On learning in the clinical environment

Abstract

Introduction: The clinical environment has been increasingly acknowledged as an important setting for learning within healthcare professional education. In particular, researchers have highlighted the need to advance the knowledge on the social nature of learning in the workplace setting. The aim of the thesis was to explore workplace learning among undergraduate medical and nursing students. Method: The thesis adopted a socio-cultural perspective on learning and employed a qualitative approach embedded in an interpretative tradition of inquiry. Four consecutive studies were included in the thesis, the first one designed according to qualitative description whereas the other three had an ethnographic approach. Data were collected through individual interviews and field observations. Content analysis and thematic analysis were employed. Results: For the medical students, workplace learning entailed access to a variety of activities in the role of a marginal member of the healthcare team. Medical students demonstrated an adaptive approach to workplace learning. For the nursing students, workplace learning involved being entrusted to hold responsibility for patient care and the need to negotiate their basic values with those of the workplaces. Nursing students showed a hesitant approach to workplace learning. Discussion: Workplace learning was built upon varying theoretical perspectives of learning in the medical and nursing contexts respectively. The main message in the thesis argued for an upgrading of students as a powerful and active stakeholder in workplace learning, so as not to view students as passive consumers of clinical education.