Optimizing the CLE: An International Consensus Conference

Background, including statement of problem and aims:
There is tremendous focus on the clinical learning environment (CLE) due to its significant impact on learning and patient outcomes. While much has been done to identify challenges for the future of the CLE, next steps are difficult to identify. In October 2018, the Royal College of Physicians and Surgeons of Canada hosted a global consensus conference on the CLE. The objective of this conference was to reflect upon and identify gaps in the current literature in order to delineate tangible short- and long-term goals towards improving CLE’s.

Design or methodology:
After initial review of the literature, conference leaders developed a conceptual model mirroring work in established disciplines to deconstruct the complex CLE to better understand the CLE, and identify tangible goals for improvement. The model identified six different “avenues” through which the CLE was explored: Psychological, Educational, Socio-cultural, Architectural, Digital and Diversity & Inclusion. Conference participants gathered in Halifax, Nova Scotia to advance this work and after initial frame-setting, participants attended workshops focused on a specific avenue with the goal of identifying strategies aimed at optimizing the CLE for that avenue. Next, a summary of workshop findings were presented with linkages and connections between the avenues demonstrated, using a unique and interactive visual mapping exercise. Ensuing discussion highlighted new learnings and codified where overlap and synergy existed.

Results (data, outcomes and evidence):
As a result of the conference, various strategies and approaches for the improvement of the CLE were identified which are easily transferrable to other health professions. The outcomes for each avenue has been separately accepted for publication as part of a themed issue of Medical Teacher, the international journal focused on addressing the needs of teachers and administrators involved in the training of health professionals.

Conclusion/Implications:
Collectively, these papers highlight the overlap between the “avenues”, how they influence each other and collectively shape the global work to understand and improve the CLE. The expectation is that this work will add to existing knowledge and create new ideas for interventions to improve the CLE across the globe.