Adaptation and validation of the instrument Clinical Learning Environment and Supervision for medical students in primary health care

Öhman, Eva; Alinaghizadeh, Hassan; Kaila, Päivi; Hult, Håkan; Nilsson, Gunnar; Salminen, Helena

doi:10.1186/s12909-016-0809-8

Cited by 19 publications

(17 citation statements)

References 25 publications

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“…Another limitation is that the study did not did not measure organizational/−cultural differences or the mentor-mentee relationship among the different ECE environment as evaluation predictors of ECE outcomes. Therefore, questionnaires to investigate the pedagogical atmosphere during clinical exposure [43], students’ perception of social support [44], the organization of placement [45], and “patient mix” i.e., the diversity and quality of patient contacts [46], need to be adapted in future studies.…”

Section: Discussionmentioning

confidence: 99%

Correlation between early clinical exposure environment, attitudes toward basic medicine, and medical students’ basic science learning performance

Tang

Chen

et al. 2019

BMC Med Educ

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Background Early clinical exposure (ECE) is viewed as a way to provide contexts of basic science and highlight its relevance to medical practice. However, very few studies have specifically looked into how the ECE experience contributes to students’ academic performance. The purpose of this study was to investigate whether ECE experiences (external cause) or students’ learning attitudes (internal cause) more closely correlated with medical students’ academic performance. Methods Subjects who participated in the study comprised 109 s-year students at Taipei Medical University. Fifty of the 109 study participants were enrolled in an elective ECE program. The dependent variable in this study was the test score of a systems-based basic sciences (SBBS) course. Independent variables of the study included students’ attitudes and test anxiety towards the SBBS course, engagement/length of time spent in ECE, and the ECE learning environment. Data of students’ engagement in ECE, levels of their motivational beliefs and test anxiety, differences in the ECE learning environment, and the SBBS final test scores of these 109 respondents were collected for hierarchical multiple regression (HMR) analyses. Results Results of the HMR analyses revealed that students’ test anxiety towards basic science and also the learning environment of the ECE had significant positive predictive power on their SBBS test scores. Conculsion This study discovers that medical students’ academic performance in basic science correlates not only with their anxiety to testing, but even more so with the clinical environment they are exposed to. Hence we suggest including further investigations about different learning environments on ECE experiences in future studies. Electronic supplementary material The online version of this article (10.1186/s12909-019-1612-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Correlation between early clinical exposure environment, attitudes toward basic medicine, and medical students’ basic science learning performance

Tang

Chen

et al. 2019

BMC Med Educ

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“…In year 2014 and 2015, all students at the SRC were asked to anonymously fill in pre-selected parts of the clinical learning environment, supervision and nurse teacher evaluation scale (CLES + T), by the end of their clinical placement [ 14 , 15 ]. The CLES + T has demonstrated good psychometric properties including high reliability [ 15 , 16 ]. In alignment with the use of the instrument within the primary care section of the medical program, Karolinska Institutet, pre-selected sections focusing on three dimensions of the learning environment were used: Pedagogical atmosphere (items 1–9: the atmosphere at the workplace, including whether the staff was easy to approach, whether one felt comfortable at the unit, the staff’s interest in student supervision, opportunities for meaningful and multi-dimensional learning).…”

Section: Methodsmentioning

confidence: 99%

Experiences of a student-run clinic in primary care: a mixed-method study with students, patients and supervisors

