Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Fleit HB

PROVIDER: S-EPMC5364543 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Fleit Howard B HB Iuli Richard J RJ Fischel Janet E JE Lu Wei-Hsin WH Chandran Latha L

BMC medical education 20170323 1

<h4>Background</h4>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.<h4>Methods</h4>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 des ...[more]

PMID: 28335770

Similar Datasets

Project description:ImportanceBurnout is a highly prevalent issue among medical trainees, but there has been limited research characterizing burnout specifically among medical students from groups who are underrepresented in medicine (URIM).ObjectiveTo assess the association between components of the medical school learning environment and burnout among medical students who are URIM vs those who are not.Design, setting, and participantsThis retrospective cross-sectional survey study evaluated responses of allopathic medical students graduating from all US allopathic medical schools in 2016 and 2017 to the American Medical Colleges Graduation Questionnaire. Analysis was completed between December 1, 2019, and July 1, 2020.ExposuresSelf-identification as a medical student who is URIM.Main outcomes and measuresSelf-reported measures of medical student overall, disengagement, and exhaustion-related burnout using the Oldenburg Burnout Inventory for Medical Students.ResultsThe American Medical Colleges Graduation Questionnaire had an 81% response rate, yielding 26 567 complete participant responses that were included the analysis. A total of 13 645 individuals (51.4%) were male, and 3947 (14.9%) identified as URIM (ie, Alaska Native, Black, Hispanic/Latinx, Native American, and/or Pacific Islander). Medical students who are URIM reported modestly higher levels of exhaustion-related burnout (mean [SD], 11.84 [3.62] vs 11.48 [3.61]; P < .001) and modestly lower mean burnout scores associated with disengagement (mean [SD], 9.24 [3.56] vs 9.36 [3.58]; P = .047). Medical students who are URIM also reported marginally less favorable student-faculty interactions in the learning environment (mean [SD], 14.09 [3.45] vs 14.29 [3.35]; P < .001). Medical students who are URIM were more likely to be in the top quartile of those who experienced exhaustion-related burnout (odds ratio, 1.19 [95% CI, 1.09-1.29]) but less likely to be in the top quartile for disengagement (odds ratio, 0.87 [95% CI, 0.80-0.94]). Regardless of URIM status, those who reported learning environment scores in the bottom quartile were more likely to experience higher rates of burnout as were those who experienced at least 1 episode of discrimination.Conclusions and relevanceThis survey study found that medical students who are URIM had a higher risk for exhaustion-related burnout. This burnout is likely multifactorial and could represent a resiliency or survival bias, the burden of increased responsibility, and/or recurrent discrimination. The learning environment can play a key role in mitigating burnout in both medical students who are URIM and those who are not and is deserving of further research.

Project description:INTRODUCTION:The effectiveness of medical school efforts in addressing suboptimal student wellbeing rests, in part, on how students perceive their learning environment. The study aim was to determine whether students' sport background was a contributing factor in students' perceptions of the medical program as supportive of their basic psychological needs for autonomy, competence, and relatedness. We also examined the relationship between sport background and students' leisure-time exercise in medical school. METHODS:Using an online questionnaire, quantitative data were collected from students enrolled in the 4?year medical program at a large Canadian university. Two hundred (n?=?200) students had complete responses on the measures used in the study. Analysis of variance and correlational analysis were used to examine the relationships between students' sport background, their perceptions of the learning environment, and leisure-time exercise in medical school. RESULTS:Compared with students with no sport background, students with a team sport background perceived their need for relatedness to be satisfied to a greater degree in the medical program. Students who pursued sports at higher levels of involvement (competitively) perceived the medical program as more autonomy-supportive than students who pursued sports at lower levels of involvement (recreationally). Irrespective of their sport background, students' involvement in leisure-time exercise decreased over the years in the medical program. However, students with a sport background engaged in leisure-time exercise in medical school to a greater extent than students with no sport background. DISCUSSION:The findings indicate that sport background is associated with students' perceptions of the learning environment as supportive of their needs for autonomy and relatedness, but not for competence, and is linked to their leisure-time exercise in medical school. The observed relationships could help inform medical schools curricular initiatives in preventing student burnout right from the start of medical school.

Dataset Information

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

Background

Methods

Results

Conclusions

Publications

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

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets