Medical student perceptions of learning during the critical care program of Sydney Medical School: The deliberate attainment of basic airway management skills in a core rotation

Abstract

Introduction: This thesis explores student learning in the context of the Critical Care Medicine Rotation (CCMR) during the Sydney Medical School Program (SMP). It focused on how medical students learn basic airway management skills as a means, to explore student learning in this environment. Study Design: The use of assessment was deliberately used in order, to identify both the effect of assessment and the experience of the rotation on student learning.This was explored from a interpretative/constructive theoretical approach. The mixed methods study design included a combination of pre and post testing of theory and practical skills assessment conducted by simulation and clinicial assessment of basic airway skills. Then focus groups explored student perceptions of the assessment and the components of the Critical Care rotation on their learning. Limitations: Study limitations include the conduct of the study at a single site by a single researcher, the results however, provide very useful insights into student learning and areas identified for future research. Study findings: The study found a significant change in declarative knowledge and a consistent level of student ability to manage basic airways in both simulation and clinical setting. The students identifying, that the assessments guided their learning during the rotation. The themes of ‘Goal setting’, ‘active learning’ ,’peer continuum’ and ‘conflict’ identified. Observation, questioning, guidance and participation were core features of student learning. The students’ valued time to observe peers, wanting to understand their peers ‘thought processes’ (clinical reasoning) and the ‘process of clinical activities’ as a stage before active participation, with active participation core to their learning. The students demonstrated a strong preference for clear direction from their tutors, specifically students identified questioning, being questioned and being able to teach back were important to the process of their learning. Students identified that ‘Conflict’ with curriculum requirements external to the clinical rotation, were a major problem. These requirements restricted the students’ ability to gain an adequate clinical experience, within the CCM context by reducing time spent in the clinical environment. Conclusion: The current program was found to be effective for student learning, however, opportunities exist for additional improvements.