Learning In Clinical Setting Research Articles

Teaching and Learning in Clinical Settings

Richard Hays Radcliffe, 2006, £24.95, 168 pages ISBN: 1 85775 751 3 Rating: ★★★/5 This book is timely. The establishment of more medical schools in the United Kingdom is leading to expansion in medical student numbers, which will place a greater burden on existing clinical firms. Tuition fees mean today's learners expect higher education institutions and trusts to be more accountable for the syllabus they provide. Learning and assessment theories are fashionable, and this is one of the latest contributions by Radcliffe on the subject. When I …

What do medical students actually do on clinical rotations?

As medical schools make use of an increasing variety of clinical teaching settings, it is of interest to find that that there is very little published research that explores the actual learning activities undertaken by students in different environments. This study was designed to describe and analyse a typical week for students learning the same curricular material in one of three Australian settings: an urban tertiary teaching hospital, a remote secondary referral hospital and a rural community-based programme. Twenty-eight students completed week-long learning logs in weeks 9 and 35 of a 40-week academic year. Each student recorded his or her activity in 15-minute intervals for each week. Analysis of these data revealed that, compared with the hospital-based students, the community-based students reported greater patient contact, more time spent in clinical settings and increased time supervised by experienced clinicians. Whilst the community-based students valued their learning in clinical settings more highly than the learning they undertook at their home, the opposite was found for the tertiary hospital-based students. This study, the first to compare student activity in these three prototypical settings in the medical education literature, provides empirical evidence supporting community-based programmes as credible alternatives to traditional teaching hospital-based environments.

Reflective practise in clinical teaching.

The present paper describes the process of reflective practise in clinical teaching through a workshop entitled 'Effective Clinical Teaching'. The clinical teachers were invited to analyze the content of a videotape in which various clinical teaching scenarios were presented. Following this, they discussed a series of questions designed to promote reflective activities and evaluated the interaction among the student, the client and the clinical teachers in each scenario. The teachers also identified the positive and negative aspects of the teaching approaches portrayed on the tape. Finally, the participants made recommendations that would improve the interaction and suggested alternate teaching strategies to enhance the learning outcome. In addition, there was sharing of clinical teaching experiences among the clinical teachers. Through this process of reflection on action, the clinical teachers were able to understand various teaching approaches as perceived by students, and to address the issues that might hinder student learning in clinical settings. Different reflective activities have also been proposed to enhance student's reflective learning skills.

Strategic planning in medical education: enhancing the learning environment for students in clinical settings.

The 1999 Cambridge Conference was held in Northern Queensland, Australia, on the theme of clinical teaching and learning. It provided an opportunity for groups of academic medical educators to consider some of the challenges posed by recent changes to health care delivery and medical education across a number of countries. This paper describes the issues raised by the practical challenges posed by the current environment and how they might be addressed in ways that could promote more effective learning in clinical settings. A SWOT analysis is a tool that can help in forward planning by identifying the strengths, weaknesses, opportunities and threats presented by any situation. Our SWOT analysis was used to generate a list of items, from which we chose those most feasible and most likely to promote positive change. Twenty different issues were identified, with four of them chosen by consensus for further elaboration. The discussion gave rise to four main recommended strategies: ensuring that clinical teachers thoroughly understand the purpose and process of learning in clinical settings; equipping learners with 'survival skills'; making the best use of learning resources within different clinical environments and making judicious use of information technology to enhance learning efficiency. The four strategies were selected not only because of their inherent importance, but also because of their feasibility. Modest changes can motivate students to feel part of a clinical team and a 'community of practice' and enhance their capacity for self-regulated practice.

Book Reviews

AbstractBook reviewed in this article:Child ren with Speci.c Language Impairment By Laurence B. LeonardUncommon Understanding: Development and Disorders in Language Communication By D. V. M. BishopFacilitating Learning in Clinical Settings Edited by Lindy McAllister, Michelle Lincoln, Sharynne Mcleod and Diana MaloneyGenetics and Hearing Impairment By A Martini, A. Read and D. StephensVocal Pathologies: Diagnosis, Treatment and Case Studies By J. P. Dworkin and R. J. Meleca

A correlation study of students' perception of their active role as related to their clerkship experiences

Previous studies have indicated the importance of students' active involvement in clinical learning. The present study examined medical students' active participation in clinical clerkships as related to their ratings of clerkship experiences. The general hypothesis is that students' perception of being active in the clerkship will be positively related to their experience with attendings and residents and to their overall satisfaction with their clerkship experience. This hypothesis was examined in teaching rounds, work rounds and in conferences, and was confirmed in the study. Future study may be needed to explore specific approaches to bring students into an active process in different clinical learning settings.

Three exemplary models of case-based teaching

Teaching in response to case presentations is an essential feature of clinical teaching in medicine. Yet, this form of case-based teaching is often done poorly. Using qualitative methods of interviews, observations, and recordings of teaching rounds, the author describes three different yet exemplary pedagogical strategies for organizing teaching rounds in general internal medicine. These include: (1) case-bedside teaching that involves case discussion in a conference room followed by demonstrations at the bedside, (2) case-lecture teaching that blends quick reviews of cases with more formal presentations on relevant topics, and (3) case-iterative teaching that involves discovery-learning using complex cases. From these three case studies, five general principles of experiential learning in clinical settings are derived: anchoring instruction in cases, actively involving learners, modeling professional thinking and action, providing direction and feedback, and creating a collaborative learning environment. These three approaches to teaching rounds overcome common problems associated with learning in clinical settings.

Structured experiential learning exercises: a facilitation to more effective learning in clinical settings.

Structured experiential exercises can help to make students more aware of the learning skills required in each of the four phases of experiential learning. These exercises should be structured to increase the trust and communication between the clinical nursing instructor and the students, as well as to assist the students to understand better their own and others' values and group processes. We believe that exercises that fulfill these objectives enable the students to adjust better to the learning styles required in a clinical course. Moreover, students who obtain increased awareness of their own values and those of others may become more effective members of the nursing profession.