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. 2017 Nov 22;17(1):226.
doi: 10.1186/s12909-017-1065-2.

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

Caroline Kilty  1 , Anel Wiese  1 , Colm Bergin  2 , Patrick Flood  3 , Na Fu  4 , Mary Horgan  5 , Agnes Higgins  6 , Bridget Maher  1 , Grainne O'Kane  7 , Lucia Prihodova  7 , Dubhfeasa Slattery  8 , Slavi Stoyanov  9 , Deirdre Bennett  10
Affiliations

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

Caroline Kilty et al. BMC Med Educ. .

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.

Keywords: Clinical learning environment; Duty hours regulations; European working time directive; Graduate medical education; Group concept mapping; Postgraduate medical education.

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Conflict of interest statement

Ethical approval and consent to participate

Ethical approval for this study was granted by the Clinical Research Ethics Committee of the Cork University Hospitals. The work was conducted in accordance with the Declaration of Helsinki. All participants were provided with information on the study gave consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
10 cluster solution with domain names
See this image and copyright information in PMC

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