This study studied the learning environment of the Orthopedic ward. Generally, students appreciated the welcoming learning environment of the orthopedic ward. Similar to our study, Zafar et al also found a higher level of satisfaction with the microlearning environment of their four major clinical postings (4). It is observed that the students' overall perceptions of the educational environment are more optimistic during the internship period. The reason for students' positive response is that learning in the clinical environment has many fortes. It is focused on real life clinical scenarios in the context of professional practice and students are motivated by its relevance to their profession (5). Moreover, it is a unique setting where facilitators and students can model attitudes, can learn history taking, physical examination, decision making, clinical reasoning, teamwork, professionalism, and empathy in an integrated manner (15). Another reason to appreciate the LE of the orthopedic ward is that it is interesting, and new practical knowledge was given in this specialty, e.g., reading X-rays and dealing with fractures, real-life situations, and trauma problems. The adult learner learns better when relevance is created. Adult students are most likely to want to learn about subjects that will have immediate payoffs in their lives, especially regarding their social roles (16).
This study found that the male undergraduates had a more positive response to the LE of the orthopedic ward than their female colleagues. This might be because male students are more interested in the field of Orthopedics as compared to females. The recent report of AMA revealed that Orthopedic is the topmost specialty selected by the male residents while females' most prioritized field of specialty is Gynaecology (17). Another remarkable finding in this study is that fourth-year students much appreciated their placement in the Orthopedic ward than final year students. They admitted that this posting had a friendly, welcoming and open atmosphere. It is observed that junior learners tend to show better satisfaction than their seniors because they had lesser expectations from their educational systems (18).
Though in both domains of the questionnaire, the students positively perceive their learning experience, "staff attitude" has a more significant positive response than the "teaching quality." The literature shows a huge impact of encouraging teacher behavior on learners' motivation levels. Instructors' nonverbal acts such as smiling, having a good attitude, and positive facial expressions improve the learning experience for students (19). Offering balanced and supportive teacher-student relationships is one of the most important principles of teaching (20, 21). A constructive, nurturing learning environment is an essential part of learning. Staff behavior and attitude make a student feel comfortable, a place where healthy relationships with peers and teachers flourish (23). Moreover, learning process can be improved by constructing a positive and encouraging atmosphere (24).
Although students' overall perception of the orthopedic ward LE is positive, to statements 4,10,11, and 12, " more than 50% of students had neutral, disagree, and strongly disagree responses. For statement number four (Faculty showed an interest in students' learning), more than 50% of participants perceived that faculty do not take an interest in students learning. It is evident that students who felt that the teaching staff lacked interest in them reported feeling less motivated (25). In contrast, faculty who let students share their views and demonstrate genuine academic interest in students report stronger student outcomes (26).
It is observed in this study that three out of four statements i.e. 10,11, and 12 (“I was able to meet my learning objectives on this placement” “I had the opportunity to deal with the patient as a whole on this placement” and “I was given tasks suitable for my stage of training on this placement) which had more than 50% disagree, strongly disagreed and neutral responses belong to the ‘’teaching quality’’ sub-category, which showed that teaching quality should be improved to enhance the LE of the orthopedic ward. In a clinical setting, a teacher had to play take several responsibilities simultaneously and had to switch from one role to another. Most clinical teachers globally have to go through rigorous clinical training to gain knowledge and skills but little to no teaching training. Moreover, Yoo et al (26) found a significant correlation between learner's happiness with the learning environment of a medical institute, which ultimately enhances the student’s development as a person as well as a professional. Therefore, it is the responsibility of an institute to provide essential teaching skills to the clinicians so that students could have better learning experiences in wards (15).