandling av pasienter, mener derfor forfatterne at det er behov for en real overhaling av medisinsk pedagogisk praksis allerede på medisinstudiet.…”