STUDENTS’ EXPERIENCES OF INTERACTION WITH THE SUPERVISORS DURING THE TRANSITION TO CLINICAL CLERKSHIPS

Dian Puspita Sari; Yoga Pamungkas Susani; Dewi Suryani; Emmy Amalia

doi:10.22146/jpki.40749

STUDENTS’ EXPERIENCES OF INTERACTION WITH THE SUPERVISORS DURING THE TRANSITION TO CLINICAL CLERKSHIPS

https://doi.org/10.22146/jpki.40749

Dian Puspita Sari^(1*), Yoga Pamungkas Susani⁽²⁾, Dewi Suryani⁽³⁾, Emmy Amalia⁽⁴⁾

(1) Faculty of Medicine, Universitas Mataram
(2) Universitas Mataram
(3) Universitas Mataram
(4) Universitas Mataram
(*) Corresponding Author

Abstract

Background: Transition to clinical clerkships involves significant changes for students in terms of learning environment and approach to learning. As clinical supervisors, doctors are one of the essential learning resources who also provide access for participation in a clinical environment. This study explored undergraduate medical students’ experiences during the transition to clinical clerkships to understand how these experiences affect their learning.This paper aims to report factors affecting students’ interaction with supervisors during the transition period.
Method: This was a qualitative phenomenological study. Participants were selected purposely to represent gender and group of student rotations. Eight 4th year medical students (five female, three male) submitted audio diaries during their first 12 weeks of clinical clerkships. Forty-six of the 73 audio diaries collected in the study contained interactions with supervisors, and these interactions were captured in 76 excerpts.
Results: Six themes emerged regarding factors affecting the interaction: (1) characters of the supervisors including the willingness to teach, showing concerns, asking questions to test comprehension, inviting explicitly; (2) supervisors’ workload; (3) students’ clinical knowledge and skills; (4) students’ initiatives: actively participating, asking questions; (5) curriculum and organization: the chance to do mutual interaction (i.e.,mini-CEX), clarity of students’ roles and educational goals; (6) senior peers.

Conclusions: Interactions between students and supervisors during the transition to clinical clerkships were influenced by factors internal to both parts and external factors like curriculum and organization, workload,and the presence of senior peers. However, during this phase, where students had not developed a situational understanding of the new environment, supervisors’ characters strongly influenced the interactions through the provision of affective support.

