Hamoen Esther C, van Blankenstein Floris M, de Jong Peter G M, Reinders Marlies E J
Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands.
PLoS One. 2025 Jan 14;20(1):e0316858. doi: 10.1371/journal.pone.0316858. eCollection 2025.
Clinical workplace learning is often suboptimal due to the dynamics of the clinical learning environment and several challenges encountered in clinical practice. At LUMC, clinical teachers introduced a novel blended learning program that included both the introduction of a Clinical Teaching Unit (CTU) and Small Private Online Course (SPOC). This study aimed to analyze the educational content and design of our educational interventions, by categorizing and comparing the dimensions of the learning program before and after the interventions. The novel blended learning program was integrated into a clerkship internal medicine, aiming to optimize clerks' clinical workplace learning. Therefore, a traditional inpatient ward was transformed into a CTU, featuring the introduction of learning activities that promoted multidisciplinary and interprofessional learning. It included an integrated SPOC, aiming to improve clinical reasoning skills, feedback and collaboration of the clerks. The authors analyzed the clerkships' content and design, by categorizing the social-epistemological dimensions of the teaching modes offered before (traditional clerkship) and after (including CTU and SPOC) the intervention. These dimensions consisted of individual versus group (collaborative), and objectivist versus constructive learning categories. The CTU model added eleven group activities to the clinical workplace, of which nine were characterized as constructivist-group activities. It also led to more active learning of the clerks, compared to the traditional clerkship. Analysis of the SPOC revealed 344 teaching modes in total, which included 113 objectivist-individual, 205 constructive-individual and 23 constructive-group activities. Compared to a traditional clerkship, the CTU with SPOC led to more constructivist and collaborative learning and a more diverse educational program. This study illustrates a methodology to address active and collaborative learning activities in an educational program, and offers tools to evaluate and redesign one's teaching program. The methods and models described can be applied to clinical environments in other areas of medicine.
由于临床学习环境的动态性以及临床实践中遇到的一些挑战，临床工作场所学习往往不尽人意。在莱顿大学医学中心（LUMC），临床教师引入了一种新颖的混合式学习项目，该项目包括设立临床教学单元（CTU）和小型私人在线课程（SPOC）。本研究旨在通过对干预前后学习项目的维度进行分类和比较，分析我们教育干预措施的教育内容和设计。这个新颖的混合式学习项目被整合到内科实习中，旨在优化实习生的临床工作场所学习。因此，一个传统的住院病房被改造成了一个临床教学单元，引入了促进多学科和跨专业学习的学习活动。它包括一个综合的小型私人在线课程，旨在提高实习生的临床推理能力、反馈能力和协作能力。作者通过对干预前（传统实习）和干预后（包括临床教学单元和小型私人在线课程）所提供教学模式的社会认识论维度进行分类，分析了实习的内容和设计。这些维度包括个体学习与小组（协作）学习，以及客观主义学习与建构主义学习类别。临床教学单元模式在临床工作场所增加了11项小组活动，其中9项被归类为建构主义小组活动。与传统实习相比，它还使实习生的学习更加积极主动。对小型私人在线课程的分析总共发现了344种教学模式，其中包括113种客观主义个体活动、205种建构主义个体活动和23种建构主义小组活动。与传统实习相比，结合了小型私人在线课程的临床教学单元带来了更多的建构主义和协作学习，以及更加多样化的教育项目。本研究阐述了一种在教育项目中处理主动和协作学习活动的方法，并提供了评估和重新设计教学项目的工具。所描述的方法和模式可应用于医学其他领域的临床环境。
