Professional Workplace-Learning. Can Practical Wisdom be Learned?

Abstract

This article aims at investigating whether physicians can acquire and develop practical wisdom in their practices through structural case discussions focused on learning. Our starting point is that practical wisdom is essential to realize the moral purpose of professional care: to help each individual patient to alleviate her suffering and to promote her health in a way that is attuned to her individual personality and situation. In recent publications on learning practical wisdom after the formal curriculum, we have found two different opinions. Some authors claimed that practical wisdom can only be learned implicitly from experiences in the workplace; others that learning practical wisdom can also be accomplished intentionally in peer groups reflecting on their work. We have analyzed the lessons learned from 100 case reviews, recorded by the participating physicians themselves. The discussions had been organized in a Dutch general hospital during a twelve-year period. We have found that the joint practitioners really did acquire practical wisdom through reflection and deliberation, partly implicitly, partly explicitly. We have also discovered that they managed to translate practical wisdom into the infrastructure and the culture of collaborating groups, practices and the institutional work context. The results of this investigation have led us to formulate proposals to stimulate the learning of practical wisdom through reflection on everyday work in hospitals. Practical wisdom will foster the realization of the moral purpose of professional medical practices.