| Summary: | Mike Nantamu Kagawa,1 Sarah Kiguli,2 Hannes Steinberg,3 Mpho Priscilla Jama4 1Department of Obstetrics & Gynaecology, Makerere University, Kampala, Uganda; 2Department of Paediatrics & Child health, Makerere University, Kampala, Uganda; 3Department of Family Medicine, University of the Free State, Bloemfontein, Republic of South Africa; 4Division Student Learning and Development, Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South AfricaCorrespondence: Mike Nantamu Kagawa, Department of Obstetrics & Gynaecology, Makerere University, Kampala, Uganda, Tel +256772449613, Email kagawanm@gmail.comPurpose: The workplace is an important element of the learning ecosystem for medical students during their competence development. It offers engagement opportunities that enable students to participate in clinical activities as part of learning in their preparation for future clinical practice. The purpose of this study was to explore the perceptions and experiences of lecturers, administrators, and students of Makerere University College of Health Sciences about the workplace, at Mulago National Referral and Teaching Hospital, as a learning environment for the undergraduate medical students with the ultimate aim of identifying opportunities and challenges to learner competence development in the learning environment for purposes of improvement.Methods: The study design was cross-sectional descriptive with a qualitative approach using key informant interviews for the lecturers and administrators and focus group discussions for the students. The framework method was used to perform thematic data analysis.Results: The workplace was perceived to be well endowed with adequate patient numbers, a suitable case mix and unrestricted access to patients which enhanced competence development. The challenges reported included inadequate resources, such as infrastructure, equipment and supplies and overcrowding, which compromised competence development. The resource challenge appeared insurmountable in the context of two autonomous institutions with divergent planning priorities in terms of teaching, research, and patient care.Conclusion: There were mixed perceptions about the learning environment at the hospital with both enabling and challenging factors on the backdrop of two autonomous institutions with divergent planning priorities in terms of teaching, research, and patient care. In order to improve the workplace as a learning environment, it is imperative that the two institutions find common ground in terms of clinical care, students’ teaching and provision of supplies that are essential not only for patient care but competence development of the learners who are the clinicians of tomorrow.Keywords: workplace learning, learning ecosystem, competence development, medical education
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