title: Workplace learning: an analysis of students' expectations of learning on the ward in the Department of Internal Medicine.
abstract: BACKGROUND
  Learning on the ward as a practice-oriented preparation for the future workplace plays a crucial role in the medical education of future physicians. However, students' ward internship is partially problematic due to condensed workflows on the ward and the high workload of supervising physicians. For the first time in a German-speaking setting, students' expectations and concerns about their internship on the ward are examined in a qualitative analysis regarding their internal medicine rotation within clinical medical education.
  
  
  METHODS
  Of a total of 168 medical students in their 6th semester at the Medical Faculty of Heidelberg, 28 students (m=8, f=20, Ø 23.6 years) took part in focus group interviews 3 to 5 days prior to their internship on the internal medicine ward within their clinical internal medicine rotation. Students were divided into four different focus groups. The protocols were transcribed and a content analysis was conducted based on grounded theory.
  
  
  RESULTS
  We gathered a total of 489 relevant individual statements. The students hope for a successful integration within the ward team, reliable and supportive supervisors and supervision in small groups. They expect to face the most common diseases, to train the most important medical skills, to assume full responsibility for their own patients and to acquire their own medical identity. The students fear an insufficient time frame to achieve their aims. They are also concerned they will have too little contact with patients and inadequate supervision.
  
  
  CONCLUSIONS
  For the development and standardization of effective student internships, the greatest relevance should be attributed to guidance and supervision by professionally trained and well-prepared medical teachers, entailing a significant increase in staff and costs. A structural framework is required in order to transfer the responsibility for the treatment of patients to the students at an early stage in medical education and in a longitudinal manner. The data suggest that the development and establishment of guidelines for medical teachers associated with clearly defined learning objectives for the students' internships are urgently needed. Based on our findings, we provide first recommendations and suggest possible solutions.
authors.affiliation: University Hospital Heidelberg, Department of General Practice und Health Services Research, Heidelberg, Germany.
authors.forename: Nadja
authors.initials: N
authors.lastname: Köhl-Hackert
authors.affiliation: University of Heidelberg, Department of Nephrology, Heidelberg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Krautter
authors.affiliation: Universityhospital Heidelberg, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Andreesen
authors.affiliation: Universityhospital Heidelberg, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Hoffmann
authors.affiliation: Universityhospital Heidelberg, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Herzog
authors.affiliation: Universityhospital Heidelberg, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Jünger
authors.affiliation: Universityhospital Heidelberg, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Nikendei
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003469:Culture; D004504:Education, Medical, Undergraduate; D005260:Female; D017144:Focus Groups; D005858:Germany; D006748:Hospital Departments; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D010819:Physician's Role; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D057188:Workflow; D016526:Workload / Q000523:psychology; D055815:Young Adult
keywords: Workplace learning; clinical training; focus groups; grounded theory; undergraduate medical education