Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Perspectives on Medical Education
Published in: Perspectives on Medical Education 1/2012

Open Access 01-03-2012 | Review Article

Workplace learning

Author: Tim Dornan

Published in: Perspectives on Medical Education | Issue 1/2012

Login to get access

Abstract

This critical review found Dutch research to be strong at the undergraduate and residency levels and more or less absent in continuing medical education. It confirms the importance of coaching medical students, giving constructive feedback, and ensuring practice environments are conducive to learning though it has proved hard to improve them. Residents learn primarily from experiences encountered in the course of clinical work but the fine balance between delivering clinical services and learning can easily be upset by work pressure. More intervention studies are needed. Qualitative research designs need to be more methodologically sophisticated and use a wider range of data sources including direct observation, audio-diaries, and text analysis. Areas for improvement are clear but achieving results will require persistence and patience.
Literature
1.
Flexner A. Medical education in the United States and Canada. A report to the Carnegie foundation for the advancement of teaching. Boston: Updyke; 1910.
2.
Dornan T, Boshuizen H, King N, Scherpbier A. Experience-based learning: a model linking the processes and outcomes of medical students’ workplace learning. Med Educ. 2007;41:84–91.PubMedCrossRef
3.
de Feijter JM, de Grave WS, Dornan T, Koopmans RP, Scherpbier AJJA. Students’ perceptions of patient safety during the transition from undergraduate to postgraduate training: activity theory analysis. Adv Health Sci Educ Theory Pract. 2010. doi:10.​1007/​s10459-010-9266-z.PubMed
4.
Teunissen P, Westerman M. Opportunity or threat; ambiguity in the consequences of transitions in medical education. Med Educ. 2011;45:51–9.PubMedCrossRef
5.
Kennedy TJT, Regehr G, Baker GR, Lingard LA. Progressive independence in clinical training: a tradition worth defending? Acad Med. 2005;80(Suppl):S106–11.PubMedCrossRef
6.
Dornan T, Ashcroft D, Heathfield H, et al. An in depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education. EQUIP study. London: General Medical Council; 2009.
7.
Frank JR, editor. The CanMEDS 2005 physician competency framework. Ottawa: Office of Education, The Royal College of Physicians and Surgeons of Canada; 2005.
8.
Boor K, Scheele F, van der Vleuten CP, Scherpbier AJ, Teunissen PW, Sijtsma K. Psychometric properties of an instrument to measure the clinical learning environment. Med Educ. 2007;41:92–9.PubMedCrossRef
9.
Boor K, Scheele F, van der Vleuten CP, Teunissen PW, den Breejen EM, Scherpbier AJ. How undergraduate clinical learning climates differ: a multi method case study. Med Educ. 2008;42:1029–36.PubMedCrossRef
10.
Boor K, van der Vleuten C, Teunissen P, Scherpbier A, Scheele F. Development and analysis of D-RECT, an instrument measuring residents’ learning climate. Med Teach. 2011;33:820–7.PubMedCrossRef
11.
Dornan T. Self-assessment in CPD: lessons from the UK undergraduate and postgraduate education domains. J Cont Educ Health Prof. 2008;28:32–7.
12.
Wong G, Greenhalgh T, Westhorp G, Pawson R. Realist methods in medical education research: what are they and what can they contribute? Med Educ. 2012;46:89–96.PubMedCrossRef
13.
Dornan T, Tan N, Boshuizen H et al. Experience based learning (eXBL). Realist synthesis of the conditions, processes, and outcomes of medical students’ workplace learning. BEME. 2012; (In peer review).
14.
Remmen R, Denekens J, Scherpbier A, et al. An evaluation study of the didactic quality of clerkships. Med Educ. 2000;34:460–4.PubMedCrossRef
15.
van der Hem-Stokroos HH, Scherpbier AJJA, van der Vleuten CPPM, de Vries H, Haarman HJTHM. How effective is a clerkship as a learning environment. Med Teach. 2001;23:599–604.CrossRef
16.
Dolmans DHJM, Wolfhagen IHAP, Essed GGM, Scherpbier AJJA, van der Vleuten CPM. The impacts of supervision, patient mix, and numbers of students on the effectiveness of clinical rotations. Acad Med. 2002;77:332–5.PubMedCrossRef
17.
van der Hem-Stokroos HH, Daelmans HEM, van der Vleuten CPM, Haarman HJThM, Scherpbier AJJA. A qualitative study of constructive clinical learning experiences. Med Teach. 2003;25:120–6.PubMedCrossRef
18.
van der Hem-Stokroos H, Daelmans H, van der Vleuten C, Haarman H, Scherpbier A. The impact of multifaceted educational structuring on learning effectiveness in a surgical clerkship. Med Educ. 2004;38:879–86.PubMedCrossRef
19.
Mainhard MT, van den Hurk MM, van de Wiel MWJ, Crebolder HFJM, Scherpbier AJJA. Learning in a clinical education programme in primary care: the Maastricht Adoption Programme. Med Educ. 2004;38:1236–43.PubMedCrossRef
20.
Prince KJAH, Boshuizen HPA, van der Vleuten CPM, Scherpbier AJJA. Students’ opinions about their preparation for clinical practice. Med Educ. 2005;39:704–12.PubMedCrossRef
21.
Wimmers PF, Schmidt HG, Splinter TAW. Influence of clerkship experiences on clinical competence. Med Educ. 2006;40:450–8.PubMedCrossRef
22.
