Abstract
Learning has been defined as a condition for improving the quality of healthcare practice. The focus of this paper is on physicians’ learning and their support of others’ learning in the context of Swedish healthcare. Data were generated through individual and focus group interviews and analyzed from a socio-material practice theory perspective. During their workday, physicians dynamically alternated between their own learning and their support of others’ learning in individual patient processes. Learning and learning support were interconnected with the versatile mobility of physicians across different contexts and their participation in multiple communities of collaboration and through tensions between responsibilities in healthcare. The findings illustrate how learning enactments are framed by the existing “practice architectures.” We argue that productive reflection on dimensions of learning enactments in practice can enhance physicians’ professional learning and improve professional practice.
Highlights
Learning has been defined as a condition for improving the quality of healthcare practice
Four categories of enactments of learning and learning support in medical practice were discerned in the physicians’ accounts in relation to (a) individual patient processes, (b) versatile mobility across contexts, (c) multiple communities of collaboration, and (d) tensions between professional responsibilities. These categories are described in detail titled “Engaging in Individual Patient Processes,” “Creating Versatile Mobility Across Contexts,” “Participating in Multiple Communities of Collaboration,” and “Giving and Taking Professional Responsibilities.”
Our findings indicate that the medical practice architectures vary between different medical disciplines, thereby displaying the dynamics and complexity of physicians’ opportunities and constraints for learning and support of others’ learning in healthcare
Summary
Learning has been defined as a condition for improving the quality of healthcare practice. The focus of this paper is on physicians’ learning and their support of others’ learning in the context of Swedish healthcare. Data were generated through individual and focus group interviews and analyzed from a sociomaterial practice theory perspective During their workday, physicians dynamically alternated between their own learning and their support of others’ learning in individual patient processes. Healthcare systems, which are multiprofessional and organized in specialized and differentiated disciplines (Glouberman & Mintzberg, 2001), can be seen as complex adaptive systems (Plsek & Greenhalgh, 2001). The changing structures and Sciences, conditions of healthcare systems globally raise important questions regarding the Linköping Univer- quality of learning that health professionals acquire in their daily work. Collaborasity tion, quality improvement, and patient safety are some areas in which learning
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