A model of influences on the clinical learning environment: the case for change at one U.S. medical school

Autor: Latha Chandran, Janet E. Fischel, Howard B. Fleit, Richard J Iuli, Wei-Hsin Lu
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Faculty
Medical
Students
Medical
020205 medical informatics
Whistleblowing
Interprofessional Relations
education
Organizational culture
02 engineering and technology
Education
03 medical and health sciences
Patient safety
0302 clinical medicine
0202 electrical engineering
electronic engineering
information engineering
Medicine
Humans
Learning
030212 general & internal medicine
Program Development
Qualitative Research
Schools
Medical
Medicine(all)
Medical education
business.industry
Learning environment
Professional development
Medical student mistreatment
General Medicine
Institutional leadership
United States
Leadership
Professionalism
Workforce
Needs assessment
Accountability
Clinical learning environment
Harassment
Non-Sexual
business
Professional Misconduct
Needs Assessment
Stress
Psychological
Qualitative research
Research Article
Education
Medical
Undergraduate
Zdroj: BMC Medical Education
ISSN: 1472-6920
Popis: Background The learning environment within a school of medicine influences medical students’ values and their professional development. Despite national requirements to monitor the learning environment, mistreatment of medical students persists. Methods We designed a program called WE SMILE: We can Eradicate Student Mistreatment In the Learning Environment with a vision to enhance trainee and faculty awareness and ultimately eliminate medical student mistreatment. We provide a description of our program and early outcomes. Results The program has enhanced student awareness of what constitutes mistreatment and how to report it. Faculty members are also aware of the formal processes and procedures for review of such incidents. Our proposed model of influences on the learning environment and the clinical workforce informs the quality of trainee education and safety of patient care. Institutional leadership and culture play a prominent role in this model. Our integrated institutional response to learning environment concerns is offered as a strategy to improve policy awareness, reporting and management of student mistreatment concerns. Conclusions Our WE SMILE program was developed to enhance education and awareness of what constitutes mistreatment and to provide multiple pathways for student reporting, with clear responsibilities for review, adjudication and enforcement. The program is demonstrating several signs of early success and is offered as a strategy for other schools to adopt or adapt. We have recognized a delicate balance between preserving student anonymity and informing them of specific actions taken. Providing students and other stakeholders with clear evidence of institutional response and accountability remains a key challenge. Multiple methods of reporting have been advantageous in eliciting information on learning environment infringements. These routes and types of reporting have enhanced our understanding of student perceptions and the specific contexts in which mistreatment occurs, allowing for targeted interventions. A common platform across the healthcare professions to report and review concerns has afforded us opportunities to deal with interprofessional issues in a respectful and trustworthy manner. We offer a model of learning environment influences with leadership and institutional culture at the helm, as a way to frame a comprehensive perspective on this challenging and complex concern. Electronic supplementary material The online version of this article (doi:10.1186/s12909-017-0900-9) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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