Effective teaching and learning on the wards: easier said than done?

OBJECTIVES The aim of this study was to evaluate the teaching and learning during a clinical placement, and to draw lessons from the findings to inform medical educators about more efficient and effective ways of teaching and learning. METHODS This study involved students and teachers from a final year clinical placement on a graduate-entry medical programme. Questionnaires, focus groups, unstructured observation and structured observation using time sampling were used to elicit student and clinician perceptions of various learning opportunities. RESULTS Analysis revealed positive perceptions of the variety of different learning opportunities available to final year students undertaking a clinical rotation, as well as a high degree of congruency between student and clinician perceptions of these. Questionnaire data indicated that both groups valued hands-on learning and a broad knowledge base. Analysis of observation variables revealed a dominance of passive and low-level cognitive actions across learning sessions, particularly (and counter-intuitively) during bedside teaching. DISCUSSION This study highlighted a number of strengths and weaknesses in the clinical teaching that took place during these rotations. In particular, it highlighted congruency between student and teacher perceptions of good teaching and learning. At the same time, it flagged a potential disjunct between student and teacher expectations (or understandings) of various learning opportunities, and revealed a much broader disconnection between what is most valued and what is easiest to deliver in the clinical context. The results emphasise the need for quality rather than quantity, contextual blended learning, protected teaching time, the valuing of close student-teacher interaction and faculty development.