How Clerkship Students Learn From Real Patients in Practice Settings

Abstract

Findings strongly suggest that medical students learn from real patients by participating in patient care within an educational practice. Their learning is affected by clinicians' willingness to engage in supportive dialogue. Promoting an informal, inclusive discourse of workplace learning might enhance clerkship education. This approach should take its place alongside-and perhaps ahead of-the currently dominant discourse of "clinical teaching."

Experience, trajectories, and reifications: an emerging framework of practice-based learning in healthcare workplaces

“…While students' learning trajectories were the main level of analysis in this paper, they also explained how, at the level of personal experiences, making mistakes ''affected all developmental outcomes in this study'' and how, at the reifications level, hierarchies and limitations traditionally attached to the role of students affected students' development (Smith et al 2013). Steven and colleagues longitudinal and multi-method qualitative research on ''how undergraduate medical students learn from real patients in practice settings'' confirmed the basic assumption underlying the ETR framework; learning and acting are part of the same process (Steven et al 2014). This study illustrated how three different types of activities, ''education without patient care, education within patient care, and patient care without education'', provided the social and cultural context for different kinds of personal experiences.…”

“…Late 2013 and early 2014 three different research groups published three papers from different geographical contexts, all looking at medical students' workplace learning in undergraduate training programs (Smith et al 2013;Steven et al 2014;Karani et al 2014). In their focus group study on a new way for students to participate in real patient care through 'pre-prescribing', Smith and colleagues stressed the importance of professional identity formation through participation in practice.…”

“…This study illustrated how three different types of activities, ''education without patient care, education within patient care, and patient care without education'', provided the social and cultural context for different kinds of personal experiences. Furthermore, they discussed the importance of discourse within each of these activities to open up or close off possibilities for students' trajectories of engagement (Steven et al 2014). Karani et al 2014 used focus groups to study what medical students learned from residents and ''which teaching strategies are used by the best resident teachers''.…”

Solutions to Common Problems in Training Learners in General Internal Medicine Ambulatory Settings

“…Medical students should be encouraged to participate actively in patient care and make diagnostic and management decisions under supervision (12). Participatory learning with real patients confers a sense of legitimate involvement and facilitates identity formation (8,12,13).…”

Portfolio Assessment Implementation in Clinical Year of Community Medicine Module: Students Perspective

“…The students should have commitment to medicine's clinical and social problems, specific skills to practice in the community, and learn on how to play a role in health service management directly or in the real time for the community [3]. This learning strategy has also supported solution for clerkship learning to Flexner concept of spiral curriculum that moving practice based learning from inpatient to ambulatory settings, from hospitals to community settings and into longitudinal integrated clinical attachments [4].…”