The Nursing Home as a Learning Environment: Dealing With Less Is Learning More

Frederique Molema, Raymond Koopmans, Esther Helmich*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)


Purpose Despite the imperative to develop adequate competence in caring for the growing demographic of elderly patients with complex health care problems, nursing homes are underused as learning environments for the education of future doctors; thus, the authors aimed to gain more insight into the characteristics of the nursing home as a learning environment.

Method Approaching the nursing home as a learning environment from a predominantly sociocultural perspective, the authors carried out five focus group interviews (December 2011 through February 2012) with 36 family medicine and elderly care medicine residents during their nursing home placements. Data analysis was an iterative process following a grounded theory approach. The software ATLAS.ti supported data analysis.

Results The authors identified 23 themes in five categories regarding the nursing home as a learning environment: organization, medical opportunities, communication, teamwork, and supervision. Working and learning in a nursing home was characterized by dealing with less (i.e., fewer resources), yet the residents reported that dealing with less resulted in learning more. Family medicine and elderly care residents from different backgrounds differed in their perceptions and specific learning needs.

Conclusions To the authors' knowledge, this study is one of the first to identify characteristics of the nursing home as a learning environment. The main challenge in the nursing home is dealing with less, which, according to the residents in the present study, often leads to learning more. To ensure that learning really happens, the authors call for high-quality supervision to support learners in the nursing home environment.

Original languageEnglish
Pages (from-to)497-504
Number of pages8
JournalAcademic Medicine
Issue number3
Publication statusPublished - Mar-2014
Externally publishedYes


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