Scaffolding Clinical Reasoning of Health Care Students: A Qualitative Exploration of Clinicians’ Perceptions on an Interprofessional Obstetric Ward

Abstract

Purpose: Interprofessional education (IPE) on a ward supports students to generate interprofessional patient care plans as a means to learn about the roles, responsibilities, and clinical reasoning of other professions. We investigated how clinicians guide the clinical reasoning of students from their own and other professions and whether clinicians from nursing, midwifery, and medicine could scaffold students from all professions, that is, by providing just-in-time and tailored support. Methods: Nine supervising clinicians from medicine, nursing, and midwifery were interviewed and a repeat interview held 3 to 15 weeks later; one nurse supervisor was interviewed only once. Using conventional content analysis, themes were identified inductively. Next, we applied an existing scaffolding framework to conceptualise how clinicians supported the clinical reasoning in an IPE setting. Results: Themes were clinicians’ interventions and intentions, results of interventions and of IPE, characteristics of students and clinicians, interactions between clinicians and students, and logistics. Clinicians applied various interventions and expressed several intentions to guide the learning of students from all professions. Clinicians stimulated students’ clinical reasoning by structuring meetings, asking students to explain their thoughts to each other and through giving group assignments. Thus, clinicians used peer-assisted learning for the students. By collaborating with other supervising clinicians regarding the form and amount of guidance to give to the students, clinicians applied peer-assisted learning for themselves as well. Conclusion: Clinicians can learn to scaffold the clinical reasoning of students from different professions, when they are provided with training, good examples, and structures. An existing scaffolding framework can serve as an overview of aims and interventions to provide just-in-time guidance to students from all professions. The scaffolding framework is useful for training clinicians and for depicting the pedagogical approach for IPE wards.

Twelve tips on how to motivate healthcare professions students and their supervisors for Interprofessional Education

“…Visser C, Oosterbaan S, Mørk Kvist B, Croiset G, Kusurkar R MedEdPublish https://doi.org/10.15694/mep.2020.000243.1 Traditionally, orthopaedic, obstetric or geriatric wards are chosen for IPE in Sweden and Denmark (Jakobsen, 2016;Oosterom et al, 2019). Our experience is with an internal medicine ward and an obstetric ward (Visser et al, 2019;Visser et al, 2020).…”

Raisonnement clinique et simulation : faciliter la priorisation d’hypothèses grâce aux patients simulés. Données d’une recherche quantitative

“…13 Le débriefing permettant une explicitation immédiate du RC contribue au soutien sur mesure et au moment opportun pour les étudiants (scaffolding). 14 Depuis la mise en place de cliniques simulées RC, nous avons amélioré la rédaction des scénarios de simulation, afin qu'ils permettent la génération de plusieurs hypothèses, avec des éléments clés précis mais nous n'avons pas modifié le briefing des PS, omettant ainsi de mettre l'accent sur ces éléments discriminants.…”

Scaffolding in Health Sciences Education Programmes: An Integrative Review

“…Students in health sciences programmes should be supported to adapt to the demands of learning complex skills and knowledge in constantly changing platforms, such as dynamic and evolving healthcare systems. Through scaffolding, educators support students’ learning by breaking down tasks and providing “just-in-time” strategies to enhance learning [ 1 , 2 ]. Van De Pol et al [ 3 ] define scaffolding as temporary support provided by an educator to aide students in completing a learning task that would prove difficult without such support.…”

“…Students in health sciences programmes develop competence in various contexts. Literature confirms that classrooms, simulation laboratories, community, and clinical environments are indispensable platforms for effective health sciences education [ 2 , 7 , 19 – 22 ]. These learning platforms are constantly changing in response to the dynamic and evolving healthcare systems.…”

“…Students need support in adapting to these continuously changing platforms. Scaffolding as a support strategy has been reported to improve students’ comprehension of basic sciences knowledge [ 7 ], communication skills [ 23 ], evidence-based practice [ 18 ], academic literacy [ 24 ], clinical reasoning [ 2 , 25 ], psychomotor [ 26 ], reflection [ 27 , 28 ], and metacognitive skills [ 29 ] that are essential in adapting to dynamic learning platforms.…”