a Department of Pediatrics and Child Health , University of Manitoba , Winnipeg, Manitoba , Canada.
b Department of Medicine and Centre for Medical Education , McGill University , Montreal , Quebec , Canada.
Med Teach. 2019 Apr;41(4):391-397. doi: 10.1080/0142159X.2019.1566602. Epub 2019 Apr 22.
This perspective is part of a series of articles that are outcomes of a consensus conference, that seek to offer a comprehensive examination of the clinical learning environment (CLE), using different academic disciplines and areas of focus termed "avenues." The education dimensions of the CLE are discussed in detail in this perspective, along with critical linkages to the other avenues. Using iterative presentations, discussion and small group work, in October 2018, the consensus conference participants explored the education, psychological, sociocultural, diversity and inclusion, digital and architectural aspects of the CLE. The education avenue of the CLE includes elements of teaching and learning such as the curriculum, clinical experiences, the assessment system, educational program governance, trainee selection, faculty development, and program evaluation and improvement. Within the educational domain, we focus on organizational and personal/social aspects of the CLE, including (1) curriculum design and deployment, including placement of trainees in clinical settings, organizational culture, practices and policies, and accreditation and regulatory requirements from the organizational domain (2) the education system, including assessment, program evaluation and organization and governance; and (3) elements from the personal and social domains, including peer-to-peer, trainee-faculty, and trainee-patient relationships that influence how and what postgraduate trainees learn, trainee selection, informal and hidden curricula, and trainees' perceptions of their learning environment. We provide suggestions for further research and recommendations for addressing challenges and facilitating improvement in the educational aspects of the CLE, along with actionable practice points.
本观点是一系列文章的一部分，这些文章是共识会议的成果，旨在使用不同的学术学科和关注领域（称为“途径”），对临床学习环境（CLE）进行全面检查。本观点详细讨论了 CLE 的教育维度，并与其他途径建立了关键联系。在 2018 年 10 月，共识会议的参与者通过迭代呈现、讨论和小组工作，探讨了 CLE 的教育、心理、社会文化、多样性和包容性、数字和建筑方面。CLE 的教育途径包括教学和学习的要素，如课程、临床经验、评估系统、教育计划治理、学员选拔、教师发展以及计划评估和改进。在教育领域，我们专注于 CLE 的组织和个人/社会方面，包括（1）课程设计和部署，包括将学员安置在临床环境中、组织文化、实践和政策，以及来自组织领域的认证和监管要求；（2）教育系统，包括评估、课程评估和组织与治理；以及（3）个人和社会领域的要素，包括同伴、学员与教师、学员与患者之间的关系，这些关系影响研究生学员的学习方式和内容、学员选拔、非正式和隐性课程，以及学员对学习环境的看法。我们提供了进一步研究的建议和解决 CLE 教育方面挑战并促进改进的建议，以及可行的实践要点。
