The clinical learning environment.

This paper presents a brief review of the attributes of effective learning environments in clinical settings. Recent studies articulate the perceived importance of social and organizational factors as determinants of learning. Differences are evident among hospitals and among departments within hospitals with regard to the quality of the learning environment they offer. These differences are reflected in the orientation towards teaching and learning, the level of autonomy, variety and workload, and the quality of supervision and social support. Differences are also evident in the type and quality of opportunities for practice of important skills and in the availability of educational resources. These factors are perceived as major determinants of the effectiveness of learning in clinical settings. The implications for clinical teachers and administrators are discussed. The authors argue that emphasis should be given to the creation of supportive and well-organized learning environments in clinical settings. This may require a great emphasis on the role of clinical teachers as designers of opportunities for learning and managers of learning resources.