Stalmeijer Renée E, Varpio Lara
School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Center for Health Professions Education, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Med Educ. 2021 Aug;55(8):894-902. doi: 10.1111/medu.14520. Epub 2021 Apr 10.
The trajectory towards becoming a medical professional is strongly situated within the clinical workplace. Through participatory engagement, medical trainees learn to address complex health care issues through collaboration with the interprofessional health care team. To help explain learning and teaching dynamics within the clinical workplace, many scholars have relied on socio-cultural learning theories. In the field of medical education, this research has largely adopted a limited interpretation of a crucial dimension within socio-cultural learning theory: the expert who guides the trainee into the community is almost exclusively from the same profession. We contend that this narrow interpretation is not necessary. This limited focus is one we choose to maintain-be that choice intentional or implicit. In this cross-cutting edge paper, we argue that choosing an interprofessional orientation towards workplace learning and guidance may better prepare medical trainees for their future role in health care practice.
By applying Communities of Practice and Landscapes of Practice , and supported by empirical examples, we demonstrate how medical trainees are not solely on a trajectory towards the Community of Physician Practice (CoPP) but also on a trajectory towards various Landscapes of Healthcare Practice (LoHCP). We discuss some of the barriers present within health care organisations and professions that have likely inhibited adoption of the broader LoHCP perspective. We suggest three perspectives that might help to deliberately and meaningfully incorporate the interprofessional learning and teaching dynamic within the medical education continuum.
Systematically incorporating Landscapes of Competence, Assessment, and Guidance in workplace-based education-in addition to our current intraprofessional approach-can better prepare medical trainees for their roles within the LoHCP. By advocating and researching this interprofessional perspective, we can embark on a journey towards fully harnessing and empowering the health care team within workplace-based education.
成为医学专业人员的轨迹很大程度上处于临床工作场所之中。通过参与式互动，医学实习生学会与跨专业医疗团队协作，以解决复杂的医疗保健问题。为了帮助解释临床工作场所中的学习和教学动态，许多学者依赖于社会文化学习理论。在医学教育领域，这项研究在很大程度上对社会文化学习理论的一个关键维度采用了有限的解释：指导实习生融入该领域的专家几乎完全来自同一专业。我们认为这种狭义的解释并非必要。这种有限的关注点是我们选择保持的——无论这种选择是有意还是无意的。在这篇前沿论文中，我们认为选择一种跨专业的工作场所学习和指导取向可能会让医学实习生更好地为他们未来在医疗保健实践中的角色做好准备。
通过应用实践共同体和实践景观理论，并辅以实证例子，我们展示了医学实习生不仅在朝着医师实践共同体（CoPP）发展，还在朝着各种医疗保健实践景观（LoHCP）发展。我们讨论了医疗保健组织和专业中存在的一些可能阻碍采用更广泛的LoHCP视角的障碍。我们提出了三个视角，可能有助于在医学教育连续体中有意且有意义地纳入跨专业学习和教学动态。
除了我们目前的专业内方法之外，在基于工作场所的教育中系统地纳入能力景观、评估景观和指导景观，可以让医学实习生更好地为他们在LoHCP中的角色做好准备。通过倡导和研究这种跨专业视角，我们可以踏上在基于工作场所的教育中充分利用和赋能医疗团队的征程。
