THE CLINICAL LEARNING-ENVIRONMENT

This paper presents a brief review of the attributes of effective lear ning environments in clinical settings. Recent studies articulate the perceived importance of social and organizational factors as determina nts of learning. Differences are evident among hospitals and among dep artments within hospitals with regard to the quality of the learning e nvironment they offer. These differences are reflected in the orientat ion towards teaching and learning, the level of autonomy, variety and workload, and the quality of supervision and social support. Differenc es are also evident in the type and quality of opportunities for pract ice of important skills and in the availability of educational resourc es. These factors are perceived as major determinants of the effective ness of learning in clinical settings. The implications for clinical t eachers and administrators are discussed. The authors argue that empha sis should be given to the creation of supportive and well-organized l earning environments in clinical settings. This may require a great em phasis on the role of clinical teachers as designers of opportunities for learning and managers of learning resources.