Advances in Health Sciences Education

, Volume 20, Issue 2, pp 531–557 | Cite as

Conceptions of how a learning or teaching curriculum, workplace culture and agency of individuals shape medical student learning and supervisory practices in the clinical workplace

  • Pia Strand
  • Gudrun Edgren
  • Petter Borna
  • Stefan Lindgren
  • Gitte Wichmann-Hansen
  • Renée E. Stalmeijer
Article
First Online:
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Accepted:

Abstract

The role of workplace supervisors in the clinical education of medical students is currently under debate. However, few studies have addressed how supervisors conceptualize workplace learning and how conceptions relate to current sociocultural workplace learning theory. We explored physician conceptions of: (a) medical student learning in the clinical workplace and (b) how they contribute to student learning. The methodology included a combination of a qualitative, inductive (conventional) and deductive (directed) content analysis approach. The study triangulated two types of interview data from 4 focus group interviews and 34 individual interviews. A total of 55 physicians participated. Three overarching themes emerged from the data: learning as membership, learning as partnership and learning as ownership. The themes described how physician conceptions of learning and supervision were guided by the notions of learning-as-participation and learning-as-acquisition. The clinical workplace was either conceptualized as a context in which student learning is based on a learning curriculum, continuity of participation and partnerships with supervisors, or as a temporary source of knowledge within a teaching curriculum. The process of learning was shaped through the reciprocity between different factors in the workplace context and the agency of students and supervising physicians. A systems-thinking approach merged with the “co-participation” conceptual framework advocated by Billet proved to be useful for analyzing variations in conceptions. The findings suggest that mapping workplace supervisor conceptions of learning can be a valuable starting point for medical schools and educational developers working with changes in clinical educational and faculty development practices.

Keywords

Clinical supervision Clinical workplace Co-participation Sociocultural learning theory Systems thinking Workplace learning Undergraduate medical students 
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Notes

Acknowledgments

The authors wish to express their gratitude to the physicians from Skåne University Hospitals in Lund and Malmoe and from Helsingborg General Hospital who participated in this study. Financial support was provided through the regional agreement on medical training and research (ALF) between The Skåne Regional Council and Lund University.

Conflict of interest

None of the authors have any conflicts of interest to declare for this article.

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Pia Strand
    • 1
  • Gudrun Edgren
    • 1
  • Petter Borna
    • 2
  • Stefan Lindgren
    • 5
  • Gitte Wichmann-Hansen
    • 3
  • Renée E. Stalmeijer
    • 4
  1. 1.Faculty of MedicineLund UniversityLundSweden
  2. 2.Department of pediatricsSkåne University HospitalMalmöSweden
  3. 3.Centre for Teaching and Learning, School of Business and Social SciencesAarhus UniversityÅrhusDenmark
  4. 4.Department of Educational Development and Research, Faculty of Health, Medicine and Life SciencesMaastricht UniversityMaastrichtThe Netherlands
  5. 5.Department of Clinical Sciences, Faculty of MedicineLund UniversityMalmöSweden

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