scholarly journals Using the CLER Pathways to Excellence to Evaluate the Learning Environments at a Multi-Site Institution

2018 ◽  
Vol 10 (6) ◽  
pp. 683-687
Author(s):  
Maria Aaron ◽  
Philip Shayne ◽  
Erica Brownfield ◽  
Nathan O. Spell ◽  
Jaffar Khan ◽  
...  
Keyword(s):  
Learning Environment ◽  
Learning Environments ◽  
Clinical Training ◽  
Clinical Care ◽  
Evaluation Process ◽  
Audience Response ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Supportive Culture ◽  
Effective Supervision

ABSTRACT Background The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review (CLER) program visits 1 participating site per sponsoring institution. While valuable, feedback on that site does not necessarily generalize to all learning environments where trainees and faculty provide clinical care, and institutions may be missing significant insight and feedback on other clinical learning sites. Objective We explored how the Emory Learning Environment Evaluation process—modeled after CLER—could be used to improve the learning environments at 5 major clinical training sites. Methods Participants were recruited via e-mail. Sites hosted separate 60-minute sessions for medical students, residents and fellows, and faculty. We used the CLER Pathways to Excellence to develop a combination of fixed choice and opened-ended questions deployed via an audience response system and verbal queries. Data were analyzed primarily through descriptive statistics and graphs. Results Across sites, per session, medical student participants ranged from 9–16, residents and fellows ranged 21–30, and faculty ranged 15–29. Learners agreed that sites: (1) provided a supportive culture for requesting supervision (students 100%; residents and fellows 70%–100%), and (2) provided a supportive culture for reporting patient safety events (students 94%–100%; residents and fellows 91%–95%). Only a minority of residents and fellows and faculty agreed that they were educated on how to provide effective supervision (residents and fellows 21%–52%; faculty 45%–64%). Conclusions Data from this process have helped standardize improvement efforts across multiple clinical learning environments within our sponsoring institution.

scholarly journals CORRELATION BETWEEN PERCEPTION ON CLINICAL LEARNING ENVIRONMENTS AND CAREER CHOICE ON CLERKSHIP STUDENTS IN FACULTY OF MEDICINE UNIVERSITAS SEBELAS MARET

2019 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Adinda Kharisma Apriliani ◽  
Eti Poncorini Pamungkasari ◽  
Amandha Boy Timor Randita
Keyword(s):  
Medical Students ◽  
Learning Environment ◽  
Career Choice ◽  
Learning Environments ◽  
Career Choices ◽  
Health Workers ◽  
Observational Research ◽  
Clinical Learning ◽  
Weak Correlation ◽  
Clinical Learning Environment

Background: Needs of health workers, especially general practitioners, relatively high in Indonesia. Career choices among medical students are various, such as general practitioner, specialist, medical researcher, etc. Many factors affect medical students’ career choices, one of them is learning environments. This study aims to prove the correlation between clerkship students’ perceptions of clinical learning environments and their career choices.Methods: This research was an analytical observational research with cross sectional approach. The subjects were clerkship students who underwent clinical rotation. The samples were 178 clerkship students from all departments. They were chosen by probability proportional to size sampling. Every respondent was given career choices questionnaire and PHEEM questionnaire which has analyzed for its validity and reliability with α≥0,6 (α=0,826) and r≥0,30 (r=0,442). The result of this study was analyzed by Chi-square test and followed by Contingency Coefficient with 95% confidence level (α = 0,05). Result: The result showed that students’ perception of clinical learning environment “good but still need improvement” category was nearly the same as “plenty of problems” category. The result on the students’ career choices, most students choose clinical career. There was significant correlation between perception of clinical learning environment and career choices on clerkship students of medical faculty, Sebelas Maret University with p <0,05 (p= 0,018), x2 count (x2=5,625) > x2 table (x2=3,841) and also very weak correlation (C= 0,189).Conclusion: There was very weak correlation between perception of clinical learning environments and career choice on clerkship students. 

Role of the clinical learning environment in preparing new clinicians to engage in quality improvement efforts to eliminate health care disparities

2019 ◽  
Author(s):  
Baretta R Casey ◽  
Marie Chisholm-Burns ◽  
Morgan Passiment ◽  
Robin Wagner ◽  
Laura Riordan ◽  
...  
Keyword(s):  
Health Care ◽  
Learning Environment ◽  
Learning Environments ◽  
Health Care System ◽  
Health Care Disparities ◽  
Care Delivery ◽  
The United States ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Care System

