The Development of the Framework of Effective Teaching-Learning in Clinical Education: A Meta-Synthesis Approach

Teaching as the center of every curriculum is a set of actions undertaken to create and facilitate student learning. In recent years, the number of qualitative studies of effective teaching in clinical education of undergraduate medical education has increased. As the number of research studies grows, it is necessary to aggregate them. Therefore, the purpose of this study was to synthesize effective teaching-learning factors through the meta-synthesis in clinical education. In this study, the meta-synthesis approach was used to synthesize qualitative evidence in relation to effective teaching-learning factors in clinical education. From 1990 to 2021, electronic databases and journals were searched to identify studies and publications on effective teaching-learning factors in clinical education. Based on the combination and search strategies in the databases (OVID, PubMed, Web of Science, SCOPUS, Eric, Magiran, and SID), 33,799 and 56 studies were identified from other sources. Following reviewing the full text of the articles, 53 studies were selected. Forty-five studies were selected and included in the meta-synthesis process after critical appraisal using the Critical Appraisal Skills Program. The synthesis of qualitative evidence was developed as an effective teaching-learning framework in clinical education. Based on this comprehensive framework, effective teaching-learning in clinical education can be seen through behavioral or content (learner, teacher, and patient and their behaviors), social (collaborative learning community), pedagogical (instructional design and teaching-learning opportunities), contextual (positive and supportive clinical environment), and educational leadership (classroom management and structure) lenses. The current research is the first qualitative meta-synthesis to provide a thorough and comprehensive review of effective teaching-learning factors in clinical education. The results of this meta-synthesis provide a holistic view of clinical education and can help with clinical teaching-learning design.