Abstract
BackgroundClinical teaching plays a crucial role in the transition of medical students into the world of professional practice. Faculty development initiatives contribute to strengthening clinicians’ approach to teaching. In order to inform the design of such initiatives, we thought that it would be useful to discover how senior medical students’ experience of clinical teaching may impact on how learning during clinical training might be strengthened.MethodsThis qualitative study was conducted using convenience sampling of medical students in the final two months of study before qualifying. Three semi-structured focus group discussions were held with a total of 23 students. Transcripts were analysed from an interpretivist stance, looking for underlying meanings. The resultant themes revealed a tension between the students’ expectations and experience of clinical teaching. We returned to our data looking for how students had responded to these tensions.ResultsStudents saw clinical rotations as having the potential for them to apply their knowledge and test their procedural abilities in the environment where their professional practice and identity will develop. They expected engagement in the clinical workplace. However, their descriptions were of tensions between prior expectations and actual experiences in the environment.They appreciated that learning required them to move out of their “comfort zone”, but seemed to persist in the idea of being recipients of teaching rather than becoming directors of their own learning. Students seem to need help in participating in the clinical setting, understanding how this participation will construct the knowledge and skills required as they join the workplace. Students did not have a strong sense of agency to negotiate participation in the clinical workplace.ConclusionsThere is the potential for clinicians to assist students in adapting their way of learning from the largely structured classroom based learning of theoretical knowledge, to the more experiential informal workplace-based learning of practice. This suggests that faculty developers could broaden their menu of offerings to clinicians by intentionally incorporating ways not only of offering students affordances in the clinical learning environment, but also of attending to the development of students’ agentic capability to engage with those affordances offered.
Highlights
Clinical teaching plays a crucial role in the transition of medical students into the world of professional practice
Aligned with our interpretivist stance, the results section initially presents the themes that we developed from the data as our interpretation of these as tensions between the students’ prior expectations of clinical teaching and their actual experience thereof
While analysing the data we continually referred to how the findings would impact on faculty development initiatives to strengthen the teaching role of clinicians - the action that would result from the research
Summary
Clinical teaching plays a crucial role in the transition of medical students into the world of professional practice. Undergraduate medical curricula, are often rounded off with a student internship (clerkship) as the final phase This liminal space [3] provides the opportunity to make use of the support and supervision characteristic of being a student, while learning the tasks and responsibilities that will be required after graduation. In order to use the opportunity optimally, the student is required to adapt their way of learning from the largely structured classroom based learning of theoretical knowledge to the more experiential informal workplace-based learning of practice [4, 5]. The similarity with situated learning can be seen, through which participation in meaningful work facilitates the learner joining the community of practice [10] This is where the specific learning potential of the student internship lies
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