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Theses Doctoral

Community of Reflective Practice: Clinical Education in Taiwan

Chang, Yan-Di

Medical practice entails lifelong learning of both the science and art of medicine. However, it is not easy to teach or observe what one has learned about the latter. Previous literature has found that learning during the clinical phase is influenced by both the macro, structural issues and micro, individual factors. This ethnographic study investigates the deliberate, systematic, and sustained effort of clinical education at a district hospital in Taiwan in order to find out how medical educators can train and retain caring and competent physicians. It focuses on the students’ experiences during their clerkship, formal and informal teachings such as ward rounds, teachings at the operating room, and fortnightly medical humanities discussions, as well as what the hospital has done to create a conducive environment for teaching and learning. Using a grounded theory approach, it uncovers the problems novices face in clinical practice and learning and effective techniques expert clinicians use in teaching. It concludes that the most effective and efficient education happens when learning is made explicit and visible, when teachers actively engage students in legitimate peripheral participation, when learners become self-directed in their endeavors, and when there is a community of reflective practitioners.

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Academic Units
Anthropology
Thesis Advisors
Varenne, Herve H.
Degree
Ph.D., Columbia University
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