How physicians teach in the clinical setting: The embedded roles of teaching and clinical care.

Abstract:

BACKGROUND:Clinical teaching lies at the heart of medical education. However, few studies have explored the embedded nature of teaching and clinical care. The goal of this study was to examine the process of clinical teaching as it naturally, and spontaneously, unfolds in a broad range of authentic contexts with medical students and residents. METHODS:This focused ethnographic study consisted of 160 hours of participant observation and field interviews with three internal medicine teams. Thematic analysis guided data organization and interpretation. FINDINGS:Three overlapping themes emerged: the interconnectedness between clinical work and pedagogy; a multiplicity of teachers; and the influence of space and artifacts on teaching and learning. Clinical teaching, which was deeply embedded in clinical care, was influenced by the acuity of patient problems, learner needs, and the context in which teaching unfolded; it also occurred on a spectrum that included planned, opportunistic, formal, and informal teaching (and learning). CONCLUSIONS:Study findings suggest that clinical teaching, which is marked by an intersection between service and teaching, can be viewed as an example of work-based teaching. They also yield suggestions for the enhancement of clinical teaching in inpatient settings, faculty development, and educational policies that recognize clinical teaching and learning.

journal_name

Med Teach

journal_title

Medical teacher

authors

Steinert Y,Basi M,Nugus P

doi

10.1080/0142159X.2017.1360473

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

1238-1244

issue

12

eissn

0142-159X

issn

1466-187X

journal_volume

39

pub_type

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