Enhancing the Graduate Medical Education Clinical Learning Environment Through Community of Practice Forums.

IF 5.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES
James N Woodruff, Monica B Vela, Wei Wei Lee, John F McConville
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Abstract

Abstract: An optimal clinical learning environment (CLE) is associated with improved learning and patient care outcomes. Significant concerns exist about the state of the CLE in graduate medical education (GME). Research suggests GME programming falls short in interpersonal aspects of training that promote trainee engagement and psychological safety. Furthermore, published educational interventions in the CLE lack adequate theoretical backing to inform a rational approach to interventions in the CLE that could address these important problems.The authors apply the 2002 work of Etienne Wenger on communities of practice (COP) to address these GME CLE concerns. To distinguish this COP intervention from earlier theoretical work on COPs, the authors refer to this management concept as "COP forums." COP forums favorably influence the GME CLE through effects that complement experiential learning in patient care. COP forums support trainee psychological safety, mentorship from near peers, and opportunities to innovate-effects that can serve as a counterbalance to the time pressures, hierarchy, and compliance culture often experienced in the clinical environment. Deliverables of COP forums, including practice innovation and trainee self-efficacy, can favorably impact organization-wide performance and engagement.This article describes the historical position of COP forums in the evolution of COP theory and outlines the basic structure and function of COP forums. It contrasts COP forums to other COP-related concepts to explain their relevance to the GME CLE. Examples of innovative GME COP forums illustrate the structure and function of these interventions. Finally, the authors call for more research on the impact of COP forums on the GME CLE. To avoid confusion, such scholarship must account for the ongoing evolution of the larger COP framework and target specific dimensions of the theory most pertinent to the medical education research question at hand.

通过实践社区论坛改善医学研究生教育临床学习环境。
摘要:最佳的临床学习环境(CLE)与学习和患者护理效果的改善息息相关。医学研究生教育(GME)中的临床学习环境状况令人担忧。研究表明,医学研究生教育计划在促进学员参与和心理安全的人际培训方面存在不足。此外,已发表的 CLE 教育干预措施缺乏足够的理论支持,无法为解决这些重要问题的 CLE 干预措施提供合理的方法。作者运用艾蒂安-温格(Etienne Wenger)2002 年关于实践社区(COP)的研究成果来解决 GME CLE 中的这些问题。为了将这一实践社区干预措施与早期关于实践社区的理论研究区分开来,作者将这一管理概念称为 "实践社区论坛"。COP 论坛通过补充患者护理方面的体验式学习,对 GME CLE 产生有利影响。COP 论坛支持受训者的心理安全、来自同龄人的指导以及创新的机会,这些效果可以平衡临床环境中经常遇到的时间压力、等级制度和遵纪守法文化。COP 论坛的成果,包括实践创新和受训者的自我效能,可以对整个组织的绩效和参与度产生有利影响。本文介绍了 COP 论坛在 COP 理论发展中的历史地位,并概述了 COP 论坛的基本结构和功能。本文将 COP 论坛与其他与 COP 相关的概念进行对比,以解释其与 GME CLE 的相关性。创新型 GME COP 论坛的实例说明了这些干预措施的结构和功能。最后,作者呼吁就 COP 论坛对 GME CLE 的影响开展更多研究。为避免混淆,此类学术研究必须考虑到 COP 大框架的不断演变,并针对与当前医学教育研究问题最相关的理论的具体方面。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Academic Medicine
Academic Medicine 医学-卫生保健
CiteScore
7.80
自引率
9.50%
发文量
982
审稿时长
3-6 weeks
期刊介绍: Academic Medicine, the official peer-reviewed journal of the Association of American Medical Colleges, acts as an international forum for exchanging ideas, information, and strategies to address the significant challenges in academic medicine. The journal covers areas such as research, education, clinical care, community collaboration, and leadership, with a commitment to serving the public interest.
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