Contextual reading and analysis of the team's narratives about the system in which clinical education and healthcare processes are experienced.

OBJECTIVE

Understanding the health system and the clinical and learning experiences from the perspective of complexity theory requires a reflective and contextual approach. The context in which experience takes place consists of multidimensional elements that influence each other, such as sociocultural environment, work/educational climate, stakeholders, educational/healthcare system. In this framework, it is important to read and analyze the parties' experiential narratives within their contexts. The aim of this study is to analyze the narratives of the team working in a surgical clinic about their clinical education and healthcare experiences in terms of the "institutional, clinical and national system" as one of the contextual elements in which the experience is lived. In line with this purpose, the research problems were identified as follows: (1) what are the experiences and narratives of the team regarding the system in clinical education and healthcare processes, (2) how do the parties relate to the system, and (3) what are the outcomes of different ways of relating?

METHODS

This narrative study was conducted in the surgical clinic of a university hospital. The voluntary participant group consisted of 31 participants, including clinical instructors (n=5), surgical residency students (n=5), medical students/interns (n=15) and nurses (n=6) working as a team in the clinic. The narratives obtained through in-depth interviews were analyzed using the "Three-Stage Contextual Theme Analysis" created for this study.

RESULTS

The themes that emerged from the analysis were grouped under three contextual categories: "clinical system: structure, functioning and workload", "clinical environment, climate and culture", "national, social environment and extra challenging situations". The themes related to the consequences of these contextual experiences were grouped under two categories: "ways of coping/not coping" and "consequences/effects".

CONCLUSION

The contextual dimension of the experience can cause parties to live experiences in their own way and to focus more on their context and not see enough of what others experience. This points to the importance of planning, conducting and evaluating clinical education, research and healthcare processes within their context, including the system.