Author(s): Joseph Holdsworth, Rebecca Holdsworth Corresponding Author institution: University of Liverpool
Background There are recognised challenges for teaching in the clinical environ-
ment: in particular time constraints, the balance between the clinical responsi- bilities and teaching, an unpredictable environment, and the varying stages of professional development of the learners, such as medical students, foundation year doctors or junior registrars The clinical setting is varied and challenging, but is an important part of a medical students’ undergraduate training. It is part of a duty of a doctor to teach, yet doctors are not always as confident in their teach- ing role compared to their clinical role. The value of a teaching method and teaching as perceived by medical students can alter the engagement of the medi- cal student in their teaching, therefore this is a topic necessary to research. The aim of my research is to understand the perceptions medical students have re- garding the value they place on the teaching they experience in the clinical setting during medical school.
Methodology This research took an interpretivist stance, following an
Interpretative Phenomenological Analysis methodology. IPA combines ideas from both phenomenology and hermeneutics, creating a method which is both de- scriptive, and interpretative as it recognises that all phenomena are interpreted. A total of eight medical students expressed interest in participating: two fifth- year, four fourth- year and two intercalating students. Three of these dropped out. A sample size of five was suitable for the purposes of this research. Semi- structure interviews were used to collect qualitative data from five medical students at the University of Liverpool. Interviews were transcribed and analysed, this produced multiple themes. I listened to the audio recording and transcribed each interview myself as this allowed familiarity with the participants responses, I used NVIVO to aid this.
Results Twenty- nine themes and three superordinate themes were produced from
the data. These demonstrate the participants’ views of their teaching methods and teaching experienced in the clinical setting, and they value the perceived from these.
The interpretation of the themes, lead to the emergence of three superordinate themes, the teaching, the teacher and the learner. Due to the complexity of the
© 2020 The Authors. The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd. themes, these superordinate themes were not definitive, themes sometimes fell
under the ideas of more than one superordinate theme. A thematic diagram il- lustrates the relationships between the themes and superordinate themes.
Discussion The understanding of perceptions medical students have regarding
the value they place on the teaching they experience in the clinical setting dur- ing medical school is a complex matter. Teaching methods identified by partici- pants’ were broader than those recognised in the literature. The value of teaching methods changed for participants, both over the progression of their degree but also over the individual years of their degree, due to patient involvement in teaching methods and the extent to which participants’ motivational factors were addressed. Participants valued greater independence in the clinical setting as they progressed through their degree, active engagement and group size also affected the perceived value of teaching. The value of teaching methods in the clinical setting changed, teaching methods were valued if they were perceived as able to address the participants’ motivational factors. The extent to which teach- ing methods incorporated patient involvement changed the perceived value of the teaching method itself. Participants valued increasing independence in their teaching experiences in the clinical setting as they progressed through medical school. This was not well documented in literature, and so this is an area this study has helped highlight. If participants were actively engaged with their teaching, which was encouraged through questioning, increased value was also perceived. A smaller group size created a perception of more learning opportuni- ties which was valued.
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