Fröberg

Leanderson

Fläckman

et al. 2018

Scandinavian Journal of Primary Health Care

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ObjectiveTo explore how a student-run clinic (SRC) in primary health care (PHC) was perceived by students, patients and supervisors.DesignA mixed methods study. Clinical learning environment, supervision and nurse teacher evaluation scale (CLES + T) assessed student satisfaction. Client satisfaction questionnaire-8 (CSQ-8) assessed patient satisfaction. Semi-structured interviews were conducted with supervisors.SettingGustavsberg PHC Center, Stockholm County, Sweden.SubjectsStudents in medicine, nursing, physiotherapy, occupational therapy and psychology and their patients filled in questionnaires. Supervisors in medicine, nursing and physiotherapy were interviewed.Main outcome measuresMean values and medians of CLES + T and CSQ-8 were calculated. Interviews were analyzed using content analysis.ResultsA majority of 199 out of 227 student respondents reported satisfaction with the pedagogical atmosphere and the supervisory relationship. Most of the 938 patient respondents reported satisfaction with the care given. Interviews with 35 supervisors showed that the organization of the SRC provided time and support to focus on the tutorial assignment. Also, the pedagogical role became more visible and targeted toward the student’s individual needs. However, balancing the student’s level of autonomy and the own control over care was described as a challenge. Many expressed the need for further pedagogical education.ConclusionsHigh student and patient satisfaction reported from five disciplines indicate that a SRC in PHC can be adapted for heterogeneous student groups. Supervisors experienced that the SRC facilitated and clarified their pedagogical role. Simultaneously their need for continuous pedagogical education was highlighted. The SRC model has the potential to enhance student-centered tuition in PHC.Key PointsKnowledge of student-run clinics (SRCs) as learning environments within standard primary health care (PHC) is limited.We report experiences from the perspectives of students, their patients and supervisors, representing five healthcare disciplines.Students particularly valued the pedagogical atmosphere and the supervisory relationship.Patients expressed high satisfaction with the care provided.Supervisors expressed that the structure of the SRC supported the pedagogical assignment and facilitated student-centered tuition – simultaneously the altered learning environment highlighted the need for further pedagogical education.Student-run clinics in primary health care have great potential for student-regulated learning.

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“…The Clinical Learning Environment and Supervision (CLES) Tool has been acknowledged as a valid and reliable instrument to evaluate clinical learning environments for nursing students 7. It has been adapted in several countries and contexts including for medical students in a primary healthcare setting 8. In this context it was adapted to assess the learning environment for DF students at UCD and on clinical placements in ambulance services, GP surgeries, hospitals and military medical facilities.…”

Section: Methodsmentioning

confidence: 99%

Irish Defence Forces combat medical technician training: experience of a novel university medical school-based programme

Loughman

Berry²,

Hickey³

et al. 2020

BMJ Mil Health

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AimsThis study explores the opinions and experiences of Irish Defences Forces’ (IDF) graduates from University College Dublin’s Diploma in Military Medicine Care (DMMC). It aims to identify which aspects of medical education are relevant for the development of military graduates in the role of Combat Medical Technician (CMT) in future.MethodsA validated Clinical Learning Environment Score tool was adapted and incorporated into an online survey. This was sent electronically to 71 graduates. Responses were anonymous.Results38 (54%) graduates responded. Student feedback was positive regarding teaching and clinical placements in the DMMC. In total 16 (42%) students reported use of their new skills in their daily work. Of the 9 (24%) deployed overseas, all used their new skills. Emergency and occupational health skills were used more frequently, while advanced skills were used rarely.ConclusionAn increased emphasis on frequently used skills should be considered. Links to healthcare services would be of benefit to graduates in skills maintenance. Key advanced skills, such as intravenous cannulation and advanced airway management are rarely used but mechanisms to maintain them will improve the relevance of the programme to the CMT role. A change in how the IDF acknowledges qualifications may support more graduates in advancing and maintaining their career in the military medical workforce.

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Adaptation and validation of the instrument Clinical Learning Environment and Supervision for medical students in primary health care

Cited by 19 publications

References 25 publications

Correlation between early clinical exposure environment, attitudes toward basic medicine, and medical students’ basic science learning performance

Correlation between early clinical exposure environment, attitudes toward basic medicine, and medical students’ basic science learning performance

Experiences of a student-run clinic in primary care: a mixed-method study with students, patients and supervisors

Irish Defence Forces combat medical technician training: experience of a novel university medical school-based programme

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