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Morris TJ, Collins S, Hart J. Informal peer-assisted learning amongst medical students: A qualitative perspective. CLINICAL TEACHER 2024; 21:e13721. [PMID: 38272845 DOI: 10.1111/tct.13721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 11/24/2023] [Indexed: 01/27/2024]
Abstract
PURPOSE Peer-assisted learning (PAL) can occur informally as part of a medical programme and complements the formal curriculum. However, little is known about the mechanisms and processes of how informal peer-assisted learning (IPAL) is enacted. MATERIALS AND METHODS This paper presents data from an ethnographic and semi-structured interview study with Year 1 and 2 undergraduate medical students at a UK university. RESULTS Peers were observed assisting each other informally: a process that developed as part of the integrated, group-based approach to undergraduate medical education at a UK university. IPAL took place both within and outside of formal teaching sessions and included explanation/clarification of particular points, sharing resources, guiding pronunciation and demonstrating skills. Students placed a high value on IPAL and believed that it was beneficial. When IPAL broke down, this led to negative emotions that presented obstacles to learning, such as resentment. CONCLUSIONS IPAL is an important part of academic support for medical students, and this work shows both its scope, extending from formal to informal teaching, and how it is enacted. This understanding can help educators situate IPAL within student education.
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Affiliation(s)
- Timothy J Morris
- School of Medical Sciences, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
- Directorate of Clinical Biochemistry, Manchester University NHS Foundation Trust, Manchester, UK
| | - Sarah Collins
- School of Medical Sciences, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - Joanne Hart
- School of Medical Sciences, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
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Smith LE, McBride ME, Henschen B, Bierman J, Uchida T, Eppich W. Mechanisms of Near-Peer Learning in a Longitudinal Clerkship: A Grounded Theory Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:771-777. [PMID: 38527027 DOI: 10.1097/acm.0000000000005715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
PURPOSE Many medical schools incorporate longitudinal clerkships, which promote continuity and may offer early clinical exposure during the preclinical curriculum. However, the mechanisms of near-peer learning and how it contributes to the development of clinical skills in longitudinal clinical experiences are less clear. The authors explored how peer-to-peer interactions among medical students influenced their developmental trajectories from nascent clinicians to more seasoned practitioners capable of juggling dual roles of clinical care and clinical supervision within longitudinal clerkships. METHOD The Education-Centered Medical Home (ECMH) at Northwestern University Feinberg School of Medicine is a longitudinal clerkship that represents an ideal setting to explore peer learning. At ECMH, continuity is established across all 4 years of medical school among small groups of students from each year, a preceptor, and a panel of outpatients. The authors conducted 6 focus groups and 9 individual interviews between March 2021 and February 2023 with medical students from all years. Using constructivist grounded theory, the authors collected and analyzed data iteratively using constant comparison to identify themes and explore their relationships. RESULTS Within ECMH, peer relationships fostered an informal learning culture that enabled meaningful peer interactions while reinforcing the established culture. The authors identified 3 essential learning practices between senior and junior medical students: preparing for patient encounters, shifting roles dynamically during the joint encounter, and debriefing encounters afterward. These practices strengthened learning relationships and supported students' developmental trajectories. CONCLUSIONS Longitudinal peer learning relationships enabled meaningful peer interaction that influenced medical students' clinical development and capability for clinical supervision. Mutual trust, familiarity, and continuity facilitate targeted feedback practices and growth at the edge of junior students' capabilities. Optimizing this peer learning environment and seeking new opportunities to use longitudinal peer learning in clinical environments could promote psychological safety and professional identity formation for medical students.
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Consorti F, Borcea MC, Melcarne R, Giacomelli L. Peer assisted learning: a meta-ethnographic synthesis of qualitative studies and recommendations for cardiovascular training, practice, and research. Minerva Cardiol Angiol 2024; 72:11-23. [PMID: 37158626 DOI: 10.23736/s2724-5683.23.06265-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Peer assisted learning (PAL) is a common method to complement more traditional teaching. Several systematic reviews and meta-analyses described the most used ways of implementation and showed that it is effective in fostering learning. A synthesis of qualitative data is missing, to highlight the perceived value by the students and to drive a successful implementation. EVIDENCE ACQUISITION The search was performed in Pubmed, Scopus and ERIC databases, with a combination of the search strings. The quality of the retrieved articles was assessed through the Critical Appraisal Skills Checklist. The analysis was performed according to the meta-ethnographic method. Fifteen articles were considered for the analysis, saturation was reached after 12 articles. EVIDENCE SYNTHESIS Three main themes emerged from the analysis: PAL is effective when implemented in a safe environment, PAL is a driver of development of students' abilities and identity, and the "dark side" of PAL. Nine sub-themes emerged as components of the themes. The final line of argument highlighted the ambivalence of PAL, as an expression of the ambivalence of the still developing professional identity of students. CONCLUSIONS This meta-ethnographic synthesis summarizes the elements of success and the threats of PAL, a method that is particularly suitable for the cardiovascular domain. It must be implemented according to some precautions, such as organization and protected time, tutor selection, training and support, a clear integration and endorsement in the framework of the medical curriculum.
