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  • 1.
    Kalén, Susanne
    et al.
    Karolinska Institutet.
    Lachmann, Hanna
    Karolinska Institutet / Sophiahemmet Högskola.
    Varttinen, Maria
    Karolinska Institutet.
    Möller, Riitta
    Karolinska Institutet.
    Bexelius, Tomas S
    Karolinska Institutet.
    Ponzer, Sari
    Karolinska Institutet.
    Medical students' experiences of their own professional development during three clinical terms: a prospective follow-up study2017In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 17, no 1, article id 47Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A modern competency-based medical education is well implemented globally, but less is known about how the included learning activities contribute to medical students' professional development. The aim of this study was to explore Swedish medical students' perceptions of the offered learning activities and their experiences of how these activities were connected to their professional development as defined by the CanMEDS framework.

    METHODS: A prospective mixed method questionnaire study during three terms (internal medicine, scientific project, and surgery) in which data were collected by using contextual activity sampling system, i.e., the students were sent a questionnaire via their mobile phones every third week. All 136 medical students in the 6th of 11 terms in the autumn of 2012 were invited to participate. Seventy-four students (54%) filled in all of the required questionnaires (4 per term) for inclusion, the total number of questionnaires being 1335. The questionnaires focused on the students' experiences of learning activities, especially in relation to the CanMEDS Roles, collaboration with others and emotions (positive, negative, optimal experiences, i.e., "flow") related to the studies. The quantitative data was analysed statistically and, for the open-ended questions, manifest inductive content analysis was used.

    RESULTS: Three of the CanMEDs Roles, Medical Expert, Scholar, and Communicator, were most frequently reported while the four others, e.g., the role Health Advocate, were less common. Collaboration with students from other professions was most usual during the 8th term. Positive emotions and experience of "flow" were most often reported during clinical learning activities while the scientific project term was connected with more negative emotions.

    CONCLUSIONS: Our results showed that it is possible, even during clinical courses, to visualise the different areas of professional competence defined in the curriculum and connect these competences to the actual learning activities. Students halfway through their medical education considered the most important learning activities for their professional development to be connected with the Roles of Medical Expert, Scholar, and Communicator. Given that each of the CanMEDS Roles is at least moderately important during undergraduate medical education, the entire spectrum of the Roles should be emphasised and developed during the clinical years.

  • 2.
    Manninen, Katri
    et al.
    Department of Learning, Karolinska Institutet, Informatics, Management and Ethics.
    Welin Henriksson, Elisabet
    Department of Neurobiology, Karolinska Institutet; Care Sciences and Society.
    Scheja, Max
    Department of Education, Stockholm University.
    Silén, Charlotte
    Department of Learning, Karolinska Institutet, Informatics, Management and Ethics.
    Patients' approaches to students' learning at a clinical education ward: an ethnographic study2014In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 14, article id 131Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: It is well known that patients' involvement in health care students' learning is essential and gives students opportunities to experience clinical reasoning and practice clinical skills when interacting with patients. Students encounter patients in different contexts throughout their education. However, looking across the research providing evidence about learning related to patient-student encounters reveals a lack of knowledge about the actual learning process that occurs in encounters between patients and students. The aim of this study was to explore patient-student encounters in relation to students' learning in a patient-centered health-care setting.

    METHODS: An ethnographic approach was used to study the encounters between patients and students. The setting was a clinical education ward for nursing students at a university hospital with eight beds. The study included 10 observations with 11 students and 10 patients. The observer followed one or two students taking care of one patient. During the fieldwork observational and reflective notes were taken. After each observation follow-up interviews were conducted with each patient and student separately. Data were analyzed using an ethnographic approach.

    RESULTS: The most striking results showed that patients took different approaches in the encounters with students. When the students managed to create a good atmosphere and a mutual relationship, the patients were active participants in the students' learning. If the students did not manage to create a good atmosphere, the relationship became one-way and the patients were passive participants, letting the students practice on their bodies but without engaging in a dialogue with the students.

    CONCLUSIONS: Patient-student encounters, at a clinical education ward with a patient-centred pedagogical framework, can develop into either a learning relationship or an attending relationship. A learning relationship is based on a mutual relationship between patients and students resulting in patients actively participating in students' learning and they both experience it as a joint action. An attending relationship is based on a one-way relationship between patients and students resulting in patients passively participating by letting students to practice on their bodies but without engaging in a learning dialogue with the students.

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