A study of a new web-based tool called Learning Moment, which helps medical students track their learning experiences while on rotation, revealed that the most student learning happens in patients’ rooms.
The tool was developed by clinicians at Boston Medical Center (BMC) and BU School of Medicine to help students reflect on their experiences and share their learning with peers.
"We hope that our study will highlight the potential of Learning Moment as a tool to foster experiential learning by encouraging reflective observation during practice,” study author Dr. Alexander Sheng, assistant professor of emergency medicine at BU School of Medicine and emergency medicine physician at BMC, said in a statement. "The data from Learning Moment has the potential to help educators better understand the intricacies of local learning microenvironments as well as the broader clinical learning ecosystem."
The pressure for doctors to see more patients in less time and the increase in documentation and billing requirements has created barriers to bedside teaching, according to the study authors. Researchers noted that this time crunch is particularly relevant in emergency medicine where direct observation time of residents interacting with patients by faculty was only 3.6 percent.
Moreover, researchers hypothesized that the most frequent learning experiences would occur at the physicians’ workstation but found that the most frequent learning moments were reported in patients’ rooms.
The study included 42, third and fourth-year medical students rotating through BMC’s emergency department over a six-month period. The participants were asked to break down what they learned and were given an option to track where the learning experience occurred. Their information was shared with peers in a community feed. This displayed the lesson learned and the category. For example, the learning “pearl” could be different ways cocaine can cause chest pain and the category would be information gathering.
Over the six-month study students tracked a total of 323 “learning moments,” but only 266 of the answers reported where the learning occurred. One hundred and thirty-five learning moments happened in patients' rooms, which accounted for 50.8 percent of reported learning moment locations. Physician work stations accounted for the second most, with 67 moments tracked there.
“Although successfully piloted in the ED, LM is potentially adaptable to other clinical departments and institutions as we seek to inform the design of optimal learning ecosystems and maximize experimental learning for all future trainees,” the authors wrote. “Efforts are ongoing to make LM avilable to more learner populations in new learning environments as we continue to demonstrate the feasibility and value of our platform to various stakeholders throughout health professions education.”