Examining the clinical learning environment through the architectural avenue

Abstract

Medical education has traditionally focused on the learners, the educators, and the curriculum, while tending to overlook the role of the designed environment. Experience indicates, however, that processes and outcomes of medical education are sensitive to the qualities and disposition of the spaces in which it occurs. This includes the clinical education within the patient care environment, termed the clinical learning environment (CLE). Recognition of this has informed the design of some new clinical learning spaces for the past decade. Competency-based clinical education can drive design requirements that differ materially from those associated with general purpose educational or clinical spaces. In this article, we outline two conceptual frameworks: (i) materialist spatiality and (ii) actor-network theory and consider how they can guide the design of spaces to support competency-based medical education and to guide the evaluation and discussion of the educational impacts of the spaces once built. We illustrate the use of these frameworks through discussion of the educational ambitions that underpinned the design of some recent clinical educational spaces. We close with practical points for consideration by educators and designers.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article

Glossary

Heterogeneous assemblages: Imported from the work of French philosopher Bruno Latour, the term assemblage has come to favor for describing how humans and non-human actors are mutually constitutive. Assemblage means both a collection and a joinery; a group of parts and an intersection. Tracing assemblages is a core part of sociomaterial research of people and things.

Additional information

Notes on contributors

Jonas Nordquist

Jonas Nordquist, PhD, is working at the Department of Medicine (Huddinge), Karolinska Institutet, Sweden and Department of Research and Education, Karolinska University Hospital, Sweden.

Ming-Ka Chan

Ming-Ka Chan, MD, MHPE, FRCPC is working at the Department of Paediatrics, University of Manitoba, Canada.

Jerry Maniate

Jerry Maniate is working at the, MD, FRCPC Department of Medicine and Department of Innovation in Medical Education, University of Ottawa, Canada. He is also the Vice President of Education, The Ottawa Hospital, Canada.

David Cook

David Cook, MD, PhD is working at the Sydney Medical School, University Sydney, Australia.

Cathal Kelly

Cathal Kelly, MCh, BSc, FRCSI, eMBA, C. Dir. is working at the Royal College of Surgeons of Ireland, Ireland.

Allan McDougall

Allan McDougall, MA, PhD is working at the Faculty of Education, University of Ottawa, Canada.