Learning communities (LC’s) are currently being established at many U.S. medical schools as a means to enhance the learning environment for students and faculty. The medical school learning environment (LE), which encompasses the physical, social, and psychological context in which students learn, is felt to be a key determinant in students’ professional formation. 1 LC’s offer opportunities for longitudinal relationships with faculty, vertical integration among classes, and a greater sense of coherence between the espoused and enacted values. LC’s provide a range of curricular and extra-curricular programming including clinical skills training, professionalism dialogues, community service, and student well-being.
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In a recently acclaimed text on the future of medical education, Cooke and colleagues2 advocate for a more intentional shaping of the medical school learning environment, to build a sense of coherence between principles taught in the classroom and the lived experience of being a medical student. One avenue to achieving such coherence is enhancing relationships and longitudinal connections among teachers, learners, and patients across the four years of medical school. Hirsh and colleagues at Harvard3 advocate for enhanced continuity for medical students, primarily via faculty, peer and patient relationships. It is through such longitudinal relationships that students develop a sense of professional intimacy with teachers and peers, receive valued feedback, and gain the emotional comfort to take intellectual risks in their learning.
Learning communities can effectively address this need for continuity and can create a sense to the experience of medical school. 4 Broadly defined, a learning community (LC) is a group of people sharing common values and beliefs, who are actively engaged in learning together and from each other. LC’s typically offer these core features: a sense of membership, a sense of personal influence, fulfilment of individual needs, and shared events and emotional connections5. The origins of LC’s date back to 19th century British boarding schools, where house systems were used to subdivide students into smaller residential groups to better address their personal, social and emotional needs. Popularized by the fictional Hogwarts School of the Harry Potter novels, houses provided a sense of tradition, identity, and belonging, as well as leadership opportunities6. Evergreen State College (Olympia, Washington) pioneered the modern university LC in the 1980’s, and demonstrated that LC participation enhanced retention rates and academic achievement7.
At the Johns Hopkins School of Medicine, the Colleges Advisory Program (CAP), was founded in 2005 in an effort to enhance clinical skills teaching, career advising and students’ professional development. Modeled after a similar program at the University of Washington, JHSOM’s program includes all students and 24 dedicated medical school faculty who devote 20% time for longitudinal teaching and advising. As students arrive, they are randomly assigned to one of four colleges, each named after a legendary Hopkins faculty: Daniel Nathans, Florence Sabin, Helen Taussig, and Vivien Thomas. Six faculty are affiliated with each college and establish longitudinal relationships with five students in every class. These units of five students and one teacher are termed “advisory molecules”. The molecules become cohesive learning groups for the Clinical Foundations of Medicine course in Year 1, and thereafter, they meet at their advisor’s home and periodically through the curriculum to share learning experiences and career plans.
Within each College, a supportive matrix of student peer relationships provides social programming, community service activities, and a vibrant peer advisory program. An annual College Olympics each fall offers spirited competition between the colleges. The second floor of the new Armstrong Education Building is dedicated to the learning communities, and creates a sense of home for students. Celebratory events held on the Colleges floor center on student transitions and milestones, including the White Coat Ceremony, transition to wards, and Match Day.
LC’s offer a new twist to medical education, offering students a greater sense of belonging and connectedness to faculty, classmates, and students across class years. Through a range of curricular and extra-curricular programming, students can pursue interests, leadership opportunities, and help to positively shape the LE for current and future students. Creating a relational student-faculty community also invites informal dialogue and reflection, which can be invaluable in mitigating the impact of the many challenging events students encounter in their training.
Excerpts from: Shochet R. Learning Communities: A New Twist to Medical Education. The Maryland Medical J. 2012; 13(1): 13- 14.
- Branch, WT. Supporting the moral development of medical students. J Gen Intern Med. 2000; 15(7):503-508.
- Molly Cooke, David M. Irby, Bridget C. O’Brien. Educating Physicians: A Call for Reform of Medical School and Residency. 2010: Stanford, CA; Jossey-Bass.
- Hirsh DA, Ogur B, Thibault, GE, Cox M. “Continuity” as an organizing principle for clinical education reform. N Engl J Med. 2007;356(8):858-866.
- Ferguson KJ, Wolter EM, Yarbrough DB, Karline JD, Krupat E. Defining and describing medical learning communities: results of a national survey. Acad Med. 2009;84:1549-1556.
- McMillan DW, Chavis DM. Sense of community: a definition and theory. J Community Psychol. 1986; 14(1): 6-23.
- Stewart RW, Barker AR, Shochet RB, Wright SM. The new and improved learning community at Johns Hopkins University School of Medicine resembles that at Hogwarts School of Witchcraft and Wizardry. Med Teach. 2007;29(4):353-7
- Learning Communities- Wikipedia, the free encyclopedia. http://en.wikipedia.org/wiki/Learning_community. Accessed February 21, 2012.
StructureLearning Communities Structure
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