Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb 14;7(2):e013046.
doi: 10.1136/bmjopen-2016-013046.

Medical students' opportunities to participate and learn from activities at an internal medicine ward: an ethnographic study

A Hägg-Martinell  1 , H Hult  2 , P Henriksson  1 , A Kiessling  1
Affiliations

Medical students' opportunities to participate and learn from activities at an internal medicine ward: an ethnographic study

A Hägg-Martinell et al. BMJ Open. .

Abstract

Objectives: To optimise medical students' early clerkship is a complex task since it is conducted in a context primarily organised to take care of patients. Previous studies have explored medical students' perceptions of facilitation and hindrance of learning. However, the opportunities for medical student to learn within the culture of acute medicine care have not been fully investigated. This study aimed to explore how medical students approach, interact and socialise in an acute internal medicine ward context, and how spaces for learning are created and used in such a culture.

Design and setting: Ethnographic observations were performed of medical students' interactions and learning during early clerkship at an acute internal medicine care ward. Field notes were taken, transcribed and analysed qualitatively. Data analysis was guided by Wenger's theory of communities of practice.

Participants: 21 medical students and 30 supervisors participated.

Results: Two themes were identified: Nervousness and curiosity-students acted nervously and stressed, especially when they could not answer questions. Over time curiosity could evolve. Unexplored opportunities to support students in developing competence to judge and approach more complex patient-related problems were identified. Invited and involved-students were exposed to a huge variation of opportunities to learn, and to interact and to be involved. Short placements seemed to disrupt the learning process. If and how students became involved also depended on supervisors' activities and students' initiatives.

Conclusions: This study shed light on how an acute internal medicine ward culture can facilitate medical students' possibilities to participate and learn. Medical students' learning situations were characterised by questions and answers rather than challenging dialogues related to the complexity of presented patient cases. Further, students experienced continuous transfers between learning situations where the potential to be involved differed in a wide variety of ways.

Keywords: ethnography; internal medical ward; learning; medical students; undergraduate.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

References

    1. Dornan T. Workplace learning. Perspect Med Educ 2012;1:15–23. 10.1007/s40037-012-0005-4 - DOI - PMC - PubMed
    1. Irby DM. Clinical teaching and the clinical teacher. J Med Educ 1986;61(Pt 2):35–45. - PubMed
    1. Aper L, Reniers J, Derese A et al. . Managing the complexity of doing it all: an exploratory study on students’ experiences when trained stepwise in conducting consultations. Bmc Med Educ 2014;14:206 10.1186/1472-6920-14-206 - DOI - PMC - PubMed
    1. Mennin S. Self-organisation, integration and curriculum in the complex world of medical education. Med Educ 2010;44:20–30. 10.1111/j.1365-2923.2009.03548.x - DOI - PubMed
    1. Vygotskij L. The collected works of L.S. Vygotsky. The history of the development of higher mental functions. Vol 4 New York: Plenum Press, 1997.

Publication types