L.D. Gruppen is professor, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: http://orcid.org/0000-0002-2107-012. D.M. Irby is professor emeritus, Department of Medicine, University of California, San Francisco, San Francisco, California. S.J. Durning is professor, Department of Medicine, and director, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland. L.A. Maggio is associate professor, Department of Medicine, and associate director, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: http://orcid.org/0000-0002-2997-6133.
Acad Med. 2019 Jul;94(7):969-974. doi: 10.1097/ACM.0000000000002702.
The learning environment (LE) is an important and frequently discussed topic in the health professions education literature. However, there is considerable inconsistency in how the LE is defined and described. The authors propose a definition of the LE and a conceptual framework to facilitate health professions educators in understanding, studying, and designing interventions to improve the LE. To arrive at this conceptual framework, the authors employed a living systems perspective that draws on various frameworks and theories, including ecological psychology, workplace learning, situated cognition, and sociomateriality theory. The conceptual framework identifies five overlapping and interactive core components that form two dimensions: the psychosocial dimension and material dimension. The psychosocial dimension comprises three components: the personal, social, and organizational. Intertwined with the psychosocial dimension at each level is the material dimension, which encompasses physical and virtual spaces. This theoretical lens can facilitate identifying and analyzing problems in the LE and guide development of interventions to mitigate them. The authors conclude with several practical suggestions for health professions educators, investigators, and editors.
学习环境（LE）是健康专业教育文献中经常讨论的一个重要话题。然而，学习环境的定义和描述存在相当大的不一致。作者提出了学习环境的定义和概念框架，以帮助健康专业教育者理解、研究和设计干预措施，以改善学习环境。为了形成这个概念框架，作者采用了一种生命系统的视角，借鉴了各种框架和理论，包括生态心理学、工作场所学习、情境认知和社会物质性理论。该概念框架确定了五个重叠和互动的核心组成部分，形成了两个维度：心理社会维度和物质维度。心理社会维度包括三个组成部分：个人、社会和组织。在每个层面上与心理社会维度交织在一起的是物质维度，包括物理和虚拟空间。这个理论视角可以帮助识别和分析学习环境中的问题，并指导干预措施的制定以减轻这些问题。作者最后为健康专业教育者、研究者和编辑提出了一些实际建议。
