Article

Empirical evidence for symbiotic medical education: a comparative analysis of community and tertiary-based programmes

Flinders University Rural Clinical School, Flinders University, Adelaide, South Australia, Australia.
Medical Education (Impact Factor: 3.62). 03/2006; 40(2):109-16. DOI: 10.1111/j.1365-2929.2005.02366.x
Source: PubMed

ABSTRACT Flinders University has developed the Parallel Rural Community Curriculum (PRCC), a full year clinical curriculum based in rural general practice in South Australia. The examination performance of students on this course has been shown to be higher than that of their tertiary hospital-based peers.
To compare the learning experiences of students in the community-based programme with those of students in the tertiary hospital in order to explain these improved academic outcomes.
A case study was undertaken, using an interpretivist perspective, with 3 structured interviews carried out over 2 academic years with each of 6 students from the community-based programme and 16 students from the tertiary hospital. The taped interviews were transcribed and analysed thematically using NUD*IST software.
The community-based programme was successful in immersing the students in the clinical environment in a meaningful way. Four key themes were found in the data. These represented clear differences between the experiences of the community-based and hospital-based students. These differences involved: the value that students perceived they were given by supervising doctors and their patients; the extent to which the student's presence realised a synergy between the work of the university and the health service; opportunities for students to meet the aspirations of both the community and government policy, and opportunities for students to learn how professional expectations can mesh with their own personal values.
This study has provided empirical evidence for the importance of the concept of symbiosis in understanding quality in medical education.

0 Followers
 · 
113 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Hidden curriculum literature suggests that different learning environments and curricular designs reinforce disparate values and behaviors. Aim: This study explores potential differences in learning environments afforded by two clerkship models through perceptions of the ideal student. Methods: In this qualitative study, research assistants interviewed 48 third-year students and 26 clinical supervisors from three US medical schools. Students and supervisors participated in longitudinal integrated clerkships (LICs) or block clerkships. Students and supervisors described the ideal student in their clerkship. Using phenomenographic techniques, authors identified five ideal student profiles and coded students’ and supervisors’ descriptions for alignment with one or more profiles. Results: Most students in both models described an ideal student who matched a learner profile (proactive and self-directed). More LIC students described an ideal student who fit a caregiver profile (engaging with and advocating for patients) and more block students described performer (appearing knowledgeable and competent) and team-player (working well with others) profiles. Supervisors’ descriptions paralleled students’ descriptions but with less emphasis on caregiving. Conclusions: Ideal student descriptions in LIC and block models may reflect different learning experiences and values emphasized in each model. These findings suggest implications for students’ construction of professional identities that warrant further exploration.
    Medical Teacher 04/2015; · 2.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hidden curriculum literature suggests that different learning environments and curricular designs reinforce disparate values and behaviors. This study explores potential differences in learning environments afforded by two clerkship models through perceptions of the ideal student. In this qualitative study, research assistants interviewed 48 third-year students and 26 clinical supervisors from three US medical schools. Students and supervisors participated in longitudinal integrated clerkships (LICs) or block clerkships. Students and supervisors described the ideal student in their clerkship. Using phenomenographic techniques, authors identified five ideal student profiles and coded students' and supervisors' descriptions for alignment with one or more profiles. Most students in both models described an ideal student who matched a learner profile (proactive and self-directed). More LIC students described an ideal student who fit a caregiver profile (engaging with and advocating for patients) and more block students described performer (appearing knowledgeable and competent) and team-player (working well with others) profiles. Supervisors' descriptions paralleled students' descriptions but with less emphasis on caregiving. Ideal student descriptions in LIC and block models may reflect different learning experiences and values emphasized in each model. These findings suggest implications for students' construction of professional identities that warrant further exploration.
    Medical Teacher 04/2015; DOI:10.3109/0142159X.2015.1033390 · 2.05 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Particularly when undertaken on a large scale, implementing innovation in higher education poses many challenges. Sustaining the innovation requires early adoption of a coherent implementation strategy. Using an example from clinical education, this article describes a process used to implement a large-scale innovation with the intent of achieving sustainability.Desire to improve the effectiveness of undergraduate medical education has led to growing support for a longitudinal integrated clerkship (LIC) model. This involves a move away from the traditional clerkship of `block rotations¿ with frequent changes in disciplines, to a focus upon clerkships with longer duration and opportunity for students to build sustained relationships with supervisors, mentors, colleagues and patients. A growing number of medical schools have adopted the LIC model for a small percentage of their students. At a time when increasing medical school numbers and class sizes are leading to competition for clinical supervisors it is however a daunting challenge to provide a longitudinal clerkship for an entire medical school class. This challenge is presented to illustrate the strategy used to implement sustainable large scale innovation.What was doneA strategy to implement and build a sustainable longitudinal integrated community-based clerkship experience for all students was derived from a framework arising from Roberto and Levesque¿s research in business. The framework¿s four core processes: chartering, learning, mobilising and realigning, provided guidance in preparing and rolling out the `whole of class¿ innovation.DiscussionRoberto and Levesque¿s framework proved useful for identifying the foundations of the implementation strategy, with special emphasis on the relationship building required to implement such an ambitious initiative. Although this was innovation in a new School it required change within the school, wider university and health community. Challenges encountered included some resistance to moving away from traditional hospital-centred education, initial student concern, resource limitations, workforce shortage and potential burnout of the innovators.SummaryLarge-scale innovations in medical education may productively draw upon research from other disciplines for guidance on how to lay the foundations for successfully achieving sustainability.
    BMC Medical Education 01/2015; 15(1):2. DOI:10.1186/s12909-014-0282-1 · 1.41 Impact Factor

Full-text (2 Sources)

Download
68 Downloads
Available from
Jun 5, 2014