Workplace simulations (WPS), authentic learning environments at school, are increasingly used in vocational education. This article provides a theoretical analysis and synthesis of requirements considering learner skills, characteristics of the learning environment and the role of the teacher that influence good functioning in WPS and foster students' learning. WPS appeal to students' self-directed learning (SDL) and self-regulated learning (SRL) skills, as students are required to work and learn independently in these settings. To achieve individual learning, the environments should be adaptive to the learners needs. Furthermore, the teachers should support learners to become competent in the domain but also guide them to become self-directed learners. To do so the interaction between the student, the teacher and the environment is of importance. The proposed model depicts the different elements and their relations.

Medical professionals need to keep on learning as part of their everyday work to deliver high-quality health care. Although the importance of physicians’ learning is widely recognized, few studies have investigated how they learn in the workplace. Based on insights from deliberate practice research, this study examined the activities physicians engage in during their work that might further their professional development. As deliberate practice requires a focused effort to improve performance, the study also examined the goals underlying this behaviour. Semi-structured interviews were conducted with 50 internal medicine physicians: 19 residents, 18 internists working at a university hospital, and 13 working at a non-university hospital. The results showed that learning in medical practice was very much embedded in clinical work. Most relevant learning activities were directly related to patient care rather than motivated by competence improvement goals. Advice and feedback were sought when necessary to provide this care. Performance standards were tied to patients’ conditions. The patients encountered and the discussions with colleagues about patients were valued most for professional development, while teaching and updating activities were also valued in this respect. In conclusion, physicians’ learning is largely guided by practical experience rather than deliberately sought. When professionals interact in diagnosing and treating patients to achieve high-quality care, their experiences contribute to expertise development. However, much could be gained from managing learning opportunities more explