Medical students’ learning experience and participation in communities of practice at municipal emergency care units in the primary health care system: a qualitative study

Abstract

Background Medical education has been criticised for not adapting to changes in society, health care and technology. Internationally, it is necessary to strengthen primary health care services to accommodate the growing number of patients. In Norway, emergency care patients are increasingly treated in municipal emergency care units in the primary health care system. This study explores medical students’ learning experience and how they participated in communities of practice at two municipal emergency care units in the primary health care system. Methods In this qualitative study, we collected data from March to May 2019 using semi-structured individual interviews and systematic observations of six ninth-semester medical students undergoing two-week clerkships at municipal emergency care units. The interview transcripts were thematically analysed with a social constructivist approach. A total of 102 systematic observations were used to triangulate the findings from the thematic analysis. Results Three themes illuminated what the medical students learned and how they participated in communities of practice: (i) They took responsibility for emergency care patients while participating in the physicians’ community of practice and thus received intensive training in the role of a physician. (ii) They learned the physician’s role in interprofessional collaboration. Collaborating with nursing students and nurses led to training in clinical procedures and insight into the nurses’ role, work tasks, and community of practice. (iii) They gained in-depth knowledge through shared reflections when time was allocated for that purpose. Ethical and medical topics were elucidated from an interprofessional perspective when nursing students, nurses, and physicians participated. Conclusions Our findings suggest that this was a form of clerkship in which medical students learned the physician’s role by taking responsibility for emergency care patients and participating in multiple work tasks and clinical procedures associated with physicians’ and nurses’ communities of practice. Participating in an interprofessional community of practice for professional reflections contributed to in-depth knowledge of ethical and medical topics from the medical and nursing perspectives.

Mapping interaction quality for nursing and medical students in primary care placement in municipal emergency care units: a systematic observational study

“…Skaalvik et al ( 26 ) reported that when supervisors fail to engage in professional reflections, nursing students perceive missing opportunities for knowledge development. In Giske et al ( 60 ), medical students reported developing independent thinking skills if the supervisor facilitated student reflection before providing an answer to the challenge in question. Based on our results, nursing and medical students in municipal emergency care units had learning opportunities to reflect on patient situations and ethical dilemmas.…”

Music Therapy as a Topic in Medical Education: Course Concept and Student Evaluation of an Elective Course for Medical Students

“… 35 In addition to those experiences the medical students see the patients from a different perspective than a physician. 36 This makes the University of Duisburg-Essen the only institution that has integrated the subject music therapy into conventional medical education in Germany.…”