P064: Characteristics of physical space that optimize clinical learning in the emergency department: implications for design

Abstract

Introduction: Over the last few decades, health care facility design has been studied to look at its effect on many patient-centred outcomes. However, limited data exists on the impact that specific physical features of a clinical space may have on learning and the educational experience. The aim of this study is to develop a set of characteristics which clinicians, clinical teachers and residents believe should be present in a clinical space to maximize trainees learning, using an emergency department (ED) as a context. Methods: A qualitative methodology used semi- structured interviews with a purposive sample of twelve attending physicians and residents who work in EDs of varying age and design at several sites of a quaternary university hospital. We explored their perceptions of the physical features in the clinical and learning environment that supported or impeded teaching and learning. The interviews were transcribed and thematically analyzed. Results: Preliminary results show that many physical characteristics of the clinical space are perceived to have an impact on trainees learning experience. A design with separation between clinician-learner dyads and the patients, with a visual access; shared clinical space among different health care professionals within a reasonable distance; availability of enough clinical space for specific emergency presentations; features such as adequate size, appropriate light, and control of sound were all perceived to enhance and augment clinical learning. Not surprisingly, non-design factors such as the presence of a functioning team and the availability of adequate equipment and technology was considered as important as the characteristics of physical space to optimize learning. Conclusion: This study demonstrates the importance and the impact of physical space design on trainees learning in a dynamic clinical environment. It provides teachers and policy-makers with a basis for developing criteria of the physical characteristics of a healthcare facility to maximize learning.