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Affiliation(s)
| | - M Carola Borcea
- Department of General and Specialist Surgery, Sapienza University, Rome, Italy
| | - Rossella Melcarne
- Department of General and Specialist Surgery, Sapienza University, Rome, Italy
| | - Laura Giacomelli
- Department of General and Specialist Surgery, Sapienza University, Rome, Italy
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Teekens T, Giardini F, Kirgil ZM, Wittek R. Shared understanding and task-interdependence in nursing interns' collaborative relations: A social network study of vocational health care internships in the Netherlands. J Interprof Care 2023; 37:999-1009. [PMID: 37184374 DOI: 10.1080/13561820.2023.2209123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 04/21/2023] [Accepted: 04/21/2023] [Indexed: 05/16/2023]
Abstract
Shared understanding among collaborators is a key element of delivering successful interprofessional care and a main challenge for professional education concerns nurturing such understanding among students. We assessed how nursing students perceived different levels of shared understanding in their collaborations with others in clinical internships. We analyse the collaborative networks of interns to examine whether individual factors (attitudes, perceptions of collaborative cultures, and motivation) or relational factors among collaborators (task-interdependence, cooperation frequency, and interprofessional and hierarchical roles) affect shared understanding among 150 Dutch nursing interns and their collaborators (n = 865). Theoretically, we stress the importance of focusing on collaborative relations in interprofessional care settings. Multilevel models distinguish two levels in explaining the variation in shared understanding, nesting collaborative relationships within individuals. Results indicate merely 37.4% of found variation of shared understanding could be attributed to individual-level factors (variation between interns), while 62.6% of variation is found within interns, showing that shared understanding differs substantially between the collaborations one intern engages in. Multilevel models reveal that task-interdependence strongly predicts shared understanding in inter- and intraprofessional collaborations. We conclude that focusing on collaborative relations is essential to foster shared understanding in vocational internship programmes, and that health care organisations should pay explicit attention to task-interdependence in interns' collaborations.
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Affiliation(s)
- Thomas Teekens
- Department of Sociology / ICS, Faculty of Behavioural and Social Sciences, University of Groningen
| | - Francesca Giardini
- Department of Sociology / ICS, Faculty of Behavioural and Social Sciences, University of Groningen
| | | | - Rafael Wittek
- Department of Sociology / ICS, Faculty of Behavioural and Social Sciences, University of Groningen
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Joyce J, Cantillon P, Geoghegan R. Peer feedback in graduate training: A phenomenological investigation of possibilities. MEDICAL TEACHER 2022; 44:1362-1367. [PMID: 35793243 DOI: 10.1080/0142159x.2022.2094229] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Whilst feedback is an essential component of clinical education, it is often lacking in clinical workplaces due to competing priorities. Peer feedback has been proposed as a potential solution but remains underexplored in terms of practicality and effects. We aimed to examine the experiences of peer feedback among paediatric trainees, and the associated feedback culture. METHODS Following an Interpretative Phenomenological Analysis approach, the personal experiences of 12 paediatric trainees were explored using semi-structured interviews. Interpretive themes were developed between the transcripts using processes of abstraction, subsumption, contextualisation, and cross-case analysis. Themes were subsequently subjected to member checking and peer debriefing processes. RESULTS We found that peer feedback was influenced by three contextual factors, namely, prevalent feedback culture, interpersonal consent, and the quality of relationships. Peer feedback culture was lacking in clinical workplaces. Feedback between peers was constrained by avoiding criticism and maintaining work relationships. Social and cultural norms inhibited constructive peer feedback without explicit consent. CONCLUSIONS Enabling peer feedback in clinical settings requires attention to cultural, relational, and consent barriers. Potential approaches should include helping clinicians to develop greater cultural reflexivity, resident training in how to be peer educators, and enhancing institutional supports for peer feedback.
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Affiliation(s)
- John Joyce
- Department of Paediatrics, School of Medicine, National University of Ireland, Galway, Ireland
| | - Peter Cantillon
- Discipline of General Practice, National University of Ireland, Galway, Ireland
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Muacevic A, Adler JR. Assessment of Virtual Peer Learning by Peer Feedback: A Pilot Project. Cureus 2022; 14:e30596. [PMID: 36420246 PMCID: PMC9679450 DOI: 10.7759/cureus.30596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Virtual learning has become the preferred modality for health education during and after the coronavirus disease 2019 (COVID-19) pandemic. Peer learning is gaining a lot of significance lately and has been successfully tested in various settings. We combined virtual delivery of health education with peer-assisted learning and evaluated the effectiveness using peer-generated feedback and tested the effectiveness of the model for different cohorts. Methods We performed this study as part of a formal educational course on Health Professions Education. The educators were volunteers from different informal multi-disciplinary groups, working in varied healthcare settings, globally. This involved eight teaching sessions which were delivered virtually and the feedback was recorded as responses to six items (questions), which the learners graded on the Likert scale. The average for each item and the larger domains was then calculated and analyzed. Results The feedback was provided by all the participants (53/53). In the feedback received item-wise, the best average rating was for legibility of the slides (4.8). The least rating was for adequate checking and assessment of prior knowledge (4.2). In terms of the broader domains, the best feedback was for the teaching material (4.6) and the lowest was for the planning of the sessions (4.4). Overall, the ratings for the domains and the items were above 3 on a scale of 1-5. Conclusions Virtual delivery of healthcare education, facilitated by peer-assisted learning, is an effective model for health education when delivered for a small group, as evidenced by the overall peer feedback. This model can be tested for larger cohorts in the future.
