Teaching and Learning in the Hospital Ward

Medical Education, 2004

Medical Education, 2003

Objective To describe the perceptions of medical students and clinical teachers of teaching and learning in the clinical setting.

The Clinical Teacher

BackgroundWhile ward rounds offer a rich opportunity for learning, the environment is chaotic, and medical students can struggle to maximise this potential. Few studies have focused on the best way to equip students for ward round learning. One proposed tool developed to orient students' learning on the ward round is called the Seek, Target, Inspect and reflect, Closure and clerk (STIC) model. This study examines the effect of using this model on the student experience of ward round learning.MethodsSeven medical students with clinical attachments on medical wards in two rural hospitals in New South Wales, Australia, participated in three sequential focus groups over an 8‐week period. Students were asked about learning practices on ward rounds, what factors influenced their learning and how using the STIC model impacted on their experience. Thematic analysis was applied to focus group transcripts.FindingsStudents valued learning opportunities from ward rounds but felt the learnin...

GMS Zeitschrift für medizinische Ausbildung, 2014

Learning on the ward as a practice-oriented preparation for the future workplace plays a crucial role in the medical education of future physicians. However, students' ward internship is partially problematic due to condensed workflows on the ward and the high workload of supervising physicians. For the first time in a German-speaking setting, students' expectations and concerns about their internship on the ward are examined in a qualitative analysis regarding their internal medicine rotation within clinical medical education. Of a total of 168 medical students in their 6th semester at the Medical Faculty of Heidelberg, 28 students (m=8, f=20, Ø 23.6 years) took part in focus group interviews 3 to 5 days prior to their internship on the internal medicine ward within their clinical internal medicine rotation. Students were divided into four different focus groups. The protocols were transcribed and a content analysis was conducted based on grounded theory. We gathered a tota...

South Sudan Medical Journal

Participation in clinical practice is key to the development of clinical skills, and so the goal of clinical work is both to deliver healthcare and facilitate learning. Four factors shape learning in the workplace: safe access to practical experience; the role of talk in the workplace; teaching opportunities; and the learning climate. The challenge is to structure and carry out work so that support for learning is built into normal work routines.

Advances in Health Sciences Education, 2014

This paper explores and contrasts undergraduate medical and nursing students' experiences of the clinical learning environment. Using a sociocultural perspective of learning and an interpretative approach, 15 in-depth interviews with medical and nursing students were analysed with content analysis. Students' experiences are described using a framework of 'before', 'during' and 'after' clinical placements. Three major themes emerged from the analysis, contrasting the medical and nursing students' experiences of the clinical learning environment: (1) expectations of the placement; (2) relationship with the supervisor; and (3) focus of learning. The findings offer an increased understanding of how medical and nursing students learn in the clinical setting; they also show that the clinical learning environment contributes to the socialisation process of students not only into their future profession, but also into their role as learners. Differences between the two professions should be taken into consideration when designing interprofessional learning activities. Also, the findings can be used as a tool for clinical supervisors in the reflection on how student learning in the clinical learning environment can be improved.

BMC Medical Education, 2014

Background: It is well known that patients' involvement in health care students' learning is essential and gives students opportunities to experience clinical reasoning and practice clinical skills when interacting with patients. Students encounter patients in different contexts throughout their education. However, looking across the research providing evidence about learning related to patient-student encounters reveals a lack of knowledge about the actual learning process that occurs in encounters between patients and students. The aim of this study was to explore patient-student encounters in relation to students' learning in a patient-centered health-care setting. Methods: An ethnographic approach was used to study the encounters between patients and students. The setting was a clinical education ward for nursing students at a university hospital with eight beds. The study included 10 observations with 11 students and 10 patients. The observer followed one or two students taking care of one patient. During the fieldwork observational and reflective notes were taken. After each observation follow-up interviews were conducted with each patient and student separately. Data were analyzed using an ethnographic approach. Results: The most striking results showed that patients took different approaches in the encounters with students. When the students managed to create a good atmosphere and a mutual relationship, the patients were active participants in the students' learning. If the students did not manage to create a good atmosphere, the relationship became one-way and the patients were passive participants, letting the students practice on their bodies but without engaging in a dialogue with the students. Conclusions: Patient-student encounters, at a clinical education ward with a patient-centred pedagogical framework, can develop into either a learning relationship or an attending relationship. A learning relationship is based on a mutual relationship between patients and students resulting in patients actively participating in students' learning and they both experience it as a joint action. An attending relationship is based on a one-way relationship between patients and students resulting in patients passively participating by letting students to practice on their bodies but without engaging in a learning dialogue with the students.

Studies in Higher Education, 2017

Through an exploration of the interdependence between workplace affordances and individual engagement, this study addressed how medical students interact with clinical learning environments (CLEs). Building on the workplace participatory practices approach outlined by Billett, CLEs can be viewed as constructed through a negotiation of meaning between the workplace and the student. Inspired by ethnography, an observational study using field observations and followup interviews was performed. Workplace affordances included being given a marginal status in the healthcare team which students adapted to through striving to fit into the workplace. Further, there were many potential activities available to students; however, students seemed selective in terms of what activities they elected to engage in. As such, interacting with CLEs entailed students navigating complexity without the immediate access to any explicit 'map' of workplace learning. This study indicates that workplaces increasingly need to invite and include students in the practice of workplaces.

Advanced Biomedical Research, 2014

Background: Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members' experience on Ward Round Teaching content. Methods and Materials: This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9). Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation. Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability) were employed (Guba and Lincoln). Results: Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1) tangible teachings (analytic intelligence, technical intelligence, legal duties) and (2) implied teachings (professionalism, professional discipline, professional difficulties). Conclusion: Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.