From corners to community: exploring medical students' sense of belonging through co-creation in clinical learning.

BACKGROUND: Belonging is critical for the development and wellbeing of medical students. Belonging, particularly within a 'relational being' paradigm, presents a significant challenge for students, especially within clinical learning environments. Co-creation is a learning relationship in which students are actively involved in the education process. It is inherently relational and promotes belonging within higher education environments. Little is known about utilising co-creation in the curriculum, within medical education. The aim of this study was to explore medical students' experience of co-creation of learning resources within the clinical learning environment. METHODS: Following ethical approval, medical students were invited to become co-creators of a learning bulletin resource, within the paediatric acute receiving unit, at a paediatric teaching hospital. Interpretative phenomenological analysis (IPA) was used to enable an in-depth exploration of how medical students experienced co-creation within the clinical learning environment. Medical students participated in semi-structured interviews about their experience, which were transcribed verbatim and analysed using IPA. The analysis integrated individual lived experiences into an analytic summary. RESULTS: Nine medical students participated. Three group experiential themes were identified: identity maturation; learning community and workplace integration. The support found within this co-created learning community, along with maturation of their identity, allowed the participants to experience a challenge to their existing worldview. This shift in perspective resulted in them responding and behaving in the workplace in new ways, which enabled them to belong as themselves in the clinical learning environment. These findings were situated within the developmental concept of self-authorship, as well as contributing to a new understanding of how co-creation promoted social integration. CONCLUSIONS: Co-creation enabled students to learn in a meaningful way. The relational power of co-creation, can be harnessed to deliver participatory learning experiences, within our increasingly complex healthcare environment, to support the learning, development and integration of doctors of the future.

From safety net to trampoline: elevating learning with growth mindset in healthcare simulation.

The Implicit Theory of Mindset proposes two different mindsets that sit at opposite ends of a spectrum: a fixed mindset versus a growth mindset. With a fixed mindset, an individual believes they are born with a certain amount of an attribute, and so their potential is both pre-determined and static. With a growth mindset, an individual believes their attributes are malleable and can strengthen over time with repeated effort, adaptable learning strategies, and challenge seeking. Adoption of a growth mindset is associated with improved academic success, more effective learning strategies, increased resilience in the face of adversity, and better mental wellbeing.The theoretical underpinning of psychological safety resonates with the Implicit Theory of Mindset as it infers that a significant number of simulation participants have a fixed mindset and are therefore more likely to be fearful of making an error. The simulation community agree that participants need to feel comfortable making errors for simulation to be successful. The key word here is comfortable. Participants feeling comfortable to make errors just scratches the surface of adopting a growth mindset. With a growth mindset, participants see errors as a positive in the simulation experience, an inevitability of the learning process, evidence that they are adequately challenging themselves to improve.Encouraging adoption of a growth mindset in participants is a powerful addition to the establishment of psychological safety because a growth mindset will re-frame participants' experiences of social comparison from negative to positive and optimize information processing. We propose a novel idea: simulation educators should be explicit in the pre-brief about what a growth mindset is and its associated benefits to encourage its adoption during the simulation activity-a simulation growth mindset intervention. If this is not possible due to time constraints, an online module or article about growth mindset would be appropriate as pre-reading to encourage adoption of a growth mindset in participants. The message is not that a simulation growth mindset intervention should replace the focus on psychological safety but rather that it should be used synergistically to provide the highest quality simulation experience.