Exploring student patterns of behaviour during clinical placements and the implications for supporting learning
Creators: name: Osborne, Fiona
name: Rothwell, Charlotte
name: Paes, Paul
name: Ellis, Janice
Publisher: name: F1000 Research Limited
Year: 2023

description: <b>Background</b><br>
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Clinical attachments are the cornerstone of undergraduate medical programmes. Log-book evaluations and observational studies suggest student behaviour during clinical placements is highly variable. As medical schools invest in longer, more diverse attachments, medical educators should consider how student learning is best supported through understanding behavioural trends.<br>
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<b>Summary of work</b><br>
The study was approached using constructivist grounded theory methodology from an interpretivist perspective to address the following research objective:

 To explore medical students’ experiences during clinical placements with a focus on engagement with learning opportunities in order to discern any patterns of behaviour and the implications for learning.

Semi-structured interviews were conducted with a sample of 18 final year medical students. Fourteen interviews were conducted face to face and four remotely due to the advent of the Covid-19 pandemic.  A pre-interview questionnaire was used to support exploration of experiences. Data collection was iterative and inductive. Analysis followed the constant-comparison method.<br>
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<b>Summary of results</b><br>
Patterns of behaviour were evident in the general approach to activity, the engagement with specific activities and the management of relationships. Generally, students demonstrated a reticence to become directly involved with activities, characterised by ‘hinting and hoping’, ‘caution/hesitance’ and ‘avoidance’. Creative manoeuvring during perceived undesirable circumstances was evident through ‘adaptation’. Trends in relation to specific activities included selective attendance and assessment-driven engagement with patients and activities. Strategic behaviours to manage relationships included deliberately cultivating a positive student impression, tactical questioning of staff and real or fabricated demonstrations of interest in staff members’ chosen specialties.<br>
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<b>Discussion and Conclusion</b><br>
Student patterns of behaviour during clinical placement have far-reaching implications for learning. Discriminatory practices governing patient interactions may detract from holistic learning and a patient-centred approach. Students’ strategic behaviours toward supervising staff have the potential to exacerbate preferential treatment and perpetuate specialty denigration. Assessment driven patterns of selective behaviour may influence professional development and preparedness for practice.<br>
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<b>Take Home Messages</b><br>
Medical students engage in a diverse range of behavioural patterns during their clinical placements which may have wide-ranging and significant implications for their learning. Understanding the nature and origin of these behaviours could help inform placement design and strategies to support student learning whilst in clinical environments.