Psychology and learning: The role of the clinical learning environment

Abstract

The clinical learning environment for the postgraduate education of physicians significantly influences the learning process and the outcomes of learning. Two critical aspects of the learning environment, when viewed through a psychology lens are (1) constructs from psychology relevant to learning, such as cognitive load theory and learner self-efficacy; and (2) psychological attributes of the context in which learning occurs such as psychological safety and “Just Culture”. In this paper, we address selected psychological aspects of the clinical learning environment, with a particular focus on the establishment and sustainment of psychological safety in the clinical learning environment for physicians. Psychological safety is defined as individuals’ perceptions that they can speak out in the learning or working context without consequences for their professional standing or risks to their status on work teams or groups. We close with seven critical strategies for use by educators, learners, health systems leaders, and other stakeholders to contribute to a clinical environment that optimizes learning. These dimensions can also provide avenues for future research to enhance the community’s understanding of psychological constructs operating in the clinical learning environment.

Acknowledgments

The information related to this work was developed from breakout group sessions who participated in the conference. The authors acknowledge all breakout group participants and other conference attendees for their contributions to this work.

Disclosure statement

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

Additional information

Notes on contributors

Kelly J. Caverzagie

Kelly J. Caverzagie, MD, serves as the Associate Dean for Educational Strategy for the University of Nebraska Medical Center (UNMC) and Vice-President for Education at Nebraska Medicine. He is actively practicing as an academic hospitalist and enjoys working with students, residents and faculty to improve health professions education.

Mitchell G. Goldenberg

Mitchell Goldenberg, MBBS, PhD(Cand), is a urology resident at the University of Toronto and a PhD candidate at the Institute of Medical Science. His academic work focuses on technical skills assessment in the operating room and improving patient safety in surgery.

Jena M. Hall

Jena M. Hall, MD, MEd, is a senior resident in Obstetrics and Gynecology and the Competency-Based Medical Education Resident Lead at Queen’s University in Kingston, Ontario. She is passionate about engagement of trainees in medical education improvement and reform and optimization of surgical coaching.