A Qualitative Study of Resident Learning in Ambulatory Clinic
- Cite this article as:
- Smith, C.S., Morris, M., Francovich, C. et al. Adv Health Sci Educ Theory Pract (2004) 9: 93. doi:10.1023/B:AHSE.0000027435.37893.47
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Qualitative analysis of a large ethnographicdatabase from observations of a residentteaching clinic revealed three importantfindings. The first finding was that breakdown,a situation where an `actor' (such as a personor the group) is not achieving expectedeffectiveness, was the most important categorybecause of its frequency and explanatory power. The next finding was that exposure to breakdownwas a necessary ingredient for reflectivelearning. The final finding was that effectiveresponse to breakdown (with concomitantreflective learning) requires six factors to bepresent: the patient is engaged directly;responsibility is matched to authority; toolsare matched to tasks; information resources arematched to need; values are matched betweenco-participants; and expectations are matchedwith capacity. These findings have implicationsfor planning, improvements and further studiesin ambulatory teaching clinics.