Keywords

clinical clerkships, medical students, transition, students-doctors interaction

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References

1. Teunissen PW, Wilkinson T. Learning and teaching in workplaces. In: Dornan T, Scherpbier
A, Mann K, Spencer J, editors. Medical Education Theory and Practice: Integrates practice, theory, innovation and research. Edin: Churchill Livingstone Elsevier; 2011. p. 431–64.
2. Egan T, Jaye C. Communities of clinical practice: the social organization of clinical learning. Heal An Interdiscip J Soc Study Heal Illn Med [Internet]. 2009;13(1):107–25. Available from: http://journals.sagepub.com/ doi/10.1177/1363459308097363
3. Spencer J. ABC of learning and teaching in medicine: Learning and teaching in the clinical environment. Bmj. 2003;326(7389):591–4.
4. Morris C, Blaney D. Work-based learning. In:Swanwick T, editor. Understanding Medical
Education. 2nd ed. West Sussex: ASME, Wiley Blackwell; 2014. p. 97–109.
5. Duvivier R, Stalmeijer R, van Dalen J, van der Vleuten C, Scherpbier A. Influence of the
workplace on learning physical examination skills. BMC Med Educ. 2014;14:61.
6. Sari DP, Susani YP. the Role of Senior Peers in Students’ Transition To Clinical Clerkships. J
Pendidik Kedokt Indones Indones J Med Educ. 2018;7(2):143.
7. Gay L, Mills G, Airasian P. Educational research:Competencies for analysis and applications.10th ed. Boston: Pearson; 2012. 672 p.
8. Brennan N, Corrigan O, Allard J, Archer J,Barnes R, Bleakley A, et al. The transition from medical student to junior doctor: Today’s experiences of Tomorrow’s Doctors. Med Educ. 2010;44(5):449–58.
9. Nowell LS, Norris JM, White DE, Moules NJ. Thematic Analysis: Striving to Meet the
Trustworthiness Criteria. Int J Qual Methods.2017;16(1):1–13.
10. Hauer KE, O’Brien BC, Hansen LA, Hirsh D,Ma IH, Ogur B, et al. More is better: Students
describe successful and unsuccessful experiences with teachers differently in brief and longitudinal relationships. Acad Med. 2012;87(10):1389–96.
11. McCarthy CP, McEvoy JW. Pimping in medical education lacking evidence and under threat. JAMA - J Am Med Assoc. 2015;314(22):2347–8.
12. McEvoy JW, Shatzer JH, Desai S V., Wright SM. Questioning Style and Pimping in Clinical
Education: A Quantitative Score Derived from a Survey of Internal Medicine Teaching Faculty.
Teach Learn Med. 2019;31(1):53–64.
13. Dornan T, Tan N, Boshuizen H, Gick R, Isba R, Mann K, et al. How and what do medical students learn in clerkships? Experience based learning (ExBL). Adv Heal Sci Educ. 2014;19(5):721–49.
14. Hägg-Martinell A, Hult H, Henriksson P,Kiessling A. Medical students’ opportunities to participate and learn from activities at an internal medicine ward: an ethnographic study.
146
15. Buery-Joyner SD, Ryan MS, Santen SA,Borda A, Webb T, Cheifetz C. Beyond mistreatment: Learner neglect in the clinical teaching environment. Med Teach [Internet].
2019;41(8):949–55. Available from: https://doi.org/10.1080/0142159X.2019.1602254
16. Godefrooij MB, Diemers AD, Scherpbier AJJA.Students´perceptions about the transition to the clinical phase of a medical curriculum with preclinical patient contact; a focus group study.BMC Med Educ. 2010;10(28):1–9.
17. Gan R, Snell L. When the learning environment is suboptimal: Exploring medical students’ perceptions of “mistreatment.” Acad Med.
2014;89(4):608–17.
18. Han H, Roberts NK, Korte R. Learning in the real place: Medical students’ learning and
socialization in clerkships at one medical school.Acad Med. 2015;90(2):231–9.
19. Prince KJAH, Boshuizen HPA, Van Der Vleuten CPM, Scherpbier AJJA. Students’ opinions
about their preparation for clinical practice.Med Educ. 2005;39(7):704–12.
20. Teunissen PW, Westerman M. Opportunity or threat: The ambiguity of the consequences of transitions in medical education. Med Educ.2011;45(1):51–9.
21. Susani YP, Rahayu GR, Sanusi R, Prabandari YS, Mardiwiyoto H. Model Identitas Profesional Mahasiswa Kedokteran. Universitas Gadjah Mada; 2015.
22. Surmon L, Bialocerkowski A, Hu W. Perceptions of preparedness for the first medical clerkship:a systematic review and synthesis. BMC MedEduc. 2016;16(1):89.
23. Masters DE, O’Brien BC, Chou CL. The thirdyear medical student grapevine: Managing
transitions between third-year clerkships using peer-to-peer handoffs. Acad Med.
2013;88(10):1534–8.
24. Chou CL, Teherani A, Masters DE, Vener M,Wamsley M, Poncelet A. Workplace learning
through peer groups in medical school clerkships. Med Educ Online. 2014;19(1).
25. Korstjens I, Moser A. Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. Eur J Gen Pract [Internet].2018;24(1):120–4. Available from: https://doi.org/10.1080/13814788.2017.1375092
26. Birt L, Scott S, Cavers D, Campbell C, Walter F. Member Checking: A Tool to Enhance Trustworthiness or Merely a Nod to Validation?Qual Health Res. 2016;26(13):1802–11.