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Conceptualizing Learning Environments in the Health Professions

Gruppen, Larry D. PhD; Irby, David M. MDiv, PhD; Durning, Steven J. MD, PhD; Maggio, Lauren A. MS(LIS), PhD

doi: 10.1097/ACM.0000000000002702
Perspectives
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The learning environment (LE) is an important and frequently discussed topic in the health professions education literature. However, there is considerable inconsistency in how the LE is defined and described. The authors propose a definition of the LE and a conceptual framework to facilitate health professions educators in understanding, studying, and designing interventions to improve the LE. To arrive at this conceptual framework, the authors employed a living systems perspective that draws on various frameworks and theories, including ecological psychology, workplace learning, situated cognition, and sociomateriality theory. The conceptual framework identifies five overlapping and interactive core components that form two dimensions: the psychosocial dimension and material dimension. The psychosocial dimension comprises three components: the personal, social, and organizational. Intertwined with the psychosocial dimension at each level is the material dimension, which encompasses physical and virtual spaces. This theoretical lens can facilitate identifying and analyzing problems in the LE and guide development of interventions to mitigate them. The authors conclude with several practical suggestions for health professions educators, investigators, and editors.

L.D. Gruppen is professor, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: http://orcid.org/0000-0002-2107-012.

D.M. Irby is professor emeritus, Department of Medicine, University of California, San Francisco, San Francisco, California.

S.J. Durning is professor, Department of Medicine, and director, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

L.A. Maggio is associate professor, Department of Medicine, and associate director, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: http://orcid.org/0000-0002-2997-6133.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Uniformed Services University of the Health Sciences, the U.S. Navy, the Department of Defense, or the U.S. Government.

Previous presentations: A scoping literature review, on which this article is based, was presented to the Josiah Macy Jr. Foundation Conference on Improving the Environment for Learning in the Health Professions, April 15–18, 2018, Atlanta, Georgia.

Correspondence should be addressed to Larry D. Gruppen, Department of Learning Health Sciences, University of Michigan Medical School, 219 Victor Vaughan House, 1111 E. Catherine St., Ann Arbor, MI 48109-2054; telephone: (734) 936-1662; email: lgruppen@umich.edu.

Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.