Creating a Positive Learning Environment 

 

Venn diagram showing how professionalism, wellbeing, and learning environment interact

 

Six Easy Things We Can Do to Help Create a Positive Learning Environment

  1. Be welcoming and inclusive:  Simple suggestions for starting off on the right foot!

Welcoming phrases:

"Welcome, I look forward to working with you."

"I'd like to introduce you to the to the staff members, so you know the team. I’d like you to feel part of the team."

Consider setting the stage for students to bring you any concerns in real time by saying something like: “I am here to help you have a great experience in (name of clerkship/rotation). We want to meet the expectations for this rotation and prepare you for your career in medicine, regardless of your specialty choice. If you have concerns about the rotation, student expectations, learning environment or how best to improve, I’d be happy to meet with you or direct you to the appropriate person. The best way to reach me is…”

Respectful inclusive phrases:

“What would you like to be called?” Remember to learn and use student names!

“What do you want to take away from this rotation?” “What are your expectations and goals for the month?”

“You look as if you might have something to say. Please share, even if your ideas aren’t fully formed.” 

“That’s a really good point.”

 

2. Demonstrate enthusiasm: Learning is enhanced when learners encounter enthusiastic role models

Introduce yourself and describe why you are excited and passionate about learning and patient care “It’s going to be hard work, but we will have fun and see interesting cases.”

Embody a positive and optimistic attitude toward the team and learning

 

3. Be a team player: Don’t denigrate other specialties or complain about appropriateness of a consult from a peer

Provide appropriate space and trust based on trainees’ level of training and competency

Invite learner’s insights, thoughts and opinions

Encourage questions and independent thinking; “I want you to feel that you can ask me any questions.”

"We can learn from each other as we work together.”

 

4. Show empathy: Put yourself in your learner’s shoes. Be supportive of their uncertainties.

If you are concerned about a student who appears to be disengaged or withdrawn, consider reaching out: “You seemed a little quiet/distracted/upset today on rounds. Is everything OK?”

Acknowledge personal struggles; “It’s really challenging when a patient…. (receives devastating news, dies…) how are you doing with this?” “I’ve struggled with XYZ as a learner myself.” 

Consider communicating to students at the beginning of the rotation not to hesitate to let you know should they ever feel the need to take a moment to reflect after a difficult patient encounter. Students might otherwise find it hard to ask.

Consider circling back after rounds; “I know rounds can be an intimidating setting so I wanted to check back with you and see what questions you may have about your patients.”

 

5. Model humility

Admit your own limitations, errors, concerns; “I don’t know all the answers.”

Think aloud and invite learners to do the same

Acknowledge insecurities, fear of harming patients and desire to know more

Be open to learning from your students - They have a heightened awareness and understanding of how social determinants of health impact patient outcomes and, when given the opportunity to participate, can be valuable contributors to the health care team

 

6. Balance, challenge, AND support*

High challenge + high support = progression through a positive environment – trainee is given specific and challenging targets with adequate opportunity to meet them.

High challenge + low support = trainees feel discouraged

Low challenge + low support = trainee believes they have reached the level required

Low challenge + high support = previous misconceptions by the trainee are cemented instead of challenged

 

Acknowledgements:

Mayo Clinic “Resources for Creating a Positive Learning Environment”
Penn State “Faculty Scripts to Help Improve the Learning Environment”
Yale “ERASE” Program
*Gavriel, G, Gavriel, J, Br J Gen Pract. 2011 Oct; 61(591): 630–632.