Background: Clinical learning environments are important because they impact the competence, satisfaction and humanistic development of trainee doctors, and ultimately the care of patients. Designing clinical learning environments is challenging, due to their dynamic and complex nature, where multiple activities, happen simultaneously, impacting each other in non-linear ways. The networked relationships between learning and other activities may present challenges and opportunities for training in clinical environments.
Aim: The aim of this project is to explore learning in complex clinical environments. Taking multiple perspectives, we will produce a holistic view of the opportunities and challenges in clinical learning environments for postgraduate medical education and training (PGMET) to inform practice and policy.
Methodology: We propose three studies triangulating on clinical learning environments. Chosen methodologies are ideal for application to complex environments (clinical settings) and interventions (education), with a view to producing practical recommendations which take account of context. These methodologies have not been applied to this topic previously.
Study 1. A Realist Synthesis / Review of the literature will address “How can clinical learning environments for PGMET be optimised?” This is an interpretive, theory-driven narrative summary of the literature seeking to describe what works, why and in what circumstances.
Study 2. Group Concept Mapping study will address “What are the perspectives of stakeholders on current clinical learning environments in Ireland and opportunities for their improvement?” GCM is an integrated mixed method, using a structured approach to identify an expert group’s understanding about a topic.
Study 3. An Activity Systems Analysis (ASA) of clinical learning environments addressing “What is the relationship between PGMET and the competing activities happening in clinical learning environments, and how does this impact learning?” ASA is a methodology arising from socio-cultural theory, emphasising learning through participation in social activity, in cultural and historical contexts.
