von Pressentin Klaus B, Waggie Firdouza, Conradie Hoffie
Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Interdisciplinary Teaching and Learning Unit, Faculty of Community and Health Sciences, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa.
BMC Med Educ. 2016 Mar 8;16:82. doi: 10.1186/s12909-016-0607-3.
The introduction of Stellenbosch University's Longitudinal Integrated Clerkship (LIC) model as part of the undergraduate medical curriculum offers a unique and exciting training model to develop generalist doctors for the changing South African health landscape. At one of these LIC sites, the need for an improvement of the local learning experience became evident. This paper explores how to identify and implement a tailored teaching and learning intervention to improve workplace-based learning for LIC students.
A participatory action research approach was used in a co-operative inquiry group (ten participants), consisting of the students, clinician educators and researchers, who met over a period of 5 months. Through a cyclical process of action and reflection this group identified a teaching intervention.
The results demonstrate the gaps and challenges identified when implementing a LIC model of medical education. A structured learning programme for the final 6 weeks of the students' placement at the district hospital was designed by the co-operative inquiry group as an agreed intervention. The post-intervention group reflection highlighted a need to create a structured programme in the spirit of local collaboration and learning across disciplines. The results also enhance our understanding of both students and clinician educators' perceptions of this new model of workplace-based training.
This paper provides practical strategies to enhance teaching and learning in a new educational context. These strategies illuminate three paradigm shifts: (1) from the traditional medical education approach towards a transformative learning approach advocated for the 21(st) century health professional; (2) from the teaching hospital context to the district hospital context; and (3) from block-based teaching towards a longitudinal integrated learning model. A programme based on balancing structured and tailored learning activities is recommended in order to address the local learning needs of students in the LIC model. We recommend that action learning sets should be developed at these LIC sites, where the relevant aspects of work-place based learning are negotiated.
作为本科医学课程的一部分，斯泰伦博斯大学纵向整合实习（LIC）模式的引入，为培养适应南非不断变化的卫生格局的全科医生提供了一种独特且令人兴奋的培训模式。在其中一个LIC实习地点，改善当地学习体验的需求变得显而易见。本文探讨了如何识别并实施针对性的教学干预措施，以改善LIC学生基于工作场所的学习。
在一个由学生、临床教育工作者和研究人员组成的合作探究小组（十名参与者）中采用了参与式行动研究方法，该小组在五个月的时间里进行了会面。通过行动与反思的循环过程，该小组确定了一项教学干预措施。
结果展示了在实施医学教育的LIC模式时所发现的差距和挑战。合作探究小组设计了一个针对学生在地区医院实习最后六周的结构化学习计划，作为商定的干预措施。干预后小组的反思强调，需要本着当地合作和跨学科学习的精神创建一个结构化计划。这些结果还增进了我们对学生和临床教育工作者对这种新的基于工作场所培训模式看法的理解。
本文提供了在新的教育背景下加强教学的实用策略。这些策略阐明了三个范式转变：（1）从传统医学教育方法转向为21世纪卫生专业人员倡导的变革性学习方法；（2）从教学医院背景转向地区医院背景；（3）从基于模块的教学转向纵向整合学习模式。建议制定一个基于平衡结构化和针对性学习活动的计划，以满足LIC模式下学生的当地学习需求。我们建议在这些LIC实习地点开展行动学习小组，在那里就基于工作场所学习的相关方面进行协商。
