Barriers to Learning During Clinical Rotations in the Emergency Department: The Perspective of Students in a Public Sector Institute of a Developing Country

Background: Clinical learning is the crux of medical education. Students perceive many barriers to effective clinical learning due to transition, poor supervision, and lack of orientation. There is an urgent need for recommendations to alleviate these barriers and improve the quality of medical education in a public sector institute of a developing country. Aims: The study aims to identify the barriers in clinical learning perceived by the students during their clinical rotations in emergency. The study also aims to provide recommendations to alleviate these barriers. Methods: A cross-sectional study conducted among 300 students from a public sector institute of Pakistan. The perception of clinical learning was assessed using a structured questionnaire in students attending medical and surgical emergency ward. Independent samples t-test and ANOVA were used to assess differences in perception scores across gender and academic years. Results: The mean perception score was 52.0±11.74. There was a significant difference in perception scores across academic years (p=0.028) with the final year having lower perception scores than the junior students. The mean scores of items in domain 1 (Transition and stress) and domain 4 (Supervision and feedback) were lower indicating a negative perception in these domains. Conclusions: Lack of clinical orientation, non-integration of the clinical curriculum in preclinical years, poor supervision, lack of resources, and a crippled feedback delivery system are barriers to clinical learning. Interventions such as integration of clinically orientated curriculum, teacher training, student-centered teaching methodology, and development of an effective feedback delivery system must be employed for quality clinical learning during rotations.