One of the key facets of the Institute for Healthcare Improvement’s Quadruple Approach is clinical experience. Continual improvement in clinical experience is crucial in facilitating better medical service delivery. Indeed, it could be rightfully argued that improving clinical experience inevitably minimizes cost, leads to better patient experience and is likely to improve outcomes. Care providers can only optimize their output in conditions that minimize stress. Clinical experience is discussed forthwith, with a focus on clinical learning experience citing the defining expectations of a good experience and the benefits thereof.
Most healthcare facilities are considered ideal environments of learning for medical students and scholars, particularly because they present a practical setting through which the learner can obtain knowledge and apply learned skills. The setting will often follow a familiar pattern in which the patient benefits from the learner’s service as the learner hones their skill under the supervision of a senior colleague or instructor. This model has undoubtedly proven to be effective in producing skilled medical personnel as the combination of theory and apprenticeship facilitates knowledge application therefore enhancing mastery of skill. The learners experience directly influences service delivery given that the learning occurs on the job. Moreover, the learning experience affects the capacity of the learner to develop the skills required, motivation, perception towards the job, self-esteem, and other factors. The discussion herein is based on research within three professions within the health sector, that is, undergraduate nursing, postgraduate medical training, as well as physiotherapy training. The expanded scope makes the findings of this discussion relevant in a wide range of scenarios.
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Practitioners of all three professions are present in Tisch Hospital, which will act as a case study for this discussion. Tisch Hospital is located in New York and serves as a training center for most clinical disciplines. Among the most common complaint at the hospital involves the work/leisure balance and supervisory issues. However, several other issues are revealed through the studies as explained forthwith. A majority of these issues accurately represent the state at Tisch Hospital, with recommendations following later on.
The perception of postgraduate trainees regarding their clinical experience in hospital settings is a pertinent issue. To that end, McConnel and Mckay (2018) conducted a modified cross-sectional study that also sought to determine their definition of an ideal clinical learning environment. McConnel and Mckay extracted the negative and positive experiences and tabulated them, identifying seven themes in the process (2018). The themes observed are responsibility levels, self-worth, teamwork, the support-autonomy balance, organization, education, and supervision. A quantitative analysis revealed gaps especially in organization and the manageability of the workload assigned. The balance between learning and work was also one of the most common concerns, whereby a significant portion of the sample felt that the balance may have tipped towards the workload.
Among the issues brought out in a different study was the reception that student nurses get from their superiors; attitudes, expectations, competence and preparedness of assigned nursing supervisors; and the student’s preparedness to learn. In the study carried out in a Bachelors in Nursing program by Dale and Dale, the above deductions were made from qualitative analysis of data obtained through a group interview (2013). The aspects that came out of the analysis were grouped into institutional, individual and relational. The relationship between the student and their supervisor was notoriously prominent as a factor that could either complicate or facilitate the student’s learning processes. Some of the challenges reported by nursing supervisors included inadequacy of skill and the stringency of timelines. Notably, all of these challenges are experienced and noted on the job, thereby directly impacting on the quality of care.
Organizations handle these and other challenges differently, due to dynamicity of factors and circumstances per time and lack of adequate standardization on clinical learning approaches. In terms of organization, some organizations allocate specific times within which learners can be present in the medical service facilities to balance between the learners' work and education. This measure also reduces the supervisory burden and allows supervisors adequate time for planning and for work. Other institutions train their medical staff on leadership and effective instruction to enable them to effectively impart the necessary mentorship on any trainees assigned to them.
Several measures are recommended to increase the efficiency and effectiveness of instruction, learning and service delivery by supervisors and learners not only at Tisch Hospital but also in the industry. To maximize the holistic growth and development of the trainee's knowledge and skill, other activities should be organized in addition to patient care, such as seminars and non-participatory involvement when administrative or managerial decisions are being made (Nehyba et al., 2017). The organizational policies and procedures should allow for trainees to access all unique training opportunities available. Organizations should also create a strong collaborative culture to facilitate greater cohesion among employees. Employees should be encouraged to appreciate and build teamwork, capitalizing on every person’s contribution. The cohesion drawn thereof is beneficial to trainees and trainers alike leading to better service delivery.
Positive clinical learning experiences offer immense benefits not only to Tisch Hospital and similar organizations, but to the health sector as a whole. For one, apprenticeship under the right tutelage brings out the potential of the learner helping them identify their strengths and weaknesses. Learners build confidence in environments which they are valued translating to higher motivation levels and better service delivery. Functional relationships between supervisors and trainees bring efficiency in the workplace and maximize transference of knowledge and skill. The trainee is able to work under experienced individuals in the same field learning aspects of the job that cannot be taught in lecture settings.
In conclusion, scanty research exists on the impact of clinical learning experience on outcomes whereas the level of correlation may be unprecedented. The capacity for positive learning experiences to improve service delivery potentially lower the costs of health service delivery. Patients’ experience at healthcare facilities such as Tisch Hospital will also benefit from improved handling and service delivery.
References
Dale, B., Leland, A., & Dale, J. G. (2013). What factors facilitate good learning experiences in clinical studies in nursing: Bachelor students’ perceptions. International Scholarly Research Notices , 2013 .
McConnell, M., & McKay, K. (2018). What factors make for a positive or negative clinical learning experience? Exploring the perceptions of postgraduate medical trainees. J Medic Educ Training, 2(2), 038.
Nehyba, K., Miller, S., Connaughton, J., & Singer, B. (2017). Assessing student clinical learning experiences. The clinical teacher, 14(4), 247-250.
