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| MEDICAL EDUCATION |
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| Year : 2023 | Volume
: 21
| Issue : 2 | Page : 126-128 |
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Advocating workplace learning in medical education
Saurabh RamBihariLal Shrivastava1, Rizki Indah Putri Lubis2
1 Deputy Director – Academics, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Medical Doctor, Master Program in Medical and Health Profession Education, Department of Medical Education, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| Date of Submission | 05-Dec-2022 |
| Date of Decision | 24-Dec-2022 |
| Date of Acceptance | 26-Dec-2022 |
| Date of Web Publication | 07-Apr-2023 |
Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603 108, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/cmi.cmi_128_22
The journey of a medical student during the undergraduate training period is quite challenging as they are expected to become competent in a wide range of attributes which are essential to a future health-care professional. It is quite obvious that considering the complex nature of attributes that a medical student must acquire, we must expose them to a number of learning opportunities, preferably in their workplace settings. Various learning theories have explained the ways, in which a medical student can learn various skills in workplace settings. However, it is the responsibility of the teacher to optimize the learning experience. Workplace learning in the field of medicine carries immense potential and offers a crucial opportunity for teachers to shape the career of medical students, who will be our future health-care providers. To conclude, workplace learning is an indispensable component of the medical curriculum. As we move forward in our global vision to improve the health indicators and quality of life of the members of the community, we have to strengthen workplace learning across all medical institutions worldwide and this will essentially require the support of all the stakeholders.
Keywords: Feedback, reflection, workplace learning
How to cite this article:
Shrivastava SR, Lubis RI. Advocating workplace learning in medical education. Curr Med Issues 2023;21:126-8 |
| Introduction | |  |
The journey of a medical student during the undergraduate training period is quite challenging as they are expected to become competent in a wide range of attributes which are essential to a future health-care professional.[1] It is quite obvious that considering the complex nature of attributes (viz. critical thinking, clinical reasoning, problem-solving, decision-making, professionalism, empathy, compassion, communication, etc.) that a medical student must acquire, we must expose them to a number of learning opportunities, preferably in their workplace settings.[1],[2],[3] In other words, workplace learning plays a defining role in producing a competent medical graduate, and thus it becomes the responsibility of the administrators, curriculum planners, departments, and faculty members to ensure that students are subjected to wide range of learning exposures that they are bound to experience in their future clinical practice.[2],[3],[4]
| Workplace Learning: Application of Learning Theories | | |
In terms of learning theories, workplace learning can be explained using a variety of them. From the perspective of behaviorism, medical students demonstrate their change in behavior (the way they approach patients) based on the stimulus (workplace teaching/teacher/patients) given to them.[5] From the cognitivism perspective, medical students learn about patient care by reducing potential distractions in the workplace and optimizing the process of conversion of working memory to long-term memory.[6] From the constructivist perspective, workplace settings offer students to acquire knowledge by building on their past experiences. With reference to humanism theory, workplace learning provides a unique opportunity for medical students to aim for self-actualization by indulging in self-directed learning.[7]
In addition, from the self-efficacy angle, medical students are empowered to make their individual judgments about their ability to carry out a specific task or activity and thereby in the process attain the desired competencies.[8] From the social cognitive theory, students learn by interacting with their environment (viz. peers, seniors, juniors, patients, and teachers) in the workplace settings. This lays down the ground that students have an ample number of opportunities to learn through peer learning and near-peer learning (from their seniors who have already gone through their stage).[9] In continuation, students learn about the importance and significance of team-based learning, and cooperative learning, which are crucial for long-term memory.[7],[8],[9] Furthermore, exposure to workplace settings also motivates students to learn based on their experiences (experiential learning).[10]
| How Do Students Learn in Their Workplace? | | |
Medical students learn in a number of ways while being at their workplace and thus it is the responsibility of the teacher to optimize the learning experience.[3] As all medical students are adult learners, to optimize and augment their learning, it is quite essential that before the workplace session, specific learning objectives are explicitly specified to the students.[3],[11] This will motivate them to stay focused on their approach and make the learning opportunity relevant and meaningful.[11] Students also will learn from their teachers through role modeling and imbibe the measured approach that their teachers adopt while dealing with different patients. In addition, workplace learning will give an opportunity to the teachers to mentor the students to strengthen their areas of weaknesses and prepare an action plan to attain the set competencies.[11],[12],[13]
