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Table 2 Themes and Examples of Themes from Interviews with Medical Learners

From: Ready to collaborate?: medical learner experiences in interprofessional collaborative practice settings

Theme

Examples

Loss of Educational Opportunities During Rounds

- “You are losing that whole, bouncing off ideas with members of the team, bouncing off ideas with the attending. I think a lot of that is lost, and a lot of valuable learning comes from those experiences.” – Intern 1

- “I feel like there was less teaching going on for the most part.” – Resident 1

- “You do miss out on the formal presentations. The med students do not get the practice, which I think is a pretty big skill. […] Bedside teaching is also gone and lost because you are trying so hard to just simplify patients’ problems into one or two things.” – Intern 1

- “I feel like the teaching has at first really struggled […]. You don’t have that time to sit and discuss things because you are with the whole team. […] I think that is a challenge as a med student and because you know the whole reason why we come is to try to learn how to manage these illnesses and things, you know, not so much how to work with the caseworker. It is good to learn that, [but] right now that is not necessarily what our goal is.” – Student 1

Feelings of Uncertainty during New Situations

- “I cannot say I think it is pancreatic cancer in front of the patient.” – Student 2a

- “I do not want to derail the whole process because I have a question about something. […] I think that it kind of hinders my freedom to kind of ask and inquire because I do not want to make it seem like I am questioning somebody’s approach to their care in front of the patient. […] So just to […] not hold [up] the process, I do not ask lots of questions.” – Student 3

- “I think there were times where maybe I would like to ask a question that if it was just med students, interns, residents and attending, maybe I would have brought up that question and we could have discussed a little bit further. But actively in front of the patient, with other team members there, I probably did not bring it up until we walked out of the room.” – Intern 2

- “I personally have a lot of anxiety from being put on stage.” – Student 2b

Strategies for Adaptation

- “I think it is still a little bit disorganized in some ways. And part of it is because we have not really forgotten our old habits and we’re trying to do new things. If we just forgot the old habits and we transitioned to new stuff, it would be easier.” – Resident 2

- “We had to figure out how to involve the med student process of learning into our rounding, so we did table rounds in the morning before in order to still have our presentations and our feedbacks.” – Student 2b

- “We had to budget time more for the patients that [were] not getting the Collaborative Care. [For] the first few days, it was like how do we cover these patients that we’re not seeing, and we had to figure out the time. And we actually have to come in earlier. Like we round with the attending at an earlier time than the other teams.” – Student 2b

- “I think [Dr. A] was really good at doing that. […] [Dr. A] took the initiative to say ‘You know what, we’re going to step back a second, I am going to do some teaching.’ […] And she is really natural when she tells the patients that. It was really good and I mean I got a lot more from those rounds. I was able to learn on the spot in the room with the patient.” – Student 4

Improved Communication with Patients and the Team

- “Eventually like we are going to be the people who are leading the conversations, when we actually do become doctors. So I think it kind of puts you in a position where you have to lead the conversation sooner than in other rotations or in other internal medicine experiences that I have had. Because there are some times where I will say everything to the attending outside the room, but then when we go in, I don’t say anything. So it gives you the opportunity to speak, interact with the patient.” – Student 5

- “I have learned […] mostly about what is important to people and what is important for the family, what is important for the patient, and how to communicate with all the members of the team, like the nursing staff. And how, I guess that is something that surprised me a lot, how I can rely on the nursing staffs more […]. I think before I never felt supported by the nursing staff and now I do, so that surprised me.” – Resident 2

- “It makes you [a] more cognizant educator as far as teaching the patient about their condition and being able to kind of dematerialize the plan into something that they can cogently […] deal with. So that is the one way it impacts you know my learning. It is more about interpersonal learning and […] just being more aware how you see things.” – Student 3