"Why have you done it that way?" Educator perceptions of student-initiated conversations about perceived deviations from evidence-based clinical practice

Abstract

Students on clinical placement may encounter practice that deviates from what they perceive to be evidence-based. However, queries by students about the evidence-base of their clinical educators decision-making and practice can be a challenging conversation to initiate. It is unclear how these conversations occur, and what impact engaging in these challenging conversations may have on practice, the learning experience, and the relationship with the educator. This study sought to explore clinical educators' experiences of student-initiated discussions that question the evidence-base of their clinical practice. And to identify their preferred approaches for students to initiate these conversations. Individual interviews were conducted with 23 clinical educators from five professions at three different hospitals in Victoria, Australia. Semi-structured interviewing techniques were employed to identify participants' context and experiences. Participants described student-initiated conversations about deviations from evidence-based practice as challenging encounters with potential for positive or negative impact on clinical educators, students and patients. They noted that the perceived appropriateness of the discussion could be influenced by the method utilised by students to initiate the conversation. Elements identified by clinical educators as barriers or enablers to support students to appropriately initiate conversations about clinical practice may be utilised by education and health providers to enhance opportunities for learning conversations to occur.

Keywords: Clinical education; Evidence based practice; Health professional education; Patient safety.