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Huang K, Mak D, Hafferty FW, Eva KW. The Advice Given During Near-Peer Interactions Before and After Curriculum Change. TEACHING AND LEARNING IN MEDICINE 2022; 34:351-359. [PMID: 34524067 DOI: 10.1080/10401334.2021.1957685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
PhenomenonNear-peer interactions (NPIs) provide formal and informal mentorship that can allow medical students to share strategies for successful training. Such capacity to convey valuable advice, however, may depend on the similitude of experiences. Given that many factors can disrupt homogeneity, including curriculum renewal, we must better understand whether junior trainees feel disadvantaged when they do not have more senior peers with similar experiences. This study was, therefore, conducted to examine the focus of, and engagement with, advice available through NPIs during curriculum renewal. Approach: We used a generic exploratory qualitative research approach. Twenty MD undergraduate students, seven from the Class of 2019 (the first cohort post-curriculum change), and thirteen from the Class of 2020 (the first cohort with access to more senior students in the new curriculum), participated in semi-structured interviews. Anonymized transcriptions were analyzed with open, axial, and selective coding to generate themes until saturation was attained. Findings: Participants from the Class of 2019 reported having particularly few reasons to seek advice; because curriculum renewal disrupted their near peers' capacity to provide critical insights, students exerted little effort to learn from them. That said, this vacuum was not generally cause for concern. Deeper probing illustrated why: advice given during NPIs in both classes more commonly focused on nonacademic (e.g., work-life balance issues) than academic advice; academic advice, when sought or offered, tended not to be aimed at improving understanding of curriculum dependent content; and, while students in both classes welcomed advice, both were wary of accepting it at face value, precluding a sense of dependence on senior peers. Insights: Students' skepticism about the overall utility of academic advice raises a number of important issues for medical education and training. Positively, it shielded students from feeling loss when advice from similarly trained students was not available, reducing concerns about disadvantage that could arise during periods of curriculum revision. On the other hand, knowing that what students perceive and what educators claim to be important aspects of training can be at odds and knowing that self-assessment is flawed makes it surprising and unsettling, respectively, that participants so readily treated the lessons learned by those who came before them as irrelevant.
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Affiliation(s)
- Kelly Huang
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - David Mak
- Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Frederic W Hafferty
- Division of General Internal Medicine and Program in Professionalism and Values, Mayo Clinic, Rochester, Minnesota, USA
| | - Kevin W Eva
- Education Research and Scholarship, University of British Columbia, Vancouver, British Columbia, Canada
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Björklund K, Stenfors T, Nilsson GH, Leanderson C. Multisource feedback in medical students' workplace learning in primary health care. BMC MEDICAL EDUCATION 2022; 22:401. [PMID: 35614484 PMCID: PMC9134659 DOI: 10.1186/s12909-022-03468-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In medical students' workplace learning, feedback is important for effective learning regarding communication and clinical skills. The provision of multisource feedback (MSF) in clinical practice with focus on the patient's perspective is rarely addressed in the literature. The overall objective was to explore the experience of MSF in medical students' clinical learning in primary healthcare (PHC). METHODS In the study, patients provided feedback by use of the Patient Feedback in Clinical Practice (PFCP) questionnaire. By use of adapted PFCP questionnaire versions peers and clinical supervisors provided feedback and students performed a self-evaluation. The MSF learning activity was evaluated using surveys (4-point Likert scale/open-ended questions), (students (n = 26), peers (n = 9) and clinical supervisors (n = 7)). Data were analysed using descriptive and qualitative content analysis. RESULTS Results (mean 4-point Likert scale) from participants evaluation of the MSF learning activity visualises the value of feedback in terms of patient-centred communication (students 3.50, peers 2.44 and clinical supervisors 3.57), guidance for further training (students 3.14, peers 2.89 and clinical supervisors 3.00) and clarification of pedagogical assignment (students 3.14, peers 2.89 and clinical supervisors 3.00). Thematic analysis of participants' free-text answers in the evaluation surveys resulted in three themes: (1) applicability of the MSF, (2) MSF - collaborative learning process and (3) MSF as a facilitator in students' clinical skills development. The participants experienced that the written MSF provided multi-facetted perspectives, which contributed to students' and peers' clinical and communication learning. MSF experience also enhanced clinical supervisors' feedback regarding communication skills, targeting the supervisors' pedagogical assignment. CONCLUSION Our findings indicate that MSF provided directly after a patient encounter, using the PFCP questionnaire as feedback provider, could be an adequate learning activity for medical students' workplace learning. The MSF, provided through the PFCP questionnaire, was experienced to neutralise and operationalise the provision of concrete feedback, facilitating peers' learning and clinical supervisors' tuition. The results visualise the importance of patients in MSF, as a valuable resource in students' workplace learning. Our study implies that this learning activity could be an applicable tool to facilitate learning and pedagogic development in clinical education in PHC.
