Rees Charlotte E, Cleland Jennifer A, Dennis Ashley, Kelly Narcie, Mattick Karen, Monrouxe Lynn V
Centre for Medical Education, Medical Education Institute, School of Medicine, University of Dundee, Dundee, UK.
Division of Medical and Dental Education, University of Aberdeen, Aberdeen, UK.
BMJ Open. 2014 Oct 16;4(10):e005980. doi: 10.1136/bmjopen-2014-005980.
To explore Foundation trainees' and trainers' understandings and experiences of supervised learning events (SLEs), compared with workplace-based assessments (WPBAs), and their suggestions for developing SLEs.
A narrative interview study based on 55 individual and 19 group interviews.
UK-wide study across three sites in England, Scotland and Wales.
Using maximum-variation sampling, 70 Foundation trainees and 40 trainers were recruited, shared their understandings and experiences of SLEs/WPBAs and made recommendations for future practice.
Data were analysed using thematic and discourse analysis and narrative analysis of one exemplar personal incident narrative.
While participants volunteered understandings of SLEs as learning and assessment, they typically volunteered understandings of WPBAs as assessment. Trainers seemed more likely to describe SLEs as assessment and a 'safety net' to protect patients than trainees. We identified 333 personal incident narratives in our data (221 SLEs; 72 WPBAs). There was perceived variability in the conduct of SLEs/WPBAs in terms of their initiation, tools used, feedback and finalisation. Numerous factors at individual, interpersonal, cultural and technological levels were thought to facilitate/hinder learning. SLE narratives were more likely to be evaluated positively than WPBA narratives overall and by trainees specifically. Participants made sense of their experiences, emotions, identities and relationships through their narratives. They provided numerous suggestions for improving SLEs at individual, interpersonal, cultural and technological levels.
Our findings provide tentative support for the shift to formative learning with the introduction of SLEs, albeit raising concerns around trainees' and trainers' understandings about SLEs. We identify five key educational recommendations from our study. Additional research is now needed to explore further the complexities around SLEs within workplace learning.
探讨基础培训医生和培训导师对监督学习活动（SLEs）的理解与体验，并与基于工作场所的评估（WPBAs）进行比较，以及他们对SLEs发展的建议。
一项基于55次个人访谈和19次小组访谈的叙事访谈研究。
在英国范围内对英格兰、苏格兰和威尔士的三个地点进行研究。
采用最大差异抽样法，招募了70名基础培训医生和40名培训导师，他们分享了对SLEs/WPBAs的理解与体验，并对未来实践提出了建议。
使用主题分析、话语分析以及对一个典型个人事件叙事的叙事分析来分析数据。
虽然参与者主动表达了对SLEs作为学习和评估的理解，但他们通常主动表达了对WPBAs作为评估的理解。与培训医生相比，培训导师似乎更倾向于将SLEs描述为评估以及保护患者的“安全网”。我们在数据中识别出333个个人事件叙事（221个SLEs；72个WPBAs）。在SLEs/WPBAs的启动、使用的工具、反馈和完成方面，人们认为其实施存在差异。个人、人际、文化和技术层面的众多因素被认为有助于/阻碍学习。总体而言，SLE叙事比WPBA叙事更有可能得到积极评价，尤其是培训医生对SLE叙事的评价。参与者通过他们的叙事来理解自己的经历、情感、身份和关系。他们在个人、人际、文化和技术层面提供了许多改进SLEs的建议。
我们的研究结果为引入SLEs转向形成性学习提供了初步支持，尽管这引发了对培训医生和培训导师对SLEs理解的担忧。我们从研究中确定了五项关键教育建议。现在需要进一步研究，以进一步探索工作场所学习中SLEs周围的复杂性。
