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The role of workplace supervisors in the clinical education of medical students is currently under debate. However, few studies have addressed how supervisors conceptualize workplace learning and how conceptions relate to current sociocultural workplace learning theory. We explored physician conceptions of: (a) medical student learning in the clinical workplace and (b) how they contribute to student learning. The methodology included a combination of a qualitative, inductive (conventional) and deductive (directed) content analysis approach. The study triangulated two types of interview data from 4 focus group interviews and 34 individual interviews. A total of 55 physicians participated. Three overarching themes emerged from the data: learning as membership, learning as partnership and learning as ownership. The themes described how physician conceptions of learning and supervision were guided by the notions of learning-as-participation and learning-as-acquisition. The clinical workplace was either conceptualized as a context in which student learning is based on a learning curriculum, continuity of participation and partnerships with supervisors, or as a temporary source of knowledge within a teaching curriculum. The process of learning was shaped through the reciprocity between different factors in the workplace context and the agency of students and supervising physicians. A systems-thinking approach merged with the "co-participation" conceptual framework advocated by Billet proved to be useful for analyzing variations in conceptions. The findings suggest that mapping workplace supervisor conceptions of learning can be a valuable starting point for medical schools and educational developers working with changes in clinical educational and faculty development practices.

Background: There is a paucity of instruments designed to evaluate the multiple dimensions of the workplace as an educational environment for undergraduate medical students., Aim: The aim was to develop and psychometrically evaluate an instrument to measure how undergraduate medical students perceive the clinical workplace environment, based on workplace learning theories and empirical findings., Method: Development of the instrument relied on established standards including theoretical and empirical grounding, systematic item development and expert review at various stages to ensure content validity. Qualitative and quantitative methods were employed using a series of steps from conceptualization through psychometric analysis of scores in a Swedish medical student population., Results: The final result was a 25-item instrument with two overarching dimensions, experiential learning and social participation, and four subscales that coincided well with theory and empirical findings: Opportunities to learn in and through work & quality of supervision; Preparedness for student entry; Workplace interaction patterns & student inclusion; and Equal treatment. Evidence from various sources supported content validity, construct validity and reliability of the instrument., Conclusion: The Undergraduate Clinical Education Environment Measure represents a valid, reliable and feasible multidimensional instrument for evaluation of the clinical workplace as a learning environment for undergraduate medical students. Further validation in different populations using various psychometric methods is needed.

Lecturing is one of the oldest forms of teaching. The lecture is as effective as other teaching formats for transmitting information. One of the major defects of the lecture method is that it tends to induce passive learning. In order to lecture effectively, the lecturer must gain and hold the attention of the audience. Also, the audience should be given a chance to elaborate on the information presented. The list of expedient lecturing skills is long. In this paper we focus on how to effectively open and close a lecture. In addition, we give suggestions to how an audience may be actively engaged.

In 2007 the Faculty of Health Sciences, Aarhus University, took a first step towards outcome-based education. During an educational development process, all courses developed clear, consistent descriptions of learning outcomes and extensive, template-based course descriptions. This enabled the Faculty to implement a new national grading system and to prepare for Aarhus University's application for an ECTS label. Furthermore, the process created the basis for alignment of outcomes, assessment and teaching. In this paper, we share results, problems encountered and lessons learned.

Introduction: The medical profession and hospital practice have changed over the last decades without a concomitant change in Danish clerkships. Therefore, the aim of this study was to analyze learning and supervision in clerkships and to discuss how traditional clerkship learning matches a modern effective hospital environment., Material and Methods: A qualitative field study based on 38 days of observations ( asymptotically equal to 135 hours) with 6 students in 8th Semester in 2 internal medical and 3 surgical wards at 2 teaching hospitals in Aarhus County during 2003. The 6 students were interviewed prior to and following clerkship. Data were coded using Ethnograph and analyzed qualitatively., Results: The students typically participated in 6 learning activities: morning reports, ward rounds, out-patient clinics, on call, clerking, and operating theatres. A common feature for the first 3 activities was the students' observational role in contrast to their more active role in the latter 3 activities. Supervision was primarily indirect as the doctors worked and thereby served as tacit role models. When direct, the supervision was didactic and characterized by information transfer., Conclusion: A clerkship offers important learning opportunities for students. They are exposed to many patients and faced with various clinical problems. However, the benefit of students learning in authentic environments is not fully utilized, and the didactic supervision used by doctors hardly matches the learning conditions in a busy hospital. Consequently, we need to reassess the students' roles and doctors' supervisory methods.

Objective: To understand core curriculum design and involvement of stakeholders., Methods: Twelve homogeneous focus group interviews with a total of 88 students, house officers, senior doctors and nurses concerning an undergraduate emergency medicine curriculum. Following content coding of transcripts, we analysed by condensation, categorisation and qualitative content analyses., Results: The focus group participants gave a range of reasons for defining objectives or outcomes. They found their involvement in the process essential. Their argumentation and beliefs differed significantly, revealing 2 opposite perspectives: objectives as context-free theory-based rules versus objectives as personal practice-based guidelines. The students favoured theory-based objectives, which should be defined by experts conclusively as minimum levels and checklists. The senior doctors preferred practice-based objectives, which should be decided in a collaborative, local, continuous process, and should be expressed as ideals and expectations. The house officers held both perspectives. Adding to complexity, participants also interpreted competence inconsistently and mixed concepts such as knowledge, observation, supervision, experience and expertise., Discussion: Participating novices' perspectives on objectives differed completely from expertise level participants. These differences in perspectives should not be underestimated, as they can lead easily to misunderstandings among stakeholders, or between stakeholders, educational leaders and curriculum designers. We recommend that concepts are discussed with stakeholders in order to reach a common understanding and point of departure for discussing outcomes. Differences in perspectives, in our opinion, need to be recognised, respected and incorporated into the curriculum design process.

Introduction: The purpose of this study was to do a quantitative description of how medical students spend their time during their clerkship in the eighth semester of study. We examined to what degree students have the possibility to learn both from the doctors and other staff and through active participation in daily work routines., Subjects and Methods: Time registration was carried out through observation of six medical students spread over 32 observation days, corresponding to 6,674 minutes. The observations cover surgical and medical clerkships in two hospitals in Aarhus, Denmark., Results: The study revealed that the students (1) were present in the clinic about four hours a day; (2) spent about two-thirds of their time with doctors; (3) received guidance to a limited degree when they spent time with doctors; (4) carried out specific and visible actions in relation to patients to a limited degree; (5) practically did not co-operate with the nursing staff., Conclusion: Recent learning theories recommend that students should work actively on a subject or a task and that they should receive guidance to ensure their reflection on the tasks performed. We observed that students have plenty of opportunity to learn through watching experienced practitioners. However, the limited amount of guidance and the students' role as observers indicate that the learning potential of being with doctors and patients is not being exploited sufficiently.