Learning in the Surgical Community of Practice

Abstract

Although apprenticeship has been at the centre of surgical education, contemporary circumstances have downgraded its role as an educational process. Situated learning theory describes how learners built their identities through active participation in a community of practice (CoP), giving a new dimension to the apprenticeship model of training. Surgical education takes place in an environment of various interacting CoPs. In order for a trainee to gain legitimate entry into a CoP, his role and potential contribution to the community’s common goal, which is patient care, has to be recognised by the other established members of the community. Influenced by the various role models in the CoP and by interaction with the members and artefacts in the community, the learner will learn how to talk and behave like a professional, establishing his professional identity. Identities in a CoP are dynamic and change as a result of conflict between the different individual members of CoP. In order to avoid conflict and successfully progress in a CoP, the surgical trainee must learn to respect and negotiate with the various rules and roles of the community. By using the enhanced power of apprenticeship, through the theory of situated learning, we can create more controlled learning environments where the benefits of participating in a CoP are still utilised. Situated learning and activity theory can help us understand the relationships between the individual members and roles in the healthcare community and help us improve training and provision of patient care.