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Advances in Health Sciences Education

, Volume 21, Issue 2, pp 415–437 | Cite as

Ad hoc supervision of general practice registrars as a ‘community of practice’: analysis, interpretation and re-presentation

  • T. ClementEmail author
  • J. Brown
  • J. Morrison
  • D. Nestel
Article

Abstract

General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also provide an opportunity for learning and teaching. Wenger’s (Communities of practice: learning, meaning, and identity. Cambridge University Press, New York, 1998) social theory of learning (‘communities of practice’) guided a secondary analysis of audio-recordings of ad hoc encounters. Data from one encounter is re-presented as an extended sequence to maintain congruence with the theoretical perspective and enhance vicariousness. An interpretive commentary communicates key features of Wenger’s theory and highlights the researchers’ interpretations. We argue that one encounter can reveal universal understandings of clinical supervision and that the process of naturalistic generalisation allows readers to transfer others’ experiences to their own contexts. The paper raises significant analytic, interpretive, and representational issues. We highlight that report writing is an important, but infrequently discussed, part of research design. We discuss the challenges of supporting the learning and teaching that arises from adopting a socio-cultural lens and argue that such a perspective importantly captures the complex range of issues that work-based practitioners have to grapple with. This offers a challenge to how we research and seek to influence work-based learning and teaching in health care settings.

Keywords

Ad hoc supervision Clinical supervision Communities of practice General practice Identity Legitimate peripheral participation Naturalistic generalisation Power Situated learning Socio-cultural theory 

Notes

Acknowledgments

We thank the supervisor and registrar participants, along with the staff of the respective practices. We gratefully acknowledge the research grant received from General Practice Education and Training Ltd (GPET).

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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • T. Clement
    • 1
    • 2
    Email author
  • J. Brown
    • 1
    • 3
  • J. Morrison
    • 1
    • 2
  • D. Nestel
    • 3
  1. 1.Southern GP TrainingWarrnamboolAustralia
  2. 2.Deakin UniversityWarrnamboolAustralia
  3. 3.HealthPEER (Health Professions Education and Educational Research), Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneAustralia

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