A national stakeholder consensus study of challenges and priorities for clinical learning environments in postgraduate medical education

Caroline Kilty, Anel Wiese, Colm Bergin, Patrick Flood, Na Fu, Mary Horgan, Agnes Higgins, Bridget Maher, Grainne O’Kane, Lucia Prihodova, Dubhfeasa Slattery, Slavi Stoyanov, Deirdre Bennett

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Abstract

Background: High quality clinical learning environments (CLE) are critical to postgraduate medical education (PGME). The understaffed and overcrowded environments in which many residents work present a significant challenge to learning. The purpose of this study was to develop a national expert group consensus amongst stakeholders in PGME to; (i) identify important barriers and facilitators of learning in CLEs and (ii) indicate priority areas for improvement. Our objective was to provide information to focus efforts to provide high quality CLEs. Methods: Group Concept Mapping (GCM) is an integrated mixed methods approach to generating expert group consensus. A multi-disciplinary group of experts were invited to participate in the GCM process via an online platform. Multi-dimensional scaling and hierarchical cluster analysis were used to analyse participant inputs in regard to barriers, facilitators and priorities. Results: Participants identified facilitators and barriers in ten domains within clinical learning environments. Domains rated most important were those which related to residents’ connection to and engagement with more senior doctors. Organisation and conditions of work and Time to learn with senior doctors during patient care were rated as the most difficult areas in which to make improvements. Conclusions: High quality PGME requires that residents engage and connect with senior doctors during patient care, and that they are valued and supported both as learners and service providers. Academic medicine and health service managers must work together to protect these elements of CLEs, which not only shape learning, but impact quality of care and patient safety.
Original languageEnglish
Article number226
Pages (from-to)-9
Number of pages9
JournalBMC Medical Education
Volume17
DOIs
Publication statusPublished - 22 Nov 2017

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Medical Education
Consensus
Learning
Patient Care
Quality of Health Care
Patient Safety
Health Services
Cluster Analysis
Medicine

Keywords

  • Graduate medical education
  • Postgraduate medical education
  • Clinical learning environment
  • European working time directive
  • Duty hours regulations
  • Group concept mapping
  • DOCTORS
  • CARE
  • COMPETENCE
  • FAILURE

Cite this

Kilty, Caroline ; Wiese, Anel ; Bergin, Colm ; Flood, Patrick ; Fu, Na ; Horgan, Mary ; Higgins, Agnes ; Maher, Bridget ; O’Kane, Grainne ; Prihodova, Lucia ; Slattery, Dubhfeasa ; Stoyanov, Slavi ; Bennett, Deirdre. / A national stakeholder consensus study of challenges and priorities for clinical learning environments in postgraduate medical education. In: BMC Medical Education. 2017 ; Vol. 17. pp. -9.
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abstract = "Background: High quality clinical learning environments (CLE) are critical to postgraduate medical education (PGME). The understaffed and overcrowded environments in which many residents work present a significant challenge to learning. The purpose of this study was to develop a national expert group consensus amongst stakeholders in PGME to; (i) identify important barriers and facilitators of learning in CLEs and (ii) indicate priority areas for improvement. Our objective was to provide information to focus efforts to provide high quality CLEs. Methods: Group Concept Mapping (GCM) is an integrated mixed methods approach to generating expert group consensus. A multi-disciplinary group of experts were invited to participate in the GCM process via an online platform. Multi-dimensional scaling and hierarchical cluster analysis were used to analyse participant inputs in regard to barriers, facilitators and priorities. Results: Participants identified facilitators and barriers in ten domains within clinical learning environments. Domains rated most important were those which related to residents’ connection to and engagement with more senior doctors. Organisation and conditions of work and Time to learn with senior doctors during patient care were rated as the most difficult areas in which to make improvements. Conclusions: High quality PGME requires that residents engage and connect with senior doctors during patient care, and that they are valued and supported both as learners and service providers. Academic medicine and health service managers must work together to protect these elements of CLEs, which not only shape learning, but impact quality of care and patient safety.",
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Kilty, C, Wiese, A, Bergin, C, Flood, P, Fu, N, Horgan, M, Higgins, A, Maher, B, O’Kane, G, Prihodova, L, Slattery, D, Stoyanov, S & Bennett, D 2017, 'A national stakeholder consensus study of challenges and priorities for clinical learning environments in postgraduate medical education', BMC Medical Education, vol. 17, 226, pp. -9. https://doi.org/10.1186/s12909-017-1065-2

A national stakeholder consensus study of challenges and priorities for clinical learning environments in postgraduate medical education. / Kilty, Caroline; Wiese, Anel; Bergin, Colm; Flood, Patrick; Fu, Na; Horgan, Mary; Higgins, Agnes; Maher, Bridget; O’Kane, Grainne; Prihodova, Lucia; Slattery, Dubhfeasa; Stoyanov, Slavi; Bennett, Deirdre.

In: BMC Medical Education, Vol. 17, 226, 22.11.2017, p. -9.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Wiese, Anel

AU - Bergin, Colm

AU - Flood, Patrick

AU - Fu, Na

AU - Horgan, Mary

AU - Higgins, Agnes

AU - Maher, Bridget

AU - O’Kane, Grainne

AU - Prihodova, Lucia

AU - Slattery, Dubhfeasa

AU - Stoyanov, Slavi

AU - Bennett, Deirdre

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N2 - Background: High quality clinical learning environments (CLE) are critical to postgraduate medical education (PGME). The understaffed and overcrowded environments in which many residents work present a significant challenge to learning. The purpose of this study was to develop a national expert group consensus amongst stakeholders in PGME to; (i) identify important barriers and facilitators of learning in CLEs and (ii) indicate priority areas for improvement. Our objective was to provide information to focus efforts to provide high quality CLEs. Methods: Group Concept Mapping (GCM) is an integrated mixed methods approach to generating expert group consensus. A multi-disciplinary group of experts were invited to participate in the GCM process via an online platform. Multi-dimensional scaling and hierarchical cluster analysis were used to analyse participant inputs in regard to barriers, facilitators and priorities. Results: Participants identified facilitators and barriers in ten domains within clinical learning environments. Domains rated most important were those which related to residents’ connection to and engagement with more senior doctors. Organisation and conditions of work and Time to learn with senior doctors during patient care were rated as the most difficult areas in which to make improvements. Conclusions: High quality PGME requires that residents engage and connect with senior doctors during patient care, and that they are valued and supported both as learners and service providers. Academic medicine and health service managers must work together to protect these elements of CLEs, which not only shape learning, but impact quality of care and patient safety.

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KW - European working time directive

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KW - DOCTORS

KW - CARE

KW - COMPETENCE

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