Activity Theory and the Surgical Workplace

  • Edward F. IbrahimEmail author
Part of the Innovation and Change in Professional Education book series (ICPE, volume 17)


This chapter explores the importance of the surgical workplace as a centre of learning. A sociocultural learning theory known as activity theory will be described and related to the field of surgery to help illuminate this multifaceted and complicated environment. Comparisons will be made with the theory of situated learning and communities of practice. Newer developments on activity theory such as knot-working and actor-network theory will be discussed. As a defining feature of activity theory, the prominent position of culturally mediated artefacts will be argued as both promoter and hinderer of expansive learning. Two published case studies of the surgical workplace will be critically considered to illustrate the strengths and weaknesses of an activity theory-based approach. Case study one examines the reality of collaborative multidisciplinary learning in practice, specifically the relationship across different specialities involved in the treatment of patients with suspected breast cancer. Case study two concerns what we can learn from how expert surgeons go about preparing to lead a theatre team towards excellent performance and how this knowledge is passed on to trainees.


Activity theory Situated learning Actor-network theory Communities of practice Artefacts Yrjo Engeström Sfard Multidisciplinary learning Workplace Informal learning Surgical team Surgical firm Apprenticeship Cognitive Acquisition Participation Davydov Reflection Zone of proximal development Performance Theatre Know working Ontologies Expansive learning Alan Bleakley Connections Situate learning Sociomaterial Jean Lave Etienne Wenger Operation Boundary object Artefacts Latour Social system Double stimulation Metaphor Lev Vygotsky Alex Leont’ev 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Trauma and Orthopaedic SurgeryWest Middlesex University HospitalIsleworthUK
  2. 2.Chelsea and Westminster Hospital NHS Foundation TrustLondonUK

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