Institute of Continuing Education, University of Cambridge, Cambridge, UK.
School of Medicine, University of Leeds, Leeds, UK.
Med Teach. 2021 Jan;43(1):38-43. doi: 10.1080/0142159X.2020.1796948. Epub 2020 Jul 29.
This paper explores the purposeful use of conceptual and methodological tools provided by Cultural Historical Activity Theory (CHAT) to transform learning cultures and practices within and across diverse clinical learning environments. We describe how Change Laboratory methodology helped clinicians and others who support student, intern, and resident education to make changes collaboratively. A case study in undergraduate medical education shows how this created new forms of medical student placement and a postgraduate study shows how it addressed supervisors' undermining behaviour towards Obstetrics and Gynaecology residents. This empirical work illustrates ways of modifying the classical Change Laboratory process to fit local contexts, resources, and needs. We conclude with lessons learned and future directions for practitioner-researchers who wish to broaden the range of methodological tools they use to transform clinical learning environments.
本文探讨了有目的地使用文化历史活动理论（CHAT）的概念和方法工具，以改变不同临床学习环境中的学习文化和实践。我们描述了变革实验室方法如何帮助临床医生和其他支持学生、实习生和住院医师教育的人进行协作式变革。一个本科医学教育的案例研究展示了这如何创造新的医学生安置形式，而一个研究生研究则展示了如何解决妇产科住院医师的监督者破坏行为。这项实证工作说明了如何修改经典变革实验室过程以适应当地的背景、资源和需求。我们总结了经验教训和未来方向，以供希望扩大用于改变临床学习环境的方法工具范围的实践者研究人员参考。