Abstract Purpose The National Collaborative for Improving the Clinical Learning Environment offers guidance to health care leaders for engaging new clinicians in efforts to eliminate health care disparities. Summary To address health care disparities that are pervasive across the United States, individuals at all levels of the health care system need to commit to ensuring equity in care. Engaging new clinicians is a key element of any systems-based approach, as new clinicians will shape the future of health care delivery. Clinical learning environments, or the hospitals, medical centers, and ambulatory care clinics where new clinicians train, have an important role in this process. Efforts may include training in cultural humility and cultural competency, education about the organization’s vulnerable populations, and continuous interprofessional experiential learning through comprehensive, systems-based QI efforts focused on eliminating health care disparities. Conclusion By preparing and supporting new clinicians to engage in systems-based QI efforts to eliminate health care disparities, clinical learning environments are instilling skills and supporting behaviors that clinicians can build throughout their careers—and helping pave the road towards equity throughout the US health care system.

scholarly journals “Back to Bedside”: Residents' and Fellows' Perspectives on Finding Meaning in Work

2017 ◽  
Vol 9 (2) ◽  
pp. 269-273 ◽  
Author(s):  
Dustin M. Hipp ◽  
Kristy L. Rialon ◽  
Kathryn Nevel ◽  
Anai N. Kothari ◽  
LCDR Dinchen A. Jardine
Keyword(s):  
Learning Environment ◽  
Learning Environments ◽  
Clinical Teaching ◽  
Direct Patient Care ◽  
Clinical Learning ◽  
Physician Burnout ◽  
Clinical Learning Environment ◽  
Daily Work ◽  
Meaning In Work ◽  
Multispecialty Group

ABSTRACT Background Physician burnout is common and associated with significant consequences for physicians and patients. One mechanism to combat burnout is to enhance meaning in work. Objective To provide a trainee perspective on how meaning in work can be enhanced in the clinical learning environment through individual, program, and institutional efforts. Methods “Back to Bedside” resulted from an appreciative inquiry exercise by 37 resident and fellow members of the ACGME's Council of Review Committee Residents (CRCR), which was guided by the memoir When Breath Becomes Air by Paul Kalanithi. The exercise was designed to (1) discover current best practices in existing learning environments; (2) dream of ideal ways to enhance meaning in work; (3) design solutions that move toward this optimal environment; and (4) support trainees in operationalizing innovative solutions. Results Back to Bedside consists of 5 themes for how the learning environment can enhance meaning in daily work: (1) more time at the bedside, engaged in direct patient care, dialogue with patients and families, and bedside clinical teaching; (2) a shared sense of teamwork and respect among multidisciplinary health professionals and trainees; (3) decreasing the time spent on nonclinical and administrative responsibilities; (4) a supportive, collegial work environment; and (5) a learning environment conducive to developing clinical mastery and progressive autonomy. Participants identified actions to achieve these goals. Conclusions A national, multispecialty group of trainees developed actionable recommendations for how clinical learning environments can be improved to combat physician burnout by fostering meaning in work. These improvements can be championed by trainees.

scholarly journals A Framework to Guide the Implementation of Best Practice Clinical Learning Environments in Community General Practice: Australia

2021 ◽  
Vol 18 (4) ◽  
pp. 1482
Author(s):  
Belinda O'Sullivan ◽  
Helen Hickson ◽  
Rebecca Kippen ◽  
Donna Cohen ◽  
Phil Cohen ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Learning Environment ◽  
Learning Environments ◽  
Best Practice ◽  
Clinical Learning ◽  
Limited Information ◽  
Clinical Learning Environment ◽  
Liaison Officer ◽  
Starting Point

Clinical education/training is increasingly being expanded to community general practice settings (primary care clinics led by doctors). This plays an important role in developing a skilled “primary-care ready” workforce. However, there is limited information to guide the implementation of high-quality learning environments suitable for the range of general practices and clinical learners they oversee. We aimed to develop a consensus-based framework to address this. A co-design participatory action research method involved working with stakeholders to agree a project plan, collect and interpret data and endorse a final framework. As a starting point, an initial draft framework was adapted from an existing framework, the Best Practice Clinical Learning Environment (BPCLE) Framework. We gathered feedback about this from a national GP Supervisor Liaison Officer Network (SLON) (experienced GP clinical supervisors) during a 90-minute face-to-face focus group. They rated their agreement with the relevance of objectives and elements, advising on clear terminology and rationale for including/excluding various components. The resulting framework was refined and re-tested with the SLON and wider GP educational stakeholders until a final graphically designed version was endorsed. The resulting “GP Clinical Learning Environment” (GPCLE) Framework is applicable for planning and benchmarking best practice learning environments in general practice.

scholarly journals Nursing Students’ Perception of the Clinical Learning Environment

