Department of medical education, Medical educational research center, Isfahan University of Medical Science, Isfahan, Iran.
School of Medical Science, Islamic Azad university of Tonekabon branch, Tonekabon, Iran.
BMC Med Educ. 2019 Jul 31;19(1):292. doi: 10.1186/s12909-019-1719-3.
An essential characteristics of clinical education is the need to learn a large number of practical and communication skills along with theoretical knowledge. It is challenging to design learning opportunities (LOs) for clinical setting. We aimed to determine optimal learning opportunities from the viewpoint of Medical curriculum planners, to determine the gap between the current condition and the optimal condition in medical schools, and to present feasible tactic for clinical learning opportunities.
This study comprised of three sub-studies and was conducted using triangulation. The first sub-study was performed using the Modified Delphi method with a view to identifying optimal learning opportunities. Data was collected by online focus group discussion and a questionnaire. The second sub-study was conducted with the aim of comparing the current condition and the optimal condition. Data was collected from nine medical schools across Iran using a checklist, available documents, observation, and interview. The third sub-study was conducted using an expert panel comprising of seven curriculum planners of the M.D.
The goal of this phase was to provide feasible tactic to improve clinical education in medical schools.
In the first sub-study, the participants determined all items, including student-centered learning, non-threatening learning environment, and record and management system of clinical learning opportunities as implementable learning opportunities with over 70% consensus. However, in the second sub-study, student-centered teaching methods were practiced in 33% of medical schools and the non-threatening learning environment in 67% of the schools, while the record and management system of learning opportunities was not launched in any of the schools. From the viewpoint of the expert panel members, learning opportunities adapted to clinical contents, specification of content-based learning opportunities, and continuous supervision on learners to achieve the expected learning outcomes were among clinical learning opportunities with over 70% consensus.
Student-centered clinical learning practices, together with virtual learning methods, can lead to clinical enhancement. Opportunities such as interactive and participatory practices should gain further consideration. Also assigning responsibility to learners and monitoring them are strategies for enhancement.
临床教育的一个重要特点是需要学习大量的实践和沟通技能以及理论知识。为临床环境设计学习机会（LO）具有挑战性。我们旨在从医学课程规划者的角度确定最佳学习机会，确定医学院校现状与最佳状态之间的差距，并为临床学习机会提出可行的策略。
本研究包括三项子研究，并使用三角测量法进行。第一项子研究使用改良 Delphi 法确定最佳学习机会。通过在线焦点小组讨论和问卷收集数据。第二项子研究旨在比较现状和最佳状态。使用清单、可用文件、观察和访谈从伊朗九所医学院收集数据。第三项子研究使用由七名医学博士课程规划者组成的专家小组进行。
这一阶段的目标是提供可行的策略来改善医学院的临床教育。
在第一项子研究中，参与者确定了所有项目，包括以学生为中心的学习、无威胁的学习环境以及临床学习机会的记录和管理系统，这些都是可实施的学习机会，达成了超过 70%的共识。然而，在第二项子研究中，以学生为中心的教学方法在 33%的医学院中实施，无威胁的学习环境在 67%的学校中实施，而学习机会的记录和管理系统在任何学校都没有启动。从专家小组成员的角度来看，适应临床内容的学习机会、指定基于内容的学习机会以及对学习者进行持续监督以实现预期学习成果的学习机会是具有超过 70%共识的临床学习机会。
以学生为中心的临床学习实践，加上虚拟学习方法，可以促进临床教学的提升。应该进一步考虑互动式和参与式实践等机会。此外，赋予学习者责任并对其进行监督也是提高学习效果的策略。
