Factors adversely affecting student learning in the clinical learning environment: a student perspective

Area of Science:

• Medical Education
• Clinical Learning Environments

Background:

• The clinical environment is integral to medical student training.
• Student learning can be significantly impacted by various factors within this setting.

Purpose of the Study:

• To identify factors, from medical students' viewpoints, that negatively affect their learning in clinical settings.
• To understand student perceptions of weaknesses in clerkship rotations.

Main Methods:

• Medical students completed questionnaires after clerkships (surgery, paediatrics, etc.).
• Evaluations included closed-ended questions on supervision, patient contact, organization, and learning climate.
• Open-ended comments focused on perceived weaknesses, with a specific analysis of sites with low vs. high supervision ratings.

Main Results:

• Key barriers to learning included limited independent patient examination opportunities and insufficient supervision time.
• Other reported weaknesses: lack of observation, inadequate feedback, negative staff attitudes, high student-to-staff ratios, few educational sessions, and poor organization.

Conclusions:

• Effective clerkships require ample opportunities for independent and supervised patient examination.
• Consistent supervision, potentially through assigned mentors, is vital for enhancing the clinical learning experience.