2020 ◽  
Vol 14 (1) ◽  
pp. 174-179
Author(s):  
Kamila Alammar ◽  
Muayyad Ahmad ◽  
Sultanah Almutairi ◽  
Olfat Salem
Keyword(s):  
Nursing Students ◽  
Learning Environment ◽  
Leadership Style ◽  
Clinical Training ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Cross Sectional ◽  
Grade Point

Introduction: Clinical learning environment placements provide opportunities for students to develop their skills, socialize to the profession and bridge the gap between academic and workplace learning. This study was conducted to investigate Saudi nursing students’ perceptions of their clinical learning environment and supervision in the hospital setting. Methods: A sample of 90 final year student nurses completing practicums at a tertiary hospital in Riyadh was included in this cross-sectional study utilizing the Clinical Learning Environment and Supervision plus Nurse Teacher scale. Results: Overall, students perceived their clinical learning environment positively. Among sub-scores, that for the leadership style of ward manager was the highest. Supervision types, nursing-teacher teacher-visit frequency and grade point average positively and significantly impacted student’s perceptions, while university type and practicum duration did not. Conclusion: Students confirmed the ward manager’s leadership style as the most significant influencing their perceptions. However, the nursing teacher’s role had the lowest mean score, suggesting the need for its enhancement and clarification and indicating the need for better communication and collaboration between nursing schools and the clinical training hospital.

scholarly journals The Mismatch Between Perceived and Preferred Expectations of Undergraduate Paramedic Students

2011 ◽  
Author(s):  
Brett Williams ◽  
Ted Brown ◽  
Christian Winship
Keyword(s):  
Learning Environment ◽  
Learning Environments ◽  
Clinical Education ◽  
Response Rate ◽  
Cross Sectional Study ◽  
Clinical Learning ◽  
Practical Skills ◽  
Clinical Learning Environment ◽  
Cross Sectional ◽  
Clinical Placements

Background: Clinical education placements provide the opportunity for students to gain practical skills and apply theoretical knowledge not otherwise available in many instances. Objectives: This research explored how undergraduate paramedic students perceive their clinical placement learning environments. Methods: A prospective cross-sectional study using a paper-based survey, the Clinical Learning Environment Inventory (CLEI), was conducted on undergraduate paramedic students studying at a large Australian university in semester 1, 2010. A total of 190 students were invited to participate in the survey. The CLEI is a standardised tool that contains 84-items and six subscales. Findings: Sixty students completed the CLEI (31% response rate). It was found that on both the actual and preferred CLEI forms, Satisfaction was found to be the most important domain having a mean score of 29.68 (SD+3.81) and 31.37 (SD+4.35) respectively.Individualisation was found to be the least important domain in both the actual and preferred form, with mean scores of 20.93 (SD+3.80) and 24.03 (SD+3.82) respectively. This indicated that paramedic students as a group sensed that theSatisfaction aspect of clinical placements are an integral aspect of their preferred clinical learning environment. Results also indicated that all six subscales were statistically different at the p<0.001 level. Conclusion: There were significant differences in the perceptions of paramedic students actual and preferred clinical learning environments. This provides educators with strategies in promoting positive learning experiences for students.

Development of Clinical Learning Environment Measure in the Undergraduate Medical Program

2018 ◽  
Vol 24 (8) ◽  
pp. 6097-6108
Author(s):  
Ardi Findyartini ◽  
Denita Biyanda Utami
Keyword(s):  
Medical Students ◽  
Pilot Study ◽  
Learning Environment ◽  
Clinical Training ◽  
Psychometric Evaluation ◽  
Individual Treatment ◽  
Clinical Learning ◽  
Undergraduate Medical Students ◽  
Clinical Learning Environment ◽  
Cross Sectional

The quality of clinical training for undergraduate medical students is greatly influenced by the clinical learning environment. To our knowledge, there has been limited measurement of clinical learning environment that utilizes tools considering specific contexts for medical students in Indonesia. Objective: This study aims to develop a questionnaire to evaluate the clinial learning environment of undergraduate medical students in Indonesia. A cross sectional study was conducted with four stages: a. Development of questionnaire items, b. Review of panel experts, c. Pilot study to non-targeted medical students, and d. Administration of the questionnaire to medical students and psychometric evaluation. A qualitative analysis on the experts’ comments was conducted. An exploratory factor analysis (EFA) was also completed. A total of 29 experts provided suggestions on the clarity and relevance of the developed items. Pilot study involved 31 non-targeted medical students. A total of 253 4th and 5th year FMUI undergraduate medical students completed the questionnaire. The EFA suggested 6 components which are perceptions on: 1. Learning opportunities and engagement; 2. Interactions with patients during clinical rotation; 3. Communication and interactions with colleagues and supervisors; 4. Facility and individual treatment; 5. Supervision process; 6. Self-confidence and awareness. A total of 10 items were removed given inadequate loading on to factors and crossloadings. The reliability of the 60 item questionnaire is excellent (Cronbach alpha 0.95). The study has developed and validated a 60 item Indonesian questionnaire to measure undergraduate medical students’ perceptions on their clinical learning environment. The future use is expected to facilitate benchmarking of clinical learning environment for undergraduate medical students in Indonesia.

