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Learner Experience & Culture

Learner experience and culture icon.

Enabling all learners to grow in a safe, stimulating and compassionate environment.

Goal Statement: 

Learners state they are valued and supported.

2023 Success Measures:

Learners state they are valued and supported during their Sunnybrook placement. Target: 95 per cent.

Overview

An extraordinary learning experience requires great teachers, committed colleagues and an environment where learners feel safe to take interpersonal risks in the work environment. Psychological safety1 is important to learners’ perception of their learning environment (Tsuei, 2019) and is also associated with how learners rate satisfaction with their clinical learning experiences (Karina, 2016). Supportive learning environments are associated with longitudinal relationships free from judgement by peers, mentors, and team members (Tsuei, 2019).

Although there are few studies about learning behaviours in the educational context, there is evidence that psychological safety increases the motivation for knowledge sharing between individuals (Siemsen, 2009). There is also evidence that there is a clear role for teachers in contributing to the creation of an educationally safe learning environment, and that group dynamics and interpersonal relationships influence academic performance (Soares, 2017).

At the core of Sunnybrook’s mission is teaching and learning. In recent years, learners have rated Sunnybrook highly (more than 90 per cent satisfaction) in terms of their placement experience and how their learning objectives were met. Well-attended student wellness events and leadership forums, orchestrated by the Student Experience Committee, contribute to these strong results. At the same time, learners have indicated that Sunnybrook, along with all other TAHSN members, needs to address such issues as incivility, especially from patients/family members and clinical staff, and harassment, typically described as disrespect, verbal assaults and bullying.

Sunnybrook’s leadership role within TAHSNe resulted in the development and subsequent widespread adoption of policies to address these issues. In addition to adopting these recommendations, the Education Program will introduce more specific evidence-informed actions over the next three years to create a safer and healthier post-postpandemic physical and virtual learning environment. Planned initiatives include strengthening the bonds within the diverse and inclusive learning community, at the clinical team level and also at the cohort or learner community level; and providing additional resources to the individual learner to foster higher levels of individual resilience since resilience is associated with the ability to withstand, adapt to, and recover from stress and adversity. Innovative assessment approaches to foster improved communication, care and teaching skills among learners with respect to patients and families will be introduced as part of including patient partners on care teams.

In addition to the focus on the learner, opportunities have been identified to strengthen the teaching community at Sunnybrook. Medical and other health professionals at academic health centres serve dual roles: both as clinician as well as teacher. Learners have identified three qualities present in effective teachers: knowledge of subject, enthusiasm (including displaying personal interest) and communication skills (Singh, 2013; Soares, 2017). Over the next three years, teachers will be supported in strengthening their ability to create safe and equitable learning environments through the provision of resources and training designed to improve the clarity of their communication, their understanding of equity, diversity, and inclusion principles and their ability to provide feedback. Mentorship opportunities for teachers will also be expanded.


Objectives, Tactics and Measures »

Objective 1: Build a stronger learning community

Tactic 1: Develop strategies for all units to orient learners to their teams.

Tactic 2: Engage learners in decision-making related to their learning experience.

Tactic 3: Provide opportunities for increased learner interaction such as a lounge, study space, and social events.

Tactic 4: Enhance opportunities to celebrate teacher and learner successes.

Measures

  • Percentage: “I felt prepared to begin my placement after the orientation”
  • Percentage: “I felt welcomed and accepted as part of the team”2
  • Percentage: “I feel that my teaching contributions are recognized”2
  • 100% of units conducted orientation for learners

Objective 2: Support learners to improve their well-being

Tactic 1: Improve access for all learners (including at SRI) to health and wellness information, resources and supports, including counseling services and library updates.

Tactic 2: Provide learners with additional infrastructure and resources such as locker space and extended shuttle services.

Tactic 3: Tackle incivility to learners through robust implementation of TAHSNe Learner Environment Survey recommendations.

Measures

  • Percentage of favourable responses to “I received appropriate assistance to address any questions or concerns I had about my placement”2
  • Percentage of favourable responses to “I was able to access the resources necessary to do the work that was expected of me (e.g., library, inter/intranet, clinical/business systems)”2
  • Number of student concerns received online via the Student Assistance inbox
  • Percentage of favourable responses (never) to “Did you personally experience harassment during your placement?”
  • Percentage of favourable responses (never) to “Did you personally experience discrimination during your placement?”
  • Number of student well-being initiatives implemented annually

Objective 3: Foster high-impact teaching

Tactic 1: Improve teacher access to resources and training (such as technology-enabled professional development opportunities covering topics like providing student feedback, and formal equity, diversity, and inclusion training, etc.).

Tactic 2: Enhance training in virtual care, virtual teaching and virtual supervision.

Tactic 3: Expand opportunities for teachers to share expertise, including formal mentorship programs.

Tactic 4: Strengthen the feedback process for learners by including patient educators on care teams.

Tactic 5: Promote and support scholarly learner experiences including developing and applying research-informed best teaching practices.

Measures

  • Percentage of favourable responses to “I would recommend my preceptor(s)/supervisor(s) for future student placements”2
  • Number of Sunnybrook staff attending preceptor/supervisor formal training initiative
  • Percentage of favourable responses to “I was supported for teaching by Sunnybrook with development opportunities and resources”2
  • Percentage of learners receiving feedback from patient educators

References

  1. . Tsuei, S. H.-T., Lee, D., Ho, C., Regehr, G., & Nimmon, L. (2019). Exploring the Construct of Psychological Safety in Medical Education. Academic Medicine, 94, 528–535. doi: 10.1097/ acm.0000000000002897
  2. Karina D. Torralba, Lawrence K. Loo, John M. Byrne, Samuel Baz, Grant W. Cannon, Sheri A. Keitz, Annie B. Wicker, Steven S. Henley, and T. Michael Kashner (December 2016) Does Psychological Safety Impact the Clinical Learning Environment for Resident Physicians? Results from the VA’s Learners’ Perceptions Survey. Journal of Graduate Medical Education: Vol. 8, No. 5, pp. 699-707.
  3. Singh, S., Pai, D.R., Sinha, N.K. et al. (2013) Qualities of an effective teacher: what do medical teachers think?. BMC Med Educ 13, 128 https://doi.org/10.1186/1472-6920-13-128
  4. Soares, A. E. & Lopes, M.P (2017) Are your students safe to learn? The role of lecturer’s authentic leadership in the creation of psychologically safe environments and their impact on academic performance. Active Learning in Higher Education https://doi.org/10.1177/1469787417742023 

Footnotes

1Psychological safety is defined as an environment where individuals are able to engage, communicate, and report mistakes or problems without any negative consequence to self, status, or career (Karina, 2016). Barbara Fredrickson at the University of North Carolina has found that positive emotions like trust, curiosity, confidence, and inspiration broaden the mind and help build psychological, social, and physical resources. We become more open-minded, resilient, motivated, and persistent when we feel safe. Humor increases, as does solution-finding and divergent thinking – the cognitive process underlying creativity. When the workplace feels challenging but not threatening, teams can sustain the broaden-and-build mode. Oxytocin levels in our brains rise, eliciting trust and trust-making behavior. https://hbr.org/2017/08/high-performing-teams-need-psychological-safety-heres-how-to-create-it  
2Measures are drawn from the TAHSN Learner Engagement (LE) Survey