Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Adv Health Sci Educ Theory Pract. 2019 Mar;24(1):125-140. doi: 10.1007/s10459-018-9853-y. Epub 2018 Oct 3.
Many medical universities offer educational development activities to support clinical teachers in their teaching role. Research has focused on the scope and effectiveness of such activities and on why individual teachers attend. However, systemic perspectives that go beyond a focus on individual participants are scarce in the existing literature. Employing activity theory, we explored how clinical teachers' engagement in educational development was affected by the systems they act within. Three focus groups were held with clinical teachers from different professions. A thematic analysis was used to map the contradictions between the systems that the participants were part of and the manifestations of these contradictions in the system of education. In our model, clinical teachers were part of three activity systems directed by the objects of patient care, research and education respectively. Contradictions arose between these systems as their objects were not aligned. This manifested through the enacted values of the academic hospital, difficulties establishing educational discussions in the clinical workplace, the transient nature of educational employments, and impediments to developing a teacher identity. These findings offer insights into the complexities of engaging in educational development as clinical teachers' priorities interact with the practices and values of the academic hospital, suggesting that attention needs to shift from individual teachers to developing the systems in which they work.
许多医科大学提供教育发展活动，以支持临床教师的教学角色。研究集中在这些活动的范围和效果上，以及为什么个别教师参加。然而，在现有文献中，系统观点超越了对个别参与者的关注，相对较少。本研究运用活动理论，探讨了临床教师参与教育发展是如何受到他们所处系统影响的。我们与来自不同专业的临床教师进行了三次焦点小组讨论。使用主题分析来绘制参与者所在系统之间的矛盾，以及这些矛盾在教育系统中的表现。在我们的模型中，临床教师分别参与了三个由患者护理、研究和教育三个目标指导的活动系统。这些系统之间的矛盾是由于它们的目标不一致而产生的。这表现在学术医院的既定价值观、在临床工作场所建立教育讨论的困难、教育工作的短暂性质以及发展教师身份的障碍上。这些发现深入了解了临床教师参与教育发展的复杂性，因为他们的优先事项与学术医院的实践和价值观相互作用，这表明需要将注意力从个别教师转移到发展他们工作的系统上。