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Affiliation(s)
- Karin Björklund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar H Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Leanderson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Ruczynski LI, van de Pol MH, Schouwenberg BJ, Laan RF, Fluit CR. Learning clinical reasoning in the workplace: a student perspective. BMC MEDICAL EDUCATION 2022; 22:19. [PMID: 34991584 PMCID: PMC8740056 DOI: 10.1186/s12909-021-03083-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/13/2021] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Clinical reasoning is a core competency for every physician, as well as one of the most complex skills to learn. This study aims to provide insight into the perspective of learners by asking students about their own experiences with learning clinical reasoning throughout the medical Master's curriculum. METHODS We adopted a constructivist approach to organise three semi-structured focus groups within the Master's curriculum at the medical school of the Radboud University Medical Center in Nijmegen (Netherlands) between August and December 2019. Analysis was performed through template analysis. RESULTS The study included 18 participants who (1) defined and interpreted clinical reasoning, (2) assessed the teaching methods and (3) discussed how they used their context in order to learn and perform clinical reasoning during their clinical rotations. They referred to a variety of contexts, including the clinical environment and various actors within it (e.g. supervisors, peers and patients). CONCLUSION With regard to the process by which medical students learn clinical reasoning in practice, this study stresses the importance of integrating context into the clinical reasoning process and the manner in which it is learnt. The full incorporation of the benefits of dialogue with the practice of clinical reasoning will require additional attention to educational interventions that empower students to (1) start conversations with their supervisors; (2) increase their engagement in peer and patient learning; (3) recognise bias and copy patterns in their learning process; and (4) embrace and propagate their role as boundary crossers.
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Affiliation(s)
- Larissa Ia Ruczynski
- Research on Learning and Education, Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands.
| | - Marjolein Hj van de Pol
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bas Jjw Schouwenberg
- Department of Pharmacology and Toxicology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Roland Fjm Laan
- Research on Learning and Education, Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Cornelia Rmg Fluit
- Research on Learning and Education, Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
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Dyar A, Stenfors T, Lachmann H, Kiessling A. What about the supervisor? Clinical supervisors' role in student nurses' peer learning: A phenomenographic study. MEDICAL EDUCATION 2021; 55:713-723. [PMID: 33325543 PMCID: PMC8246972 DOI: 10.1111/medu.14436] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Peer learning is increasingly used for healthcare students in the clinical setting. However, as peer learning between students involves students taking a teaching role, it is unclear what the supervisor's role then becomes. It is vital to determine the role of the supervisor in student peer learning to ensure high quality learning and patient safety. METHODS Semi-structured interviews were performed with 15 student nurse supervisors (nurses and assistant nurses) from two hospital wards that practice peer learning to investigate the different ways clinical supervisors view their role in students' peer learning. Transcribed data were coded and analysed using a phenomenographic approach. RESULTS Four hierarchical levels of the supervisor's understanding of their role in students' peer learning were identified: the teacher; the facilitator; the stimulator; and the team player. These categories represent an increasingly inclusive view of which people present on the ward play a role in enabling effective peer learning. CONCLUSIONS The various understandings of supervisor roles have implications for how supervision of peer learning could be implemented in the future.
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Affiliation(s)
- Anna Dyar
- Department of Clinical Sciences Danderyd HospitalKarolinska InstitutetStockholmSweden
| | - Terese Stenfors
- Department of Learning, Informatics and EthicsKarolinska InstitutetStockholmSweden
| | - Hanna Lachmann
- Department of Learning, Informatics and EthicsKarolinska InstitutetStockholmSweden
- The Swedish Red Cross University CollegeStockholmSweden
| | - Anna Kiessling
- Department of Clinical Sciences Danderyd HospitalKarolinska InstitutetStockholmSweden
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Markowski M, Bower H, Essex R, Yearley C. Peer learning and collaborative placement models in health care: a systematic review and qualitative synthesis of the literature. J Clin Nurs 2021; 30:1519-1541. [PMID: 33461240 DOI: 10.1111/jocn.15661] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/09/2020] [Accepted: 01/08/2021] [Indexed: 01/18/2023]
Abstract
AIMS To summarise the international empirical literature to provide a comprehensive overview of peer learning and collaborative practice placement models in health care and to synthesise their benefits and challenges. BACKGROUND Practical placements for students are in high demand due to the need for an increased nursing, midwifery and health professional workforce, thus collaborative placement models are an attractive solution to potentially increase placement capacity and enhance the student learning experience. DESIGN A systematic search of the literature and qualitative data synthesis using the PRISMA checklist and ENTREQ guidelines. REVIEW METHODS MEDLINE and CINAHL searched in March 2020. Quality appraisal of studies conducted. Collaborative models and empirical findings summarised. Reported benefits, challenges and implementation recommendations synthesised. Two tables developed for data representation. RESULTS 172 studies were identified by the search strategy. Of these, 47 articles were included for appraisal and synthesis. 30 articles employed qualitative, seven quantitative and ten mixed-methods approaches. Research took place in eight countries. The majority of studies employed focus groups, interviews as well as questionnaire design. The total participant sample was 3462 consisting of students and educators. CONCLUSIONS This review confirmed that any peer learning is beneficial in supporting students' confidence and team working skills. It is especially helpful when pairing first year with third-year students. The latter can demonstrate their clinical skills and prepare for working in practice. Simultaneously, expert-led learning is important for role modelling and for the recognition of acquired skills. Evidence on the optimal placement experience is inconclusive; however, it can be concluded that any form of collaborative placement model requires careful planning and continuous preparation for staff and students. RELEVANCE TO CLINICAL PRACTICE Decision makers should consider implementing at least some form of peer learning to assist students with peer support, and ideally work towards a collaborative learning environment.
