Miller Kelsey Ann, Ilgen Jonathan S, de Bruin Anique B H, Pusic Martin V, Stalmeijer Renée E
Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Harborview Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.
Med Educ. 2025 May;59(5):484-493. doi: 10.1111/medu.15564. Epub 2024 Oct 23.
Increasingly, medical training aims to develop physicians who are competent collaborators. Although interprofessional interactions are inevitable elements of medical trainees' workplace learning experiences, the existing literature lacks a cohesive model to conceptualise the learning potential residing in these interactions.
We conducted a critical review of the health professions and related educational literatures to generate an empirically and theoretically informed description of medical trainees' workplace interactions with other health professionals, including learning mechanisms and outcomes. Informed by Teunissen's conceptualisation of workplace learning, we highlight the individual, social and situated dimensions of learning from interprofessional workplace interactions.
Workplace interactions between medical trainees and other health professionals tend to be brief, spontaneous, informal and often implicit without the predefined educational goals and roles that structure trainees' relationships with physician supervisors. Yet they hold potential for developing trainees' knowledge and skills germane to the work of a physician as well as building their capacity for collaboration. Our review identified a spectrum of learning theories helpful for examining what and how trainees learn from these interactions. Self-regulated learning theories focus attention on how learning depends on trainees interpreting and judging the cues offered by other health professionals. Sociocultural frameworks including the zone of proximal development and legitimate peripheral participation emphasise the ways other health professionals support trainees in performing tasks at the border of their abilities and facilitate trainees' participation in clinical work. Both the landscapes of practice theory and cultural historical activity theory highlight the influence of surrounding social, cultural and material environments. These theories are unified into cohesive model and demonstrated through an illustrative example.
Interprofessional workplace interactions harbour a range of learning opportunities for medical trainees. Capitalising on their potential can contribute to training collaborative practice-ready physicians alongside traditional intra-professional interactions between physicians and merits future research.
医学培训越来越旨在培养有能力的协作医生。尽管跨专业互动是医学实习生职场学习经历中不可避免的要素,但现有文献缺乏一个连贯的模型来概念化这些互动中蕴含的学习潜力。
我们对卫生专业及相关教育文献进行了批判性综述,以对医学实习生与其他卫生专业人员的职场互动进行基于实证和理论的描述,包括学习机制和成果。受特伊森职场学习概念化的启发,我们强调了从跨专业职场互动中学习的个体、社会和情境维度。
医学实习生与其他卫生专业人员之间的职场互动往往是短暂、自发、非正式的,且常常是隐含的,没有预先定义的教育目标和角色来构建实习生与医生上级的关系。然而,它们有潜力培养实习生与医生工作相关的知识和技能,并培养他们的协作能力。我们的综述确定了一系列有助于研究实习生从这些互动中学到什么以及如何学习的学习理论。自我调节学习理论将注意力集中在学习如何取决于实习生对其他卫生专业人员提供的线索的解释和判断上。包括最近发展区和合法边缘参与在内 的社会文化框架强调了其他卫生专业人员支持实习生在其能力边界执行任务并促进实习生参与临床工作的方式。实践理论景观和文化历史活动理论都强调了周围社会、文化和物质环境的影响。这些理论被整合到一个连贯的模型中,并通过一个示例进行了说明。
跨专业职场互动为医学实习生提供了一系列学习机会。利用其潜力有助于培养具备协作实践能力的医生,这与医生之间传统的专业内互动同等重要,值得未来研究。