Sequencing learning experiences to engage different level learners in the workplace: An interview study with excellent clinical teachers

Abstract

Purpose: Learning in the clinical workplace can appear to rely on opportunistic teaching. The cognitive apprenticeship model describes assigning tasks based on learner rather than just workplace needs. This study aimed to determine how excellent clinical teachers select clinical learning experiences to support the workplace participation and development of different level learners.

Methods: Using a constructivist grounded theory approach, we conducted semi-structured interviews with medical school faculty identified as excellent clinical teachers teaching multiple levels of learners. We explored their approach to teach different level learners and their perceived role in promoting learner development. We performed thematic analysis of the interview transcripts using open and axial coding.

Results: We interviewed 19 clinical teachers and identified three themes related to their teaching approach: sequencing of learning experiences, selection of learning activities and teacher responsibilities. All teachers used sequencing as a teaching strategy by varying content, complexity and expectations by learner level. The teachers initially selected learning activities based on learner level and adjusted for individual competencies over time. They identified teacher responsibilities for learner education and patient safety, and used sequencing to promote both.

Conclusions: Excellent clinical teachers described strategies for matching available learning opportunities to learners’ developmental levels to safely engage learners and improve learning in the clinical workplace.

Acknowledgments

The authors would like to thank the members of the UCSF Academy of Medical Educators who participated in the study.

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

This project was funded by an education grant from the Association of American Medical Colleges Western Group on Educational Affairs. In addition, Dr. Chen’s work in medical education is supported in part by the Abraham Rudolph Endowed Chair in Pediatric Education from the UCSF Academy of Medical Educators. The funding sources had no involvement in study design, data collection and analysis, interpretation of results or preparation or approval of the manuscript.