Abstract
PurposeIn order to foster positive student experiences in the clinical learning environment, we wanted to better understand which teaching practices they regard highly.MethodsIn 2016, the authors undertook a paper ‘exemplar’ survey (ES) of all fifth year medical students at one tertiary teaching site. Students had experienced all assigned clinical rotations over a two year period. Following a 66% response rate, we identified two clear exemplar clinical areas (ECAs). Over 2016–7, six focus groups with multidisciplinary staff members from these clinical areas were held, with the aim to identify, discuss and understand their specific teaching practices in more detail.ResultsThe authors present descriptions of positive student experiences and related staff practices, in five themes. Themes emerged around foundational logistic and personal factors: central to student and staff data is that ‘welcome’ on a daily, and ongoing basis, can be foundational to learning. Central to ECA staff data are universal practices by which all staff purposefully work to develop a functional staff-student relationship and play a part in organising/teaching students. Students and ECA staff groups both understood teacher values to be central to student learning and that cultivating a student’s values is one of their major educational tasks.ConclusionsThe framework formed by this thematic analysis is useful, clear and transferrable to other clinical teaching contexts. It also aligns with current thinking about best supporting student learning and cultivating student values as part of developing professionalism. Instigating such practices might help to optimise clinical teaching. We also tentatively suggest that such practices might help where resources are scarce, and perhaps also help ameliorate student bullying.
Highlights
Get the learning environment right, and the learning will look after itself (Alan Clarke, in [1], p. 85)
We describe practices perceived as positive learning experiences by a cohort of medical students and staff from two exemplar clinical teaching areas voted the best by students
We report about these teaching practices because of the growing interest in the extent of healthcare management’s duty of care for all employees, articulated in current NZ workplace health and safety legislation [17,18,19] which stipulates management’s responsibility to effectively tackle workplace bullying
Summary
Get the learning environment right, and the learning will look after itself (Alan Clarke, in [1], p. 85). Medical student experiences in the clinical environment are crucial to their learning; what they are formally taught, see and do shapes their development as a practitioner [2, 3]. Positive experiences might result from a teacher taking time to discuss a clinical case in detail, negative from a teacher asking the student questions which are knowingly too hard for them to answer, with the aim to Currently, it is understood that a student’s negative experiences in the clinical environment will likely include bullying The bullied student can suffer negative effects on learning, academic achievement and clinical performance [12], acute and ongoing mental health issues [13] and an overall impeded professional
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