Deketelaere A, Kelchtermans G, Struyf E, De Leyn P. Disentangling clinical learning experiences: an exploratory study on the dynamic tensions in internship. Med Educ. 2006;40:908–15.PubMedCrossRef
23.
Daelmans HEM, Overmeer RM, van der Hem-Stokroos HH, Scherpbier AJJA, Stehouwer CDA, van der Vleuten CPM. In-training assessment: qualitative study of effects on supervision and feedback in an undergraduate clinical rotation. Med Educ. 2006;40:51–8.PubMedCrossRef
24.
Cooke M, Irby DM, O’Brien BC. Educating physicians: a call for reform of medical school and residency. Carnegie foundation for the advancement of teaching. San Francisco: Jossey-Bass; 2010.
25.
Teunissen P, Wilkinson T. Learning and teaching in workplaces. In: Mann K, Scherpbier A, Spencer J, Dornan T, editors. Medical education. Theory and practice. Edinburgh: Churchill Livingstone; 2011. p. 193–209.
26.
van der Zwet J, Zwietering PJ, Teunissen PW, van der Vleuten CPM, Scherpbier AJJA. Workplace learning from a socio-cultural perspective: creating developmental space during the general practice clerkship. Adv Health Sci Educ Theory Pract. 2010. doi:10.​1007/​s10459-010-9268-x.PubMed
27.
van der Zwet J, Hanssen VGA, Zwietering PJ, et al. Workplace learning in general practice: supervision, patient mix and independence emerge from the black box once again. Med Teach. 2010;32:e294–9.PubMedCrossRef
28.
Bombeke K, Symons L, Debaene L, de Winter B, Schol S, van Royen P. Help, I’m losing patient-centredness! Experiences of medical students and their teachers. Med Educ. 2010;44:662–73.PubMedCrossRef
29.
Bombeke K, et al. Medical students trained in communication skills show a decline in patient-centred attitudes: an observational study comparing two cohorts during clinical clerkships. Patient Educ Couns. 2011;84:310–8.
30.
van Hell EA, Kuks JBM, Schönrock-Adema J, van Lohuizen MT, Cohen-Schotanus J. Transition to clinical training: influence of pre-clinical knowledge and skills, and consequences for clinical performance. Med Educ. 2008;42:830–7.PubMedCrossRef
31.
van Hell EA, Kuks JBM, Raat J, van Lohuizen MT, Cohen-Schotanus J. Instructiveness of feedback during clerkships: influence of supervisor, observation and student initiative. Med Teach. 2008;31:45–50.CrossRef
32.
van Hell EA, Kuks JBM, Cohen-Schotanus J. Time spent on clerkship activities by students in relation to their perceptions of learning environment quality. Med Educ. 2009;43:674–9.PubMedCrossRef
33.
van Lohuizen MT, Kuks JBM, van Hell EA, Raat AN, Cohen-Schotanus J. Learning strategies during clerkships and their effects on clinical performance. Med Teach. 2009;31:e494–9.PubMedCrossRef
34.
Raat J, Kuks J, Cohen-Schotanus J. Learning in clinical practice: stimulating and discouraging response to social comparison. Med Teach. 2010;32:899–904.PubMedCrossRef
35.
Teunissen PW, Scheele F, Scherpbier AJ, et al. How residents learn: qualitative evidence for the pivotal role of clinical activities. Med Educ. 2007;41:763–70.PubMedCrossRef
36.
van de Wiel MWJ, Van den Bossche P, Janssen S, Jossberger H. Exploring deliberate practice in medicine: how do physicians learn in the workplace? Adv Health Sci Educ Theory Pract. 2011;16:81–95.PubMedCrossRef
37.
Teunissen PW, Boor K, Scherpbier AJ, et al. Attending doctors’ perspectives on how residents learn. Med Educ. 2007;41:1050–8.PubMedCrossRef
38.
Eraut M. Informal learning in the workplace. Stud Contin Educ. 2004;26:247–73.CrossRef
39.
Teunissen PW, Stapel DA, Scheele F, et al. The influence of context on residents’ evaluations: effects of priming on clinical judgment and affect. Adv Health Sci Educ Theory Pract. 2009;14:23–41.PubMedCrossRef
40.
Teunissen PW, Stapel DA, van der Vleuten C, Scherpbier A, Boor K, Scheele F. Who wants feedback? An investigation of the variables influencing residents’ feedback-seeking behavior in relation to night shifts. Acad Med. 2009;84:910–7.PubMedCrossRef
41.
Stok-Koch L, Bolhuis S, Koopmans R. Identifying factors that influence workplace learning in postgraduate medical education. Educ Health. 2007;20:8.
42.
Sheehan D, Wilkinson T, Billett S. Interns’ participation and learning in clinical environments in a New Zealand hospital. Acad Med. 2005;80:302–8.PubMedCrossRef
43.
Pope C, Smith A, Goodwin D, Mort M. Passing on tacit knowledge in anaesthesia: a qualitative study. Med Educ. 2003;37:650–5.PubMedCrossRef
44.
Hoffman KG, Donaldson JF. Contextual tensions of the clinical environment and their influence on teaching and learning. Med Educ. 2004;38:448–54.PubMedCrossRef
Metadata
Title
Workplace learning
Author
Tim Dornan
Publication date
01-03-2012
Publisher
Bohn Stafleu van Loghum
Published in
Perspectives on Medical Education / Issue 1/2012
Print ISSN: 2212-2761
Electronic ISSN: 2212-277X
DOI
https://doi.org/10.1007/s40037-012-0005-4

Other articles of this Issue 1/2012

Perspectives on Medical Education 1/2012 Go to the issue

Review Article

The use of progress testing

Review Article

Perspectives on faculty development: aiming for 6/6 by 2020

Editorial

Opening up our windows to the world

Review Article

Medical education: past, present and future

Book Review

Better, a surgeon’s notes on performance

Health Care and the Arts

The role of poetry and prose in medical education: the pen as mighty as the scalpel?