Does feeling part of the health care team matter for students' learning? Exploring the relationship between sense of belonging and perceived learning climate during clerkships

Purpose Teaser: This study explores the relationship between medical students' sense of belonging and their perception of the learning climate during clerkships, focusing on how these factors vary across clinical departments. The results reveal a strong positive correlation between belongingness and learning climate, with departments like family medicine and neurology ranking the highest, while ophthalmology scored the lowest. A meaningful role, defined by active participation in patient care and genuine interest from healthcare team members, is crucial in shaping both belongingness and the learning climate. Students reported that when they felt included in patient care activities and received personalized attention from supervisors, their sense of belonging and learning experience improved. The study highlights the importance of collaborative efforts from faculty, residents, nurses, and administrative staff in fostering an inclusive environment. This research underscores the need for intentional engagement strategies to enhance student participation and learning outcomes in clinical settings. This study explores the relationship between medical students' sense of belonging and perceived learning climate in clerkships, how these perceptions vary across clinical departments, and how students describe the interplay between belonging and learning climate.Purpose Teaser: This study explores the relationship between medical students' sense of belonging and their perception of the learning climate during clerkships, focusing on how these factors vary across clinical departments. The results reveal a strong positive correlation between belongingness and learning climate, with departments like family medicine and neurology ranking the highest, while ophthalmology scored the lowest. A meaningful role, defined by active participation in patient care and genuine interest from healthcare team members, is crucial in shaping both belongingness and the learning climate. Students reported that when they felt included in patient care activities and received personalized attention from supervisors, their sense of belonging and learning experience improved. The study highlights the importance of collaborative efforts from faculty, residents, nurses, and administrative staff in fostering an inclusive environment. This research underscores the need for intentional engagement strategies to enhance student participation and learning outcomes in clinical settings. This study explores the relationship between medical students' sense of belonging and perceived learning climate in clerkships, how these perceptions vary across clinical departments, and how students describe the interplay between belonging and learning climate.Method A mixed-methods approach with an explanatory sequential design was used among medical students at Maastricht University. Quantitative data from 6,434 program evaluation questionnaires completed between December 2014 and January 2020 were retrospectively analyzed to assess the relationship between belongingness and learning climate. Thematic analysis of narrative questionnaire responses and one focus group provided further insights into students' experiences. Data were integrated at the analytic and interpretation stages toward a conceptual model.Results The mean (SD) belongingness score was 3.90 (1.13). The mean (SD) learning climate score was 7.62 (1.72). A positive correlation between belongingness and learning climate was found (r = 0.693, P < .001).Significant differences were observed among clinical departments, with the family medicine department scoring highest on both measures. Having a meaningful role enabled by various stakeholders, such as residents, nurses, and consultants, was identified as key to enhancing both belongingness and learning climate. Students conceptualized a meaningful role as being allowed active participation in patient care and having genuine interest shown in them.Conclusions Students' sense of belonging and perceived learning climate are closely intertwined and shaped by the degree to which students are given meaningful roles in clinical practice. This underscores the importance of intentional engagement strategies by the broader health care team and educational administrators to foster an inclusive educational environment and promote active student participation. Roster planning can support this by scheduling learning opportunities. Faculty development should focus on supporting student learning, fostering personal engagement and open dialogue, and providing meaningful feedback. Students themselves are encouraged to actively seek meaningful ways to contribute in clinical settings.