The importance and visibility of the learning environment has grown in recent years as various regulatory agencies focus attention on possible deficiencies in the learning environment (LE). The LE has been associated with stress and burnout, quality improvement initiatives, and curriculum design. This session will discuss the challenges in developing a conceptual framework for the LE, current limitations in measuring the LE, and initiatives designed to improve the LE.

His session will review research related to learning environments, focusing on study designs and measurement methods, and will describe the growing interest in learning environments and their impact on professional development and well-being internationally.

The Accreditation Council for Graduate Medical Education (ACGME) established the Clinical Learning Environment Review (CLER) Program in 2012 to provide institutions that train residents and fellows with formative feedback to improve patient care while optimizing the clinical learning environment (CLE) in the 6 CLER Focus Areas (Patient safety, Health care quality (including health care disparities), Care transitions, Supervision, Fatigue management, mitigation, and duty hours, Professionalism).

 

In the Fall of 2018, the ACGME released its second CLER National Report of Findings, which details findings from the second set of visits to nearly 300 ACGME Sponsoring Institutions with 3 or more core residency programs. During the webinar, we will present findings from the report, as well discuss changes over time since the first cycle of CLER visits.

The panel will include a brief overview of the Learning environment from three different perspectives: nursing, osteopathic and PA education. Following those overviews, the panelists will engage in a live Q&A with the moderator and audience.

 

Nursing
At the Ohio State College of Nursing, our learning environment is illustrated by our commitment to LIVE WELL (Lead, Innovate, Vision, Execute, be Wellness-focussed, Evidenced-based, Lifelong learnings and Lights for the world, locally and globally). Evidence for our successful establishment of an effective environment for student learning in Nursing is our redesignation as a National League for Nursing Center of Excellence, recently awarded for our contributions to development of an environment that promotes student learning and professional development.  We have extended our efforts towards student learning in interprofessional education, meeting future needs for learning among the healthcare workforce.  Facilitation of learning in small groups through consistent participation in interprofessional seminars, development of collaborative learning opportunities in implicit bias among nursing and pharmacy students and clinical learning through establishment of advanced practice nursing and medical student dyads are among the activities that point to successful learning environments that promote interprofessional education.  We developed and advanced the blueprint for interprofessional education of the future at Ohio State, BuckIPE, established an academic certificate in interprofessional healthcare and lead activities supported by a HRSA funded Primary Care Training Enhancement Grant that include interprofessional learning in community education, informatics, health coaching, hot spotting, immigrant healthcare and leadership.  Process and outcome evaluation informs efforts to refine approaches and promote an effective learning environment.

 

Using the Gruppen review article as a backdrop, this portion of the webinar will focus on learning environment in PA programs. At the conclusion of the webinar, attendees will be able to discuss the components of how PA programs consider learning environment through personal, social, organizational, physical and virtual lens, thus adding to the interprofessional dialogue allowing for the identification of the elements of learning environments that are shared across the health professions. New accreditation standards for PA programs are being released Fall of 2018. This presentation will describe the role the learning environment has in program accreditation.

 

Osteopathic
Within the osteopathic medical learning environment, the considerations – not unlike those of other health education learning paradigms – encompass social, academic, professional, psychological, and physical settings and frameworks as they influence how people learn, organize, and collaborate together. Learner, faculty, and provider encounters with burnout, wellness, empathy, depression, anxiety, and interprofessionalism has risen to the forefront and the osteopathic medical education profession through it schools and its learners has been engaged in addressing these learning and practice environment issues. We will discuss some of these approaches and on-going concerns within the academic setting to positively affect teaching and learning.

The Liaison Committee on Medical Education has recognized the importance of a healthy learning environment for students to optimally learn, to promote well-being, and to develop professionalism. Since 1990 the LCME has used the Graduation Questionnaire (GQ) to survey graduating medical students about their experiences and perceptions of their school’s leaning environment. Many schools’ GQ survey results have shown that students were less likely to report unprofessionalism and mistreatment while in school suggesting students are fearful of reporting while they are students. As a result, the LCME focuses on the learning environment in the accreditation surveys of medical schools. Following Virginia Tech Carilion School of Medicine’s (VTCSOM) 2013 LCME accreditation visit, the school established the Learning Environment Advocacy Committee (LEAC), a multidisciplinary committee that serves as the clearing house for learning environment concerns from students. The learning environment concerns are reviewed by the committee, recommendations are made to investigate the concerns, and the concerns are addressed in the departments where the unprofessionalism or mistreatment occurred. The LEAC raises awareness of the importance of a healthy learning environment for students, faculty, residents, nurses and staff at VTCSOM and its clinical affiliate. This seminar will review the process of developing the LEAC, the activity of the LEAC since the committee was established, and the results of an organizational wide learning environment survey.