Transformative learning in an interprofessional student-run clinic: a qualitative study

ABSTRACT

Student-run free clinics are increasingly seen as a way for students in health professions to have early authentic exposures to providing care to marginalized populations, often in the context of interprofessional teams. However, few studies characterize what and how students may learn from volunteering at a student-run free clinic. We aimed to examine shifts in attitude or practice that volunteers report after completing a placement at an interprofessional student-run clinic in Toronto, Ontario, Canada. Transcripts from semi-structured reflective focus groups were analyzed in an exploratory thematic manner and from the perspective of transformative learning theory. Volunteers reported attitude shifts toward greater self-awareness of assumptions, recognition of the need for systemic interventions, and seeing themselves as learning and contributing meaningfully in a team even without direct-client contact. Practice shifts emerged of individualizing assessment and treatment of patients as well as increased comfort working in interprofessional teams. Attitude and practice shifts were facilitated by authentic interactions with individuals from marginalized populations, taking a patient-centered approach, and an interprofessional context. Interprofessional student-run free clinics are suited to triggering disorienting dilemmas that set the stage for transformative learning, particularly when volunteers are guided to reflect.

KEYWORDS:

• Student-run clinic
• transformative learning
• interprofessional education
• health services research

Acknowledgments

We acknowledge the clients as well as student and staff volunteers of the IMAGINE Clinic without which none of this work would have been possible. In particular, we would like to thank Yick Kan Cheung for his assistance in developing the semi-structured interview guide, facilitating reflection sessions, and transcription.

Declaration of interest

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

Enoch Ng

Enoch Ng is a resident physician in psychiatry at the University of Toronto.

Tina Hu

Tina Hu is a family physician based at Etobicoke General Hospital.

Nancy McNaughton

Nancy McNaughton is the Education Scholar for the Michener Institute of Education at the University Health Network, an Assistant Professor at the Dalla Lana School of Public Health at the University of Toronto and Scientist with the Wilson Centre for Research in Education at the University Health Network.

Maria Athina (Tina) Martimianakis

Maria Athina (Tina) Martimianakis is Associate Professor and Director of medical Education Scholarship, Department of Paediatrics and Scientist and Associate Director, Collaborations and Partnerships, Wilson Centre, Faculty of Medicine, University of Toronto.