Barriers to Learning During Clinical Rotations in the Emergency Department: The Perspective of Students in a Public Sector Institute of a Developing Country

Syed Muhammad Jawad Zaidi,Abdullah Bin Zubair,Hamza Waqar Bhatti,Muhammad Zubair Satti,Mehwish Kaneez,Muhammad Waqar Younas,Syed Faheem Bukhari,Fazila Hassan

doi:10.24018/ejmed.2020.2.6.554

Syed Muhammad Jawad Zaidi, Abdullah Bin Zubair + Show 6 more

Open Access

https://doi.org/10.24018/ejmed.2020.2.6.554

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Abstract

Background: Clinical learning is the crux of medical education. Students perceive many barriers to effective clinical learning due to transition, poor supervision, and lack of orientation. There is an urgent need for recommendations to alleviate these barriers and improve the quality of medical education in a public sector institute of a developing country. Aims: The study aims to identify the barriers in clinical learning perceived by the students during their clinical rotations in emergency. The study also aims to provide recommendations to alleviate these barriers. Methods: A cross-sectional study conducted among 300 students from a public sector institute of Pakistan. The perception of clinical learning was assessed using a structured questionnaire in students attending medical and surgical emergency ward. Independent samples t-test and ANOVA were used to assess differences in perception scores across gender and academic years. Results: The mean perception score was 52.0±11.74. There was a significant difference in perception scores across academic years (p=0.028) with the final year having lower perception scores than the junior students. The mean scores of items in domain 1 (Transition and stress) and domain 4 (Supervision and feedback) were lower indicating a negative perception in these domains. Conclusions: Lack of clinical orientation, non-integration of the clinical curriculum in preclinical years, poor supervision, lack of resources, and a crippled feedback delivery system are barriers to clinical learning. Interventions such as integration of clinically orientated curriculum, teacher training, student-centered teaching methodology, and development of an effective feedback delivery system must be employed for quality clinical learning during rotations.

Highlights

The knowledge and skills acquired during the clinical years are fundamental as they lay the core foundation for the training of medical students [1]
Lack of clinical orientation, non-integration of the clinical curriculum in preclinical years, poor supervision, lack of resources, and a crippled feedback delivery system are barriers to clinical learning. Interventions such as integration of clinically orientated curriculum, teacher training, student-centered teaching methodology, and development of an effective feedback delivery system must be employed for quality clinical learning during rotations
The present study aims to identify the barriers to learning during clinical rotations as perceived by clinical students

Summary

Introduction

The knowledge and skills acquired during the clinical years are fundamental as they lay the core foundation for the training of medical students [1]. Unlike the pre-clinical years, the learning in the clinical years is self-regulated, constant, self-directed, and patient-focused that demands students to be selfreflective and capable of recognizing the gaps between their knowledge and skills [3]. All these factors make clinical learning the gist of the medical curriculum and it can be influenced by many factors [1], [3]. The students experience an abrupt transition from preclinical to clinical phase due to increased workload, overburdened curriculum, and ethical dilemmas that may lead to ineffective learning during clinical rotations [5], [6].

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