HOW DOES CLINICAL LEARNING ENVIRONMENT CHANGES DURING PANDEMIC AFFECT ON PROFESSIONAL IDENTITY?

https://doi.org/10.22146/jpki.71483

Yoga Pamungkas Susani(1*), Dian Puspita Sari(2), Emmy Amalia(3)

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

Abstract


Background: The COVID-19 pandemic has disrupted clinical medical education, and clinical learning was forced to swiftly adapt by blending offline clinical services with online learning. Changes in the clinical learning environment will have an impact on professional identity. This study aimed to determine the impact of changes in the learning environment on medical students' professional identity. 

Methods: This was a two-phase mixed-method study with an explanatory sequential design. The PHEEM instrument measured students' perceptions of the learning environment before and during the pandemic, and PIM was used to measure professional identity. Fifty-one clinical students participated in this phase. In the second qualitative phase, fifteen students were selected to join three focus group discussions based on the proportion of sex and completion of the clinical rotation.

Results: there was a significant decrease in student perceptions of teaching during the pandemic (p 0.003). This result is in line with qualitative findings, namely a decrease in opportunities for participation and interaction in the social aspects of learning. This lowered self-confidence in clinical competence was supported by a higher correlation between perceptions of the learning environment and professional identity before the pandemic than during the pandemic (respectively r 0.561; 0.554 p < 0.01).

Conclusion: During the pandemic, there was a decrease in clinical students' participation opportunities, which resulted in decreased confidence in specific clinical competencies, but decreased participation had no effect on comfort and willingness to be engaged in the medical profession. This situation brings awareness to further improve competence through various training and practices.

 


Keywords


clinical learning environment; pandemic; professional identity

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References

  1. Lucey CR, Johnston S, Claiborne. The Transformational Effects of COVID-19 on Medical Education. JAMA - J Am Med Assoc. 2020;324(11):1033–4.
  2. Tay YX, Chow HC, Ooi CC. Impact on clinical learning during coronavirus disease 2019 pandemic: From disruption to recovery and the new norms. Korean J Med Educ. 2020;32(4):297–305.
  3. Wibowo D. Optimisme Rumah Sakit di Masa Pandemi Covid-19 [Internet]. Optimisme Rumah Sakit di Masa Pandemi Covid-19. 2020. p. 21. Available from: https://persi.or.id/wp-content/uploads/2020/05/materi_drdanielbw.pdf
  4. Cruess SR, Cruess RL, Steinert Y. Supporting the development of a professional identity: General principles. Med Teach [Internet]. 2019;41(6):641–9. Available from: https://doi.org/10.1080/0142159X.2018.1536260
  5. Bleakley A, Bligh J, Browne J. Medical education for the future, identity, power and location. New York: Springer; 2011.
  6. Wenger E. Communities of practice and social learning systems: the career of a concept. In: Blackmore C, editor. Communities of practice and Social Learning Systems. Springer Verlag and the Open University; 2009.
  7. Jaffe LE, Lindell D, Sullivan AM, Huang GC. Clear skies ahead: optimizing the learning environment for critical thinking from a qualitative analysis of interviews with expert teachers. Perspect Med Educ. 2019;8(5):289–97.
  8. Nordquist J, Hall J, Caverzagie K, Snell L, Chan MK, Thoma B, et al. The clinical learning environment. Med Teach [Internet]. 2019;41(4):366–72. Available from: https://doi.org/10.1080/0142159X.2019.1566601
  9. Creswell JW. Research Design Qualitative, Quantitative, and Mixed Methods Approaches, Third Edition. California: SAGE publications; 2009.
  10. Roff S, McAleer S, Skinner a. Development and validation of an instrument to measure the postgraduate clinical learning and teaching educational environment for hospital-based junior doctors in the UK. Med Teach. 2005;27(4):326–31.
  11. Susani YP, Sari DP, Ayu I, Widiastuti E, Lestari R. Hubungan Antara Persepsi Mahasiswa Terhadap Lingkungan Belajar , Ketersediaan Kasus dan Umpan Balik terhadap Kompetensi Mahasiswa Tahap Profesi FK Unram. J Kedokt Unram. 2017;6(1):1–8.
  12. Susani YP, Rahayu GR, Sanusi R, Prabandari YS, Mardiwiyoto H. Model Identitas Profesional Mahasiswa Kedokteran. Universitas Gadjah Mada; 2015.
  13. Susani YP, Rahayu GR, Sanusi R, Prabandari YS, Mardiwiyoto H. Developing a Model of Professional Identity in Medical Students: the Role of Motivation and. J Pendidik Kedokt Indones. 2018;7(3):159–69.
  14. Sanjaya IMB, Susani YP, Lestari R. Persepsi Mahasiswa terhadap Lingkungan Belajar Klinik Fakultas Kedokteran Universitas Mataram dan Faktor-Faktor yang Mempengaruhi. J Kedokt Unram. 2018;7(4):1–7.
  15. Gruppen L, Irby DM, Durning SJ, Maggio LA. Interventions Designed to Improve the Learning Environment in the Health Professions: A Scoping Review. MedEdPublish. 2018;7(3).
  16. Villanueva EW, Meissner H, Walters RW. Medical Student Perceptions of the Learning Environment, Quality of Life, and the School of Medicine’s Response to the COVID-19 Pandemic: A Single Institution Perspective. Med Sci Educ [Internet]. 2021;(0123456789). Available from: https://doi.org/10.1007/s40670-021-01223-z
  17. Chandratre S. Medical Students and COVID-19: Challenges and Supportive Strategies. J Med Educ Curric Dev. 2020;7(1–2).
  18. Hendelman W, Byszewski A. Formation of medical student professional identity: Categorizing lapses of professionalism, and the learning environment. BMC Med Educ. 2014;14(1):1–10.
  19. Keshmiri F, Farahmand S, Bahramnezhad F, Hossein-Nejad Nedaei H. Exploring the challenges of professional identity formation in clinical education environment: A qualitative study. J Adv Med Educ Prof. 2020;8(1):42–9.
  20. Lave J, Wenger E. Situated Learning: legitimate peripheral participation. Cambridge: Cambridge University Press; 1991.
  21. Lave J & Wenger E. Legitimate peripheral participation in communities of practice. In: Harrison R, Reeve F, Hanson A, Clarke J, editors. Supporting Lifelong Learning, Volume 1: Perspectives on learning. Routledge Falmer; 2002. p. 111–27.
  22. Wenger E. Communities of Practice: Learning, Meaning, and Identity. New York: Cambridge University Press; 1998.
  23. Asch DA, Nicholson S, Srinivas S, Herrin J, Epstein AJ. Evaluating obstetrical residency programs using patient outcomes. JAMA - J Am Med Assoc. 2009;302(12):1277–83.
  24. Cadieux G, Tamblyn R, Dauphinee D, Libman M. Predictors of inappropriate antibiotic prescribing among primary care physicians. CMAJ. 2007;177(8):877–83.
  25. Beshyah SA, Sciences B, Ibrahim WH, Corporation HM, Hajjaji I, Arekat MR. Impact of the COVID-19 Pandemic on Clinical Practice , Medical Education , and Research : An International Survey Impact de la pandémie de COVID-19 sur la pratique clinique , la formation médicale et la recherche : une enquête internationale. Tunis Med. 2020;98(08):610–8.
  26. Kinnear B, Zhou C, Kinnear B, Carraccio C, Schumacher DJ. Professional Identity Formation During the COVID-19 Pandemic. J Hosp Med. 2021;16(1):44–6.



DOI: https://doi.org/10.22146/jpki.71483

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