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Affiliation(s)
- Marianne Markowski
- School of Health Sciences and the Institute for Lifecourse Development, Faculty of Education, Health & Human Sciences, University of Greenwich, London, UK
| | - Heather Bower
- Faculty of Education, Health & Human Sciences, University of Greenwich, London, UK
| | - Ryan Essex
- Institute for Lifecourse Development, Faculty of Education, Health & Human Sciences, University of Greenwich, London, UK
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Atherley AEN, Nimmon L, Teunissen PW, Dolmans D, Hegazi I, Hu W. Students' social networks are diverse, dynamic and deliberate when transitioning to clinical training. MEDICAL EDUCATION 2021; 55:376-386. [PMID: 32955741 PMCID: PMC7984257 DOI: 10.1111/medu.14382] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 05/15/2023]
Abstract
CONTEXT Transitions in medical education are dynamic, emotional and complex yet, unavoidable. Relationships matter, especially in times of transition. Using qualitative, social network research methods, we explored social relationships and social support as medical students transitioned from pre-clinical to clinical training. METHODS Eight medical students completed a social network map during a semi-structured interview within two weeks of beginning their clinical clerkships (T0 ) and then again four months later (T1 ). They indicated meaningful interactions that influenced their transition from pre-clinical to clinical training and discussed how these relationshipsimpacted their transition. We conducted mixed-methods analysis on this data. RESULTS At T0 , eight participants described the influence of 128 people in their social support networks; this marginally increased to 134 at T1 . People from within and beyond the clinical space made up participants' social networks. As new relationships were created (eg with peers and doctors), old relationships were kept (eg with doctors and family) or dissolved over time (eg with near-peers and nurses). Participants deliberately created, kept or dissolved relationships over time dependent on whether they provided emotional support (eg they could trust them) or instrumental support (eg they provided academic guidance). CONCLUSIONS This is the first social networks analysis paper to explore social networks in transitioning students in medicine. We found that undergraduate medical students' social support networks were diverse, dynamic and deliberate as they transitioned to clerkships. Participants created and kept relationships with those they trusted and who provided emotional or instrumental support and dissolved relationships that did not provide these functions.
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Affiliation(s)
- Anique E. N. Atherley
- Faculty of Health, Medicine and Life SciencesSchool of Health Professions Education (SHE)Maastricht UniversityMaastrichtThe Netherlands
- School of MedicineUniversity of Western SydneyPenrithNSWAustralia
| | - Laura Nimmon
- Faculty of MedicineCentre for Health Education Scholarship (CHES)University of British ColumbiaVancouverBCCanada
| | - Pim W. Teunissen
- Faculty of Health, Medicine and Life SciencesSchool of Health Professions Education (SHE)Maastricht UniversityMaastrichtThe Netherlands
- Department of Obstetrics and GynaecologyVU University Medical CentreAmsterdamThe Netherlands
| | - Diana Dolmans
- Faculty of Health, Medicine and Life SciencesSchool of Health Professions Education (SHE)Maastricht UniversityMaastrichtThe Netherlands
| | - Iman Hegazi
- School of MedicineUniversity of Western SydneyPenrithNSWAustralia
| | - Wendy Hu
- School of MedicineUniversity of Western SydneyPenrithNSWAustralia
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Martin J, Kam J, Aziz S. Coffee & Cases: Peer learning in prehospital care. CLINICAL TEACHER 2021; 18:370-371. [PMID: 33415830 DOI: 10.1111/tct.13326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Joyce Kam
- GKT School of Medicine, King's College London, London, UK
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Hansen TB, Pape B, Thiesen PS, Jakobsen F. Interprofessional versus uniprofessional dyad learning for medical students in a clinical setting. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:191-200. [PMID: 32986616 PMCID: PMC7882129 DOI: 10.5116/ijme.5f50.bc76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The aim of the present study was to explore and compare medical students' perceived learning outcomes when treating patients under supervision in two different learning settings: a uniprofessional or an interprofessional dyad. METHODS The design of the study is a qualitative interview study. Data were collected from October 2016 to June 2017 via semi-structured group interviews performed at the end of the clinical placement in an orthopaedic outpatient clinic for medical students in the last semester of the curriculum. In the placement, the students worked by turns in either a uniprofessional dyad with two medical students or an interprofessional dyad with a nursing student. The data from the interviews were analysed using Systematic Text Analysis. RESULTS Overall, 21 students were interviewed. The students appreciated the authenticity of dealing with real patient problems. Both dyads provided the possibility of working as a professional, but the interprofessional dyad had a more authentic setting. In both dyads, the students' interdependence and mutual support promoted the acquisition of knowledge and skills. Working in the interprofessional dyad facilitated relationships between the professions, and the medical students became aware of some of their own profession's strengths and weaknesses. The interprofessional collaboration contributed to different perspectives on the patients' course of treatment and led to a more holistic understanding of the treatment. CONCLUSIONS Interprofessional dyads have the potential to improve learning outcomes in the clinical training of medical students. Further studies are needed to explore the benefits across medical specialities and settings.
