Exploring Medical Students' Learning Through Interprofessional Interactions in Clinical Clerkships: A Qualitative...

Medical students need help navigating clinical environments to find ways to engage in and learn from clinical work. Previous explorations focused on how physicians help students, largely neglecting the potential contributions of other health professionals (OHPs). This study explores how students learn to participate in clinical work through interactions with OHPs.

Using a constructivist grounded theory approach, researchers conducted 17 semistructured interviews with Harvard Medical School students completing clinical clerkships between 2023 and 2024. Students drew rich pictures of interprofessional interactions, which they described in the interviews. Interview data were iteratively collected and analyzed to generate a conceptual understanding of learning mechanisms and outcomes in interprofessional interactions. The landscapes of practice framework provided a sensitizing model.

Students described interprofessional interactions as entering unfamiliar territory and sought to make sense of what these interactions could tell them about how to act and interact in clinical environments. To address their initial confusion, students relied on intraprofessional lore-knowledge about OHPs verbally shared by peers and physicians. As students had experiences with OHPs, students engaged in sense making by interpreting their own and others' reactions and reconciling expectations with experience. Through these interactions, students learned to meaningfully participate by developing competence within the physician role and understanding of the roles, boundaries, and relevant expertise of other professions. This learning could be hampered by the interceding influence of intraprofessional lore or difficulties interpreting reactions of OHPs.

By interacting with OHPs, students learned to participate in clinical work by clarifying how to effectively accomplish the work of a physician as well as the roles and relevant expertise of OHPs. Educators can extract more learning from these interactions by creating mechanisms for students to reflect with OHPs in clerkships and by attending to how physicians and students talk about other professions.