Abstract
Clerkship has a vital role in undergraduated medical education. Despite potential benefits, clinical teaching has been much criticised for its variability due to its complex clinical environment. This article describes several problems and educational theories related to learning in clinical settings. Effective strategies were developed after these problems arised and learning theories were created, in terms of students, clinical teachers and teaching institution: first, the student should prepare medical knowledge and survival skills for self-directed learning in the clinical setting; second, the clinical teachers provide opportunities for active participation-effective feedback-reflection to students; and lastly, the teaching institution has to design a clerkship curriculum effectively. A clinical environment for students allowing them to participate actively is essential.
References
1. Gordon J, Hazlett C, Ten Cate O, Mann K, Kilminster S, Prince K, et al. Strategic planning in medical education: enhancing the learning environment for students in clinical settings. Med Educ. 2000. 34:841–850.
3. Davis MH. AMEE Medical Education Guide No. 15: problem-based learning: a practical guide. Med Teach. 1999. 21:130–140.
4. O'Brien B, Cooke M, Irby DM. Perceptions and attributions of third-year student struggles in clerkships: do students and clerkship directors agree? Acad Med. 2007. 82:970–978.
5. Park JH, Kim S. Evaluating clinical clerkship in medical school. Korean J Med Educ. 2004. 16:157–167.
6. Lee YM, So YH, Ahn DS, Park SH. Evaluating clinical teaching in medicine. Korean J Med Educ. 2002. 14:293–300.
7. Collins A. Sawyer RK, editor. Cognitive apprenticeship. The Cambridge handbook of the learning sciences. 2006. Cambridge: Cambridge University Press;47–60.
8. Van Der Hem-Stokroos HH, Scherpbier AJ, Van Der Vleuten CP, De Vries H, Haarman HJ. How effective is a clerkship as a learning environment? Med Teach. 2001. 23:599–604.
9. Park GH, Lee YD, Oh JH, Choi IS, Lim YM, Kim YI. Program development of student internship (subinternship) in Gachon medical school. Korean J Med Educ. 2003. 15:113–130.
10. Metcalfe DH, Matharu M. Students' perception of good and bad teaching: report of a critical incident study. Med Educ. 1995. 29:193–197.
11. Haglund ME, aan het Rot M, Cooper NS, Nestadt PS, Muller D, Southwick SM, et al. Resilience in the third year of medical school: a prospective study of the associations between stressful events occurring during clinical rotations and student well-being. Acad Med. 2009. 84:258–268.
12. Coles C. Developing medical education. Postgrad Med J. 1993. 69:57–63.
13. Ogur B, Hirsh D, Krupat E, Bor D. The Harvard Medical School-Cambridge integrated clerkship: an innovative model of clinical education. Acad Med. 2007. 82:397–404.
14. Worley P, Silagy C, Prideaux D, Newble D, Jones A. The parallel rural community curriculum: an integrated clinical curriculum based in rural general practice. Med Educ. 2000. 34:558–565.
15. Murray E, Jolly B, Modell M. Can students learn clinical method in general practice? A randomised crossover trial based on objective structured clinical examinations. BMJ. 1997. 315:920–923.
16. Kim SH, Yang EB, Ahn DS, Jeon WT, Lyu CJ. The present conditions of clinical clerkship management in Korea. Korean J Med Educ. 2009. 21:373–383.
17. Miller A, Archer J. Impact of workplace based assessment on doctors' education and performance: a systematic review. BMJ. 2010. 341:c5064.
18. Kaufman DM. Applying educational theory in practice. BMJ. 2003. 326:213–216.
19. Dewey J.
HW Lee
. Democracy and education: an introduction to the philosophy of education. 2007. 1st Engl ed. Seoul: Kyoyook Book;227–245. Korean.
20. Kolb DA. Experiential learning: experience as the source of learning and development. 1984. London: Prentice-Hall;39–43.
21. Cox K. Planning bedside teaching-1. overview. Med J Aust. 1993. 158:280–282.
22. Collins A, Brown JS, Newman SE. Resnick LB, editor. Cognitive apprenticeship: teaching the crafts of reading, writing, and mathematics. Knowing, learning, and instruction: essays in honor of Robert Glaser. 1989. New Jersey: Lawrence Erlbaum Associates;453–494.
23. Elstein AS, Schwartz A. Clinical problem solving and diagnostic decision making: selective review of the cognitive literature. BMJ. 2002. 324:729–732.
24. Neher JO, Gordon KC, Meyer B, Stevens N. A five-step "microskills" model of clinical teaching. J Am Board Fam Pract. 1992. 5:419–424.
25. Wolpaw TM, Wolpaw DR, Papp KK. SNAPPS: a learnercentered model for outpatient education. Acad Med. 2003. 78:893–898.
26. Dent JA, Harden RM. A practical guide for medical teachers. 2009. 3rd ed. Philadelphia: Churchill Livingstone;92.