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Affiliation(s)
- Torben Bæk Hansen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
| | - Britta Pape
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
| | - Pernille Staal Thiesen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
| | - Flemming Jakobsen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
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O’Regan S, Molloy E, Watterson L, Nestel D. ‘It is a different type of learning’. A survey-based study on how simulation educators see and construct observer roles. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 7:230-238. [DOI: 10.1136/bmjstel-2020-000634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/21/2020] [Indexed: 11/03/2022]
Abstract
BackgroundSimulation is reported as an appropriate replacement for a significant number of clinical hours in pregraduate programmes. To increase access for learners, educators have looked to understanding and improving learning in observer roles. Studies report equivalent learning outcomes and less stress in observer roles. However, reports on the prevalence, use and perceived value of observer roles from the educator’s perspective are lacking.MethodsAn exploratory survey for Australian and New Zealand (ANZ) simulation educators based on literature findings was developed and piloted with a small sample (n=10) of like subjects for language, clarity, skip logic and completion time. The final survey comprised 36 questions. Quantitative data were analysed using Pearson’s chi-squared test, Welch’s ANOVA and exploratory factor analysis. Select qualitative data were analysed using content analysis and summarised with frequency counts and categorisation.ResultsTwo hundred and sixty-seven surveys were completed, with 221 meeting criteria for analysis. The observer role is widely used in ANZ and most learners experience both hands-on and observer roles. The location of observers is dependent upon several factors including facility design, learner immersion, scenario design and observer involvement. Verbal briefings and/or other guides are provided to 89% of observers to direct their focus and 98% participate in the debrief. Educators value observer roles but tend to believe the best learning is hands-on.ConclusionsThe learning in observer roles is less valued by educators than hands-on roles. Focused observation provides opportunities for noticing and attributing meaning, an essential skill for clinical practice. Learning spaces require consideration of scenario design and learning objectives. Scenario design should include objectives for observer roles and incorporate the observer into all phases of simulation. Attention to these areas will help promote the value of the different type of learning available in observer roles.
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Keren D, Lockyer J, Kelly M, Chick N, Ellaway RH. In Our Own Time: Medical Students' Informal Social Studying and Learning. TEACHING AND LEARNING IN MEDICINE 2020; 32:353-361. [PMID: 32174177 DOI: 10.1080/10401334.2020.1733579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Phenomenon: Social studying and learning (SSL) is any independent, elective, self-directed and self-organized approach to learning that involves students working with their peers for the purposes of study, learning, or revision. While in-class collaborative learning has been relatively well-explored, very little is known about how medical students engage in informal SSL or about the impacts it can have. The purpose of this study was to explore medical students' practices and perceptions regarding SSL, and the ways in which this shaped their overall learning experiences. Approach: A constructivist grounded theory study was conducted at the University of Calgary. Data were collected from 23 semi-structured student interviews, which were audio recorded and transcribed. Data were analyzed using iterative data collection, memo-ing, and focused coding. Findings: Despite SSL being a common part of students' medical school experience and something that was promoted by academic advisors, how students actually engaged with SSL varied substantially, including who made use of SSL, how they made use of it, the size and focus of SSL groups, how these groups functioned, and what individuals sought to get out of them. Some students found SSL helped them to be more efficient and focused in their studying, while others benefited from comparing their knowledge and skills with those of their peers. Not everyone benefited, as some students found SSL stressful, unproductive, or socially uncomfortable. While student engagement in SSL was an enabler of academic success for some it could also be an indicator of social isolation and low self-esteem for others. Insights: Understanding how SSL can influence student experiences has the potential to inform students how and why they might engage in SSL, and it can help educators better support their students, particularly in those schools that actively encourage SSL.
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Affiliation(s)
- Daniela Keren
- Department of Family Medicine, Schulich School of Medicine and Dentistry, London, Canada
| | - Jocelyn Lockyer
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Martina Kelly
- Department of Family Medicine and Community Health Sciences, University of Calgary, Calgary, Canada
| | - Nancy Chick
- Endeavor Foundation Center for Faculty Development, Rollins College, Winter Park, Florida, USA
| | - Rachel H Ellaway
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
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Chou CL, Kalet A, Costa MJ, Cleland J, Winston K. Guidelines: The dos, don'ts and don't knows of remediation in medical education. PERSPECTIVES ON MEDICAL EDUCATION 2019; 8:322-338. [PMID: 31696439 PMCID: PMC6904411 DOI: 10.1007/s40037-019-00544-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
INTRODUCTION Two developing forces have achieved prominence in medical education: the advent of competency-based assessments and a growing commitment to expand access to medicine for a broader range of learners with a wider array of preparation. Remediation is intended to support all learners to achieve sufficient competence. Therefore, it is timely to provide practical guidelines for remediation in medical education that clarify best practices, practices to avoid, and areas requiring further research, in order to guide work with both individual struggling learners and development of training program policies. METHODS Collectively, we generated an initial list of Do's, Don'ts, and Don't Knows for remediation in medical education, which was then iteratively refined through discussions and additional evidence-gathering. The final guidelines were then graded for the strength of the evidence by consensus. RESULTS We present 26 guidelines: two groupings of Do's (systems-level interventions and recommendations for individual learners), along with short lists of Don'ts and Don't Knows, and our interpretation of the strength of current evidence for each guideline. CONCLUSIONS Remediation is a high-stakes, highly complex process involving learners, faculty, systems, and societal factors. Our synthesis resulted in a list of guidelines that summarize the current state of educational theory and empirical evidence that can improve remediation processes at individual and institutional levels. Important unanswered questions remain; ongoing research can further improve remediation practices to ensure the appropriate support for learners, institutions, and society.
