Two sides of the same coin: elements that can make or break clinical learning encounters

Purpose This project explored how faculty, residents, and students at an academic medical center have experienced meaningful learning moments and what contributed to such moments within the clinical learning environment. Methods During AY 2018–19, the authors interviewed faculty ( n = 8) and residents ( n = 5) from the Surgery and OBGYN departments at the University of Utah School of Medicine. The authors also conducted interviews ( n = 4) and focus groups ( n = 2) with 20 third- and fourth-year students. The authors used an appreciative inquiry approach to conduct interviews and focus groups, which were audio-recorded and transcribed verbatim. Transcriptions were coded using qualitative content analysis. Results The authors found that three factors determined whether learning encounters were successful: learner-centeredness, shared understanding, and learner attributes. Situations that were characterized by learner-centeredness and shared understanding led to successful learning. Likewise, some learner attributes facilitated successful learning moments. Conclusion The clinical learning environment is characterized by both successful and challenging moments. Paying attention to the factors which promote successful learning may be key to fostering a positive learning environment for all learners, but particularly for medical students.