scholarly journals The relationship between undergraduate nursing students' satisfaction about clinical learning environment and their competency self-efficacy

2019 ◽  
Vol 9 (11) ◽  
pp. 92
Author(s):  
Azza Fathi Ibrahim ◽  
Thoraya Mohamed Abdelaziz ◽  
Dalal Talaat Akel
Keyword(s):  
Nursing Students ◽  
Learning Environment ◽  
Self Efficacy ◽  
Clinical Training ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Undergraduate Nursing Students ◽  
Undergraduate Nursing ◽  
Clinical Nursing ◽  
The Relationship

Competency self-efficacy (CSE) in clinical nursing practice is necessitated to be attained by the undergraduate nursing students. It is a significant indicator of the work's acceptance and commitment to nursing roles. Self-efficacy in nursing experience enhances nursing student's abilities to achieve the clinical tasks independently, mainly in wide range field of care like Medical-Surgical Nursing. Some factors are affecting competency self-efficacy in the clinical nursing practice; the most evident factor is the nursing student’s impressions with their clinical learning environment (CLE). In the light of educational preparation for nursing undergraduates, the Faculties of Nursing emphasize to preserve a high quality of clinical learning environment for clinical nursing essentials. The clinical learning environment has an apparent function in building up students' confidence, and competency self-efficacy, particularly, during clinical skills achievement. The current paper aimed to determine undergraduate nursing student's satisfaction about the clinical learning environment and their competency self-efficacy, and then investigate the relationship between both variables. Thus, the study conducted through a descriptive, correlative research design with all nursing students who enrolled in third and fourth academic semesters (second year) during their clinical training in Medical-Surgical Nursing course, Faculty of Nursing, Alexandria University, Egypt. A triple-section questionnaire was used for data collection: First; nursing student’s sociodemographic profile, Second: Clinical Learning Environment Inventory (CLEI) which was constructed by Chan in 2002. Third: Nursing Competency Self Efficacy Scale (CSES) which was developed by Kennedy in 2013. The results showed that the undergraduate nursing students at Medical-Surgical training, Faculty of Nursing, Alexandria University, have a high satisfaction level about the clinical learning environment concerning all components of the clinical placement. As well, they have a high competency self-efficacy level in all nursing activities and tasks in the clinical training. Further, there is an obvious parallel correlation between nursing student's satisfaction about clinical learning environment and their competency self-efficacy which is significant. Conclusion & Recommendations: Adequate and planned arrangements should be settled in the nursing curricula for the nursing clinical training setting. Too, the clinical instructors should encourage students' trials to do difficult nursing tasks in a successful manner which tends to increase the student's competency self-efficacy. Further researches are required to investigate the factors affecting clinical learning environment satisfaction and competency self-efficacy among nursing students in their clinical placement. Additionally, another research is necessary about; developing an educational program about student's competency self-efficacy to guide nursing instructors in clinical training.

scholarly journals Pursuing Excellence in Clinical Learning Environments

2016 ◽  
Vol 8 (1) ◽  
pp. 124-127 ◽  
Author(s):  
Robin Wagner ◽  
Kevin B. Weiss ◽  
Morgan L. Passiment ◽  
Thomas J. Nasca
Keyword(s):  
Patient Care ◽  
Learning Environments ◽  
Clinical Training ◽  
Improve Patient Care ◽  
Teaching Hospitals ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Learning Collaborative ◽  
Expanding Circle ◽  
Accredited Institutions

ABSTRACT The Accreditation Council for Graduate Medical Education (ACGME) has launched a new shared learning collaborative as part of its larger Clinical Learning Environment Review (CLER) initiative. The collaboration, called Pursuing Excellence in Clinical Learning Environments, aims to improve teaching practices and patient care in the hospitals, medical centers, and ambulatory care sites where residents and fellows pursue their formal clinical training in a specialty or subspecialty. The Pursuing Excellence Initiative (PEI) builds on the 2015 report of findings of the CLER program. These findings demonstrate variability across the nation's teaching hospitals in addressing 6 key focus areas. PEI sets up a shared system of collaborative learning among participating sites of ACGME-accredited institutions, in which early participants share advances that will be disseminated through an expanding circle of other participants. The ACGME will award funding to encourage participation in the first major component of PEI. The goal is to stimulate high-leverage changes that will broadly improve patient care and clinical learning environments across the nation.

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