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Affiliation(s)
- Calvin L Chou
- Department of Medicine, University of California and Veterans Affairs Healthcare System, San Francisco, CA, USA.
| | - Adina Kalet
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Manuel Joao Costa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Minho, Portugal
| | - Jennifer Cleland
- Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen, Aberdeen, UK
| | - Kalman Winston
- Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
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Stenberg M, Bengtsson M, Mangrio E, Carlson E. Preceptors' experiences of using structured learning activities as part of the peer learning model: A qualitative study. Nurse Educ Pract 2019; 42:102668. [PMID: 31778874 DOI: 10.1016/j.nepr.2019.102668] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 09/01/2019] [Accepted: 11/09/2019] [Indexed: 11/29/2022]
Abstract
The clinical environment is a vital component of nurse education, constantly changing due to constraints of the current health care systems such as increasing number of students and a limited number of preceptors. Peer learning, is gaining momentum as an educational model highly suitable for clinical placements. The peer learning model incorporates structured learning activities that support student activity, but little is reported of the actual structure and content of those activities. Thereby, the aim of this study was to explore precepting nurses' experience of using structured learning activities as part of the peer learning model during clinical placement. We used a qualitative research approach, using two open self-administered global questions. The result is based on the analysis of the written responses from 62 preceptors. Four categories followed the analysis: An opportunity for collaboration, An occasion for reflection, A new educational structure, and Recommendations for development. The preceptors perceived the structured learning activities as beneficial for increased collaboration and reflection among students. Moreover, utilizing the structured learning activities was perceived to be time saving for the preceptors, however this is an area where further research is needed.
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Affiliation(s)
- Marie Stenberg
- Department of Care Science, Malmö University, SE 205 06, Sweden.
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Callese T, Strowd R, Navarro B, Rosenberg I, Waasdorp Hurtado C, Tai J, Riddle JM, Cianciolo AT. Conversation Starter: Advancing the Theory of Peer-Assisted Learning. TEACHING AND LEARNING IN MEDICINE 2019; 31:7-16. [PMID: 30663897 DOI: 10.1080/10401334.2018.1550855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This Conversation Starter article uses four selected abstracts, one each from the four regional Association of American Medical Colleges (AAMC) Group on Educational Affairs (CGEA) 2018 spring meetings, as a springboard for unpacking the definition of peer-assisted learning (PAL). The aim of this article is to prompt deeper reflection on this phenomenon and, in so doing, to foster scholarly program evaluation of this widely adopted instructional approach. This analysis calls for a more nuanced definition of PAL, one that emphasizes process over structure, one that stimulates examination of "doing" PAL and how this affects the personal and professional development of all involved.
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Affiliation(s)
- Tyler Callese
- a Wake Forest School of Medicine , Winston-Salem , North Carolina , USA
| | - Roy Strowd
- b Neurology and Oncology , Wake Forest School of Medicine , Winston-Salem , North Carolina , USA
| | | | - Ilene Rosenberg
- d Department of Medical Sciences , Frank H. Netter MD School of Medicine at Quinnipiac University , Hamden , Connecticut , USA
| | | | - Joanna Tai
- f Centre for Research in Assessment and Digital Learning , Deakin University , Geelong , Victoria , Australia
| | - Janet M Riddle
- g Department of Medical Education , University of Illinois at Chicago College of Medicine , Chicago , Illinois , USA
| | - Anna T Cianciolo
- h Department of Medical Education , Southern Illinois University School of Medicine , Springfield , Illinois , USA
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Eriksson AL, Wallerstedt SM. Developing confidence in basic prescribing skills during medical school: a longitudinal questionnaire study investigating the effects of a modified clinical pharmacology course. Eur J Clin Pharmacol 2018; 74:1343-1349. [PMID: 29955909 PMCID: PMC6132548 DOI: 10.1007/s00228-018-2508-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 06/21/2018] [Indexed: 10/29/2022]
Abstract
PURPOSE To investigate if increased focus on pharmacotherapy during medical school can increase students' confidence in basic prescribing skills, that is, performing medication reviews and writing medication discharge summaries. METHODS In 2016, the clinical pharmacology course in medical school in Gothenburg, Sweden, was modified to facilitate the students' acquisition of prescribing skills, with (i) clarified learning outcomes; (ii) supply of a list of common drugs for self-completion; (iii) instructions to practice medication reviews/discharge summaries during the ward-based education; and (iv) a concluding compulsory seminar where the students were to present prescribing-related experiences from their ward-based attendance. Questionnaires were administered to students participating in the course before (2016; n = 101) and after (2017; n = 137) implementation of the modifications. Students were asked to grade their agreement from 1 (totally disagree) to 5 (totally agree) on statements related to their perceived confidence in basic prescribing skills. RESULTS In all, 195 students returned the questionnaire (response rate 82%; median age 24 years; 68% female). Confidence was rated higher after the modifications were implemented, both regarding medication reviews and medication discharge summaries, after vs. before 3.6 ± 1.2 vs. 3.2 ± 1.0 (P = 0.024), and 4.3 ± 0.9 vs. 3.9 ± 1.1 (P = 0.008), respectively. The adjusted odds for being confident in performing these tasks were 1.49/1.36 times greater after the course modifications (P = 0.047/0.019). Perceived confidence in performing medication reviews/summary reports was positively correlated with numbers performed (P < 0.0001). CONCLUSIONS Modifications of the clinical pharmacology course during medical school, focusing on students' training in pharmacotherapy, was associated with increased confidence of this core skill for a physician.
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Affiliation(s)
- Anna L Eriksson
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden.
