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The Importance of a Nurturing Learning Environment

Lessons Learned from Loggerhead Turtles

This past summer, in a blog I wrote about the importance of learning and working environments, I mentioned the recommendations from the Macy Foundation’s April conference, “Improving Environments for Learning in the Health Professions.” Amy Barton, a panelist at the Consortium’s own conference in June, was an invited participant at the Macy Foundation event.

I was curious about what struck her the most about the discussions at the Macy Conference.  It was definitely a high-level discussion, she noted, revolving around analyzing commissioned papers about theories of learning and instruction. But what impressed her the most was the persistent focus on the social component of learning—on community—and on the importance of creating environments that are nurturing.

I asked Amy to join me and write a blog about these ideas.  She begins by talking about loggerhead turtles (!); describes the four characteristics of learning environments; relates all that to the Johns Hopkins Civility Project; and wraps it up with a closing quote from the conference.

Handing off to Amy…

It’s not often we have the opportunity to immerse ourselves in a new environment – one that is not familiar to us, where we depend on assistance and way-finding from others. Recently, I visited the Loggerhead Marine life Center in Jupiter, Fla. I had the opportunity to learn about the challenges sea turtles face from before the beginning of their lives and the fact that only 1 in 1,000 survives to adulthood. I was able to witness the loving care that mobilized volunteers provided as they cleansed new hatchlings and provided rehabilitation to those injured by predators or human intervention. The mobilization of resources and joy experienced by the release of one of the adult turtles led me to think about the environment we create for our learners…

At the Macy Foundation conference, I was struck by the strategic intentionality required to improve learning environments. At the Loggerhead Marine life Center, the commitment to the cause was nearly palpable. I found myself reflecting, are we that committed to improving the learning environment for health professionals?

One facet of the conference discussion that struck a chord with me was the conceptualization of the learning environment as a dynamic milieu in which four distinct components overlap and interact: personal component, social component, organizational component, and physical and virtual component.

The personal component consists of what individuals bring to the learning environment. It includes learning goals as well as the personal growth that occurs during the learning process and helps shape professional identity. In residency and fellowship programs, this journey to professional formation is a key outcome.

The social component consists of the relationships that occur as a result of engaging with others in the environment. Others include peers, staff, patients, and faculty who help shape the learning experience.

The organizational component includes the infrastructure that supports the learning process. In residency and fellowship programs, this includes features such as the scheduling of sub-specialty clinics, preceptor availability, and panel establishment. The organizational component also includes the overall culture of the learning environment.

Finally, the physical and virtual component includes the space for learning. This may include consult areas for preceptor meetings and online resources available for learner use.

Taken together, these concepts provide a framework to think broadly about the learning environment and to consider how various components affect learning. It is so much more than the mere space in which learning occurs. It is a dynamic state that affects and is affected by those who interact to learn and work toward optimal patient outcomes.

The component that we as individuals can profoundly influence is the social component. The manner in which we choose to interact with those we care for and work with contributes to the tenor of the learning environment. In 2002, the cofounder of the Johns Hopkins Civility Project, P. M. Forni, provided 25 rules of considerate conduct in his book, “Choosing Civility.” Some of the most pertinent for the workplace include:

  • Pay attention
  • Acknowledge others
  • Think the best
  • Listen
  • Speak kindly
  • Be inclusive
  • Accept and give praise
  • Respect other people’s time
  • Accept and give constructive criticism

None of these rules are difficult and they contribute to a positive, polite, respectful, and civil environment.

Thinking back to the hatchlings, I’m mindful of the intensity of staff dedication to creating safer environments to foster their birth, growth, and maturity. It was clearly an “all hands-on deck” proposition, despite the overwhelming odds against survival.

Can you imagine a similar experience within a learning environment for health professionals? What if everyone was committed to the success of all of our learners with the same fervor as those engaged with sea turtle rescue efforts? At that point, we may reach the vision articulated by conference participants, “Exemplary learning environments prepare, support, and inspire all involved in health professions education and health care to work toward optimal health of individuals, populations, and communities.”

Back to Candice…

How does your program provide an all-hands-on-deck learning environment? Some programs, for example, have community engagement projects that spark connectedness. Does your program do something to promote professional growth, personal fulfillment and connectedness? We’d love to hear about it!  Please consider sharing via the comments section, below.

Wishing you personal fulfillment and professional growth.  Until next time-