The learning environment for junior doctor training—what hinders, what helps

Kendall, Marilyn; Hesketh, E A; Macpherson, Stuart

doi:10.1080/01421590500069710

Cited by 34 publications

(42 citation statements)

References 15 publications

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“…The students' reflections suggest this was successful. Our findings are in keeping with previous research about the LE (Hutchinson 2003;Kendall et al 2005;Pearson and Lucas 2011). What our research adds are key features of a safe LE which students identified that can be deliberately incorporated into a LE.…”

Section: Discussionsupporting

confidence: 89%

“…Research on learning in the work place emphasises the importance of participation and meaningful interactions (Seabrook 2004b;Kendall et al 2005;Sheehan et al 2005;Egan and Jaye 2009). However concern for the potential harm to both students and patients restricts student participation in clinical situations, limiting students learning about the reasoning and judgment involved in taking responsibility for decisions about patient care.…”

Section: Introductionmentioning

confidence: 99%

“…In a broad overview of the educational environment, Hutchinson (2003) identified a safe environment as one that allows students to feel able to experiment, speak up about concerns they have, recognise knowledge gaps and test their limits. Other researchers have examined the social and psychological elements of the LE (Kendall et al 2005;Boor et al 2008;Benbassat 2013). It has also been the focus of literature reviews (Genn 2001;Roff 2005).…”

Section: Introductionmentioning

confidence: 99%

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Students’ reflections on the relationships between safe learning environments, learning challenge and positive experiences of learning in a simulated GP clinic

Young

Williamson

Egan

2015

Adv in Health Sci Educ

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Learning environments are a significant determinant of student behaviour, achievement and satisfaction. In this article we use students' reflective essays to identify key features of the learning environment that contributed to positive and transformative learning experiences. We explore the relationships between these features, the students' sense of safety in the learning environment (LE), the resulting learning challenge with which they could cope and their positive reports of the experience itself. Our students worked in a unique simulation of General Practice, the Safe and Effective Clinical Outcomes clinic, where they consistently reported positive experiences of learning. We analysed 77 essays from 2011 and 2012 using an immersion/crystallisation framework. Half of the students referred to the safety of the learning environment spontaneously. Students described deep learning experiences in their simulated consultations. Students valued features of the LE which contributed to a psychologically safe environment. Together with the provision of constructive support and immediate, individualised feedback this feeling of safety assisted students to find their own way through clinical dilemmas. These factors combine to make students feel relaxed and able to take on challenges that otherwise would have been overwhelming. Errors became learning opportunities and students could practice purposefully. We draw on literature from medical education, educational psychology and sociology to interpret our findings. Our results demonstrate relationships between safe learning environments, learning challenge and powerful learning experiences, justifying close attention to the construction of learning environments to promote student learning, confidence and motivation.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Students’ reflections on the relationships between safe learning environments, learning challenge and positive experiences of learning in a simulated GP clinic

Young

Williamson

Egan

2015

Adv in Health Sci Educ

View full text Add to dashboard Cite

show abstract

“…Whilst it is well established that nursing staff generally support junior doctors' training, this is the first report in the UK of nurses guiding trainees specifically in the area of palliative care. 16,17 A pilot study in Australia involving fifth-year medical students working with experienced palliative care nurses produced similar findings, with students reporting increased confidence when confronted with a range of situations relating to death and dying. 18 Palliative care staff also acted as a support network.…”

Section: Discussionmentioning

confidence: 71%

“…Junior doctor dissatisfaction with shift systems is well documented, but it was interesting to find that fear of not meeting staff expectations in remaining foundation programme posts was partly what motivated them to acquire acute skills during the palliative medicine post. 16,25 Trainees commencing their pre-registration year in general practice were similarly concerned about falling behind their peers. 15 When posts were split between oncology and palliative medicine, trainees felt unable to follow patients up and find out what had happened to them.…”

Section: Discussionmentioning

confidence: 99%