Learning in the Real Place

Abstract

Students' experiential learning in clerkships occurred through impression management as a function of dynamic social and reciprocal relationships between students and attendings or residents. Students reported that they did not learn comprehensive clinical reasoning skills to the degree they expected in clerkships.

How the Start into the Clinical Elective Year Could be Improved: Qualitative Results and Recommendations from Student Interviews

“…Students pointed at favorable personal attributes, such as being open-minded, actively seeking feedback, and to regulate learning in a self-directed fashion. Literature confirms respective attributes to be conducive for learning [ 32 ], [ 33 ]. While these attributes may be self-evident, we still find it important to make them explicit as professional behavior, especially to more introverted students.…”

Challenging cases during clinical clerkships beyond the domain of the “medical expert”: an analysis of students' case vignettes

“…In respect to communicational issues many students, who worked as full members of a medical team for the first time in their lives, experienced the complexity of communication with patients, their relatives, colleagues, superiors and other healthcare professions (sometimes all at the same time). In contrast to the preceding study years of guided and selected patient encounters communication now became essential for students in order to get their work done, to keep one’s place within the team and to receive the required teaching [ 4 ]. Notably, students rather struggled with problems which were closer to their personal working situation than to issues in the domain of the “Collaborator” and “Manager” roles.…”

“…Working experience in routine clinical settings is essential for undergraduate medical education [ 1 ], [ 2 ], [ 3 ]. An important facet of this learning environment is related to non-standardized situations, where plain clinical algorithms may not be sufficient to solve the problem [ 4 ]. These complex clinical situations often originate from causes beyond the domain of the CanMEDS role “Medical Expert” [ 5 ], e.g.…”

A qualitative study of undergraduate clerkships in the intensive care unit: It’s a brand new world

“…They may feel intimidated by the unfamiliarity of the surroundings and the complexity of pathology and treatments [5], promoting uncertainty and disengagement, thereby hindering learning [6, 7]. Unfamiliar departmental culture and team structures may interfere with early clerkship socialization and identity formation [7]. Moreover, active student participation, important for effective learning [8–11], may be harder to achieve in the complex, high-stakes ICU setting.…”

“…Numerous qualitative studies have evaluated undergraduate clinical workplace learning [7, 8, 11–16] but none of these studies includes data on ICM clerkships. Existing research about undergraduate ICM learning, mostly quantitative with self-selected students doing 2‑ or 3‑month electives, suggests that it is popular and achieves measurable learning outcomes [17–22].…”