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对工作场所学习文化的当代审视:一项常人方法学研究。

A contemporary examination of workplace learning culture: an ethnomethodology study.

作者信息

Newton Jennifer M, Henderson Amanda, Jolly Brian, Greaves Judith

机构信息

School of Nursing & Midwifery, Faculty of Medicine, Nursing & Health Sciences, Monash University, Bldg 13 C, Clayton Campus, Clayton, Victoria 3800, Australia.

Metro South Health Service District, Princess Alexandra Hospital, Woolloongabba, Qld 4102, Australia.

出版信息

Nurse Educ Today. 2015 Jan;35(1):91-6. doi: 10.1016/j.nedt.2014.07.001. Epub 2014 Jul 11.

Abstract

BACKGROUND

Creating and maintaining a sustainable workforce is currently an international concern. Extensive literature suggest that students and staff need to be 'engaged', that is they need to interact with the health team if they are to maximise learning opportunities. Despite many studies since the 1970s into what creates a 'good' learning environment, ongoing issues continue to challenge healthcare organisations and educators. A 'good' learning environment has been an intangible element for many professions as learning is hindered by the complexity of practice and by limitations on practitioners' time available to assist and guide novices.

OBJECTIVES

This study sought to explore the nature of the learning interactions and experiences in clinical nursing practice that enhance a 'good' workplace learning culture for both nursing students and qualified nurses.

DESIGN

An ethnomethodology study.

SETTING

A range of clinical settings in Victoria and Queensland, Australia.

PARTICIPANTS

Students and registered nurses (n=95).

METHODS

Fieldwork observations were carried out on student nurses and registered nurses, followed by an individual interview with each participant. An iterative approach to analysis was undertaken; field notes of observations were reviewed, interviews transcribed verbatim and entered into NVivo10. Major themes were then extracted.

RESULTS

Three central themes: learning by doing, navigating through communication, and 'entrustability', emerged providing insights into common practices potentially enhancing or detracting from learning in the workplace.

CONCLUSIONS

Students' and registered nurses' learning is constrained by a myriad of interactions and embedded workplace practices, which can either enhance the individual's opportunities for learning or detract from the richness of affordances that healthcare workplace settings have to offer. Until the culture/or routine practices of the healthcare workplace are challenged, the trust and meaningful communication essential to learning in practice, will be achievable only serendipitously.

摘要

背景

创建并维持一支可持续发展的员工队伍是当前国际社会关注的问题。大量文献表明,学生和员工需要“参与其中”,也就是说,如果要最大限度地利用学习机会,他们需要与医疗团队进行互动。自20世纪70年代以来,尽管针对如何营造“良好”学习环境进行了许多研究,但持续存在的问题仍在挑战着医疗保健机构和教育工作者。对于许多职业来说,“良好”的学习环境一直是一个无形的要素,因为实践的复杂性以及从业者可用于协助和指导新手的时间有限,阻碍了学习。

目的

本研究旨在探讨临床护理实践中学习互动和体验的本质,这些互动和体验能为护理专业学生和注册护士营造“良好”的工作场所学习文化。

设计

一项民族方法学研究。

地点

澳大利亚维多利亚州和昆士兰州的一系列临床场所。

参与者

学生和注册护士(n = 95)。

方法

对实习护士和注册护士进行实地观察,随后对每位参与者进行单独访谈。采用迭代分析方法;对观察的现场记录进行审查,将访谈逐字转录并录入NVivo10。然后提取主要主题。

结果

出现了三个核心主题:在实践中学习、通过沟通应对以及“可托付性”,这些主题为可能增强或减损工作场所学习的常见做法提供了见解。

结论

学生和注册护士的学习受到无数互动和内在工作场所实践的限制,这些互动和实践既可以增加个人的学习机会,也可能减少医疗保健工作场所所能提供的丰富学习条件。除非医疗保健工作场所的文化/常规做法受到挑战,否则实践中学习所必需的信任和有意义的沟通只能偶然实现。

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