We must realize that workplace learning offers a platform for the students to learn from patients (one of the best teachers), and they improve gradually by indulging in the habit of participatory learning.[14] The workplace settings offer an authentic experience to the students that can never be replicated in the classrooms. In fact, the nature of experiences and exposure to which a student gets exposed in the workplace is crucial in the acquisition and refinement of a number of skills.[11],[12] For instance, teaching cardiopulmonary resuscitation (CPR) to medical students in classroom settings in a theory session significantly differs from administering CPR on a manikin, to a real patient inwards, or to a patient in casualty or emergency wards. Each setting offers a unique learning experience to the students and thus workplace learning advocates contextual learning in authentic settings.[3],[14]
During the bedside teaching sessions, while discussing the differential diagnosis based on the complaints and clinical features of the patients, and in an attempt to move toward provisional diagnosis (by ruling out other potential conditions), the medical students learn the art of critical thinking, clinical reasoning, and problem-solving skills.[15] In other words, such workplace exposures prepare medical students to deal with all potential differential diagnoses by adopting the practice of evidence-based medicine.[13],[15] In continuation, workplace learning also instills the thought of self-directed learning among medical students, wherein they take efforts to learn about all the areas that were discussed during the bedside teaching sessions, and in the process, not only widen their knowledge base but also master the art of giving importance to good clinical practices.
Furthermore, students not only get an opportunity to strengthen their intellectual and psychomotor skills but even their affective domain-related skills.[3],[11],[12] The workplace settings offer a platform for students to communicate with the patients, their relatives, batch mates, nursing staff, paramedical staff, etc., and thus they can gradually improvise their communication skills and learn the art of empathy and compassion.[3],[14] In addition, they can also improve themselves in the domain of professionalism and become a better version of their own (of course, it will be also influenced by role modeling).[16],[17] Medical students can also augment and optimize their long-term memory by reflecting upon their clinical interactions at the workplace and this will prove to be a fruitful exercise for them.[13],[14],[15],[16] Finally, the students can also learn immensely from the structured or unstructured constructive and timely feedback that they can receive from different stakeholders in workplace settings.[18] The feedback received from different partners will provide medical students with a comprehensive insight into their performance and thus will aid in the holistic growth of the medical students and their transformation into medical practitioners in the future.[18],[19]
| Strategies to Promote Workplace Learning | | |
Workplace learning in the field of medicine carries immense potential and offers a crucial opportunity for teachers to shape the career of medical students, who will be our future health-care providers.[3] Acknowledging the scope of workplace learning and the multiple ways, in which a medical student can learn in workplace settings, it is extremely vital that specific steps should be taken by medical educators to augment the same.[13],[14] The medical education unit can be actively involved to strengthen the process of clinical teaching by training teachers about strategies to be adopted by teachers to facilitate small group teaching, interactive methods that can be employed to ensure active engagement, the importance of defining specific learning objectives, the principles and ways to give effective constructive feedback, the importance of reflection in medical teaching, and the ways in which it can be implemented among medical students.[18]
Once the teachers are trained about the wide range of teaching–learning attributes that are critical for successful and impactful workplace learning sessions, we can be confident that at least we are on the right track. The next step will be to implement these practices in an organized manner in clinical teaching sessions. Furthermore, we cannot forget that students also have to be a part of the overall process and they have to be informed about all the initiatives and the ways, in which these steps will play a role in making them a better medical practitioner. Obviously, if we are aiming for quality augmentation, the active involvement and support of the administration, the curriculum committee, the head of the department, and the department faculty members are a must. Finally, we have to plan for periodic feedback from both students and teachers to ascertain/identify the best areas and the areas that need improvement in clinical teaching.[19] The aim should be that workplace learning should be acknowledged as a dynamic process, where the impetus should be always on quality improvement.[3],[13]
| Conclusion | | |
Workplace learning is an indispensable component of the medical curriculum. As we move forward in our global vision to improve the health indicators and quality of life of the members of the community, we have to strengthen workplace learning across all medical institutions worldwide and this will essentially require the support of all the stakeholders.
Acknowledgment
This work has been derived as a part of the Master in Medical and Health Professions Education offered by the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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