- Department of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Susanna M Wallerstedt
- Department of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Chen LYC, Hubinette MM. Exploring the role of classroom-based learning in professional identity formation of family practice residents using the experiences, trajectories, and reifications framework. MEDICAL TEACHER 2017; 39:876-882. [PMID: 28440097 DOI: 10.1080/0142159x.2017.1317729] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Classroom-based learning such as academic half day has undervalued social aspects. We sought to explore its role in the professional identity development of family medicine residents. METHODS In this case study, residents and faculty from four training sites in the University of British Columbia Department of Family Practice were interviewed. The "experiences, trajectories, and reifications (ETR) framework" was used as a sensitizing tool for modified inductive (thematic) analysis of the transcripts. RESULTS Classroom-based learning provided a different context for residents' interpretation of their clinical experiences, characterized as a "home base" for rotating urban residents, and a connection to a larger academic community for residents in rural training sites. Both these aspects were important in creating a positive trajectory of professional identity formation. Teaching directed at the learning needs of family physicians, and participation of family practice faculty as teachers and role models was a precipitation of a curriculum "centered in family medicine." Interactions between family medicine residents and faculty in the classroom facilitated the necessary engagements to reify a shared understanding of the discipline of family practice. CONCLUSIONS Classroom-based learning has substantial impact on professional identity formation at an individual and collective level.
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Affiliation(s)
- Luke Y C Chen
- a Division of Hematology , University of British Columbia , Vancouver , Canada
| | - Maria M Hubinette
- b Family Practice , University of British Columbia , Vancouver , Canada
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Chou CL, Teherani A. A Foundation for Vital Academic and Social Support in Clerkships: Learning Through Peer Continuity. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:951-955. [PMID: 28353506 DOI: 10.1097/acm.0000000000001661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Most medical students on clerkships currently experience lack of continuity of patient care, disjointed learning, and frequent changes in supervisors. Clerkship programs with continuity of care, curriculum, and supervisors appear to benefit student learning and patient-centeredness. A fourth form of continuity is proposed: continuity of peers, in which a stable cohort of students frequently meets to process their experiences on clerkships. This structure builds on benefits previously seen in peer-assisted learning, including enhanced knowledge, technical skills, and collegial peer relationships. Additional advantages of peer continuity in clerkships include facilitated integration into the workplace, social support, and enhanced clinical and professional learning. Practical components required for a successful peer continuity structure include intentional formation of peer cohorts; regular meetings that cover didactic or clinical skills learning; frequent opportunities for reflection on patient care, professional development, and well-being; and skilled facilitators without evaluative roles. Theoretical support for peer continuity comes from social cognitive theory, communities of clinical practice, and social comparison theory. Therefore, in conjunction with empirical programs that have shown benefits of developing these structures, peer continuity should become a formalized educational structure in clerkships.
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Affiliation(s)
- Calvin L Chou
- C.L. Chou is professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California. A. Teherani is professor, Department of Medicine, and education researcher, Center for Faculty Educators, University of California, San Francisco, School of Medicine, San Francisco, California
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Tai JHM, Canny BJ, Haines TP, Molloy EK. Implementing Peer Learning in Clinical Education: A Framework to Address Challenges In the "Real World". TEACHING AND LEARNING IN MEDICINE 2017; 29:162-172. [PMID: 27997224 DOI: 10.1080/10401334.2016.1247000] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Phenomenon: Peer learning has many benefits and can assist students in gaining the educational skills required in future years when they become teachers themselves. Peer learning may be particularly useful in clinical learning environments, where students report feeling marginalized, overwhelmed, and unsupported. Educational interventions often fail in the workplace environment, as they are often conceived in the "ideal" rather than the complex, messy real world. This work sought to explore barriers and facilitators to implementing peer learning activities in a clinical curriculum. APPROACH Previous peer learning research results and a matrix of empirically derived peer learning activities were presented to local clinical education experts to generate discussion around the realities of implementing such activities. Potential barriers and limitations of and strategies for implementing peer learning in clinical education were the focus of the individual interviews. FINDINGS Thematic analysis of the data identified three key considerations for real-world implementation of peer learning: culture, epistemic authority, and the primacy of patient-centered care. Strategies for peer learning implementation were also developed from themes within the data, focusing on developing a culture of safety in which peer learning could be undertaken, engaging both educators and students, and establishing expectations for the use of peer learning. Insights: This study identified considerations and strategies for the implementation of peer learning activities, which took into account both educator and student roles. Reported challenges were reflective of those identified within the literature. The resultant framework may aid others in anticipating implementation challenges. Further work is required to test the framework's application in other contexts and its effect on learner outcomes.
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Affiliation(s)
- Joanna Hong Meng Tai
- a Centre for Research in Assessment and Digital Learning , Deakin University , Geelong , Victoria , Australia
- b Faculty of Medicine , Nursing and Health Sciences, Monash University , Melbourne , Victoria , Australia
| | - Benedict J Canny
- b Faculty of Medicine , Nursing and Health Sciences, Monash University , Melbourne , Victoria , Australia
- c School of Medicine , University of Tasmania , Hobart , Tasmania , Australia
| | - Terry P Haines
- b Faculty of Medicine , Nursing and Health Sciences, Monash University , Melbourne , Victoria , Australia
- d Allied Health Research Unit , Monash Health , Melbourne , Victoria , Australia
| | - Elizabeth K Molloy
- b Faculty of Medicine , Nursing and Health Sciences, Monash University , Melbourne , Victoria , Australia
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