Conceptions of how a learning or teaching curriculum, workplace culture and agency of individuals shape medical student learning and supervisory practices in the clinical workplace

Abstract

The role of workplace supervisors in the clinical education of medical students is currently under debate. However, few studies have addressed how supervisors conceptualize workplace learning and how conceptions relate to current sociocultural workplace learning theory. We explored physician conceptions of: (a) medical student learning in the clinical workplace and (b) how they contribute to student learning. The methodology included a combination of a qualitative, inductive (conventional) and deductive (directed) content analysis approach. The study triangulated two types of interview data from 4 focus group interviews and 34 individual interviews. A total of 55 physicians participated. Three overarching themes emerged from the data: learning as membership, learning as partnership and learning as ownership. The themes described how physician conceptions of learning and supervision were guided by the notions of learning-as-participation and learning-as-acquisition. The clinical workplace was either conceptualized as a context in which student learning is based on a learning curriculum, continuity of participation and partnerships with supervisors, or as a temporary source of knowledge within a teaching curriculum. The process of learning was shaped through the reciprocity between different factors in the workplace context and the agency of students and supervising physicians. A systems-thinking approach merged with the "co-participation" conceptual framework advocated by Billet proved to be useful for analyzing variations in conceptions. The findings suggest that mapping workplace supervisor conceptions of learning can be a valuable starting point for medical schools and educational developers working with changes in clinical educational and faculty development practices.

A qualitative exploration of chiropractic and physiotherapy teachers' experiences and conceptualizations of the educational environment

“…17,24,25 An interview guide was constructed from 2 criteria: to correspond to the aim of the study and, based on empirical findings from the literature, to illuminate potential challenges in the educational environment. PP interviewed the physiotherapy teachers, and ML interviewed the chiropractic teachers as, at the time, PP was a teacher in the chiropractic program and might have had personal relationships with some of the participants.…”

“…Unlike in our earlier studies, in which we employed the construct of perceptions of the phenomenon, and in line with Strand et al, 17 the present study utilizes the constructs of conceptions and conceptualizations. The latter is viewed as the process of forming a conceptual model of the phenomenon to underscore the notion of a more profound interpretation of the meaning of the educational environment.…”

Impact of Teaching Strategies on Medical Student Academic Performance

“…Teaching strategies are defined as the procedures educators use in a flexible, adaptive, self-regulated, and reflexive way to promote the achievement of meaningful learning among students, and they are often based on their own belief of how students learn best (Díaz-Barriga, 2003). Strand (2015) argued that one of the most critical factors for improving students´ learning was to illuminate beliefs among teachers about learning, not to prove them wrong or right (Hattie, 2009;Timperley, Wilson, Barrar, & Fung, 2007). However, the perspectives and experiences of medical instructors may be less well appreciated than are the perspectives of teachers in other education sectors (Biggs &Tang, 2007).…”

“…These teaching strategies may be categorized on a theoretical basis that allow the formation of pedagogical referents which, according to Martínez et al (2001), may be classified into three groups: the first being traditional referents (TR), which as a distinctive feature, are focused on the educator, and are the prevailing expository methods of traditional teaching (Gimeno & Pérez , 1992); the second group is education technology (ET), which places the educator as the organizer and designer in the planning of activities, and passively observes student achievement of learning objectives (Pérez, 1993); and within the third group are the alternate referents, (AR) which have as a distinctive feature of student group participation in their own process of learning. In the latter category are all the innovating ideas in medical education, whose referents include: critical, constructive, psychogenetic, problem-based learning, and tutorials among others (Morán, 1993;Pérez, 1993).…”

“…In the latter category are all the innovating ideas in medical education, whose referents include: critical, constructive, psychogenetic, problem-based learning, and tutorials among others (Morán, 1993;Pérez, 1993). Pedagogical referents are the didactic methods of instructors, which result of their beliefs, implied theories and practical thinking that they assume, integrate, and use as own to teach within a determined social context (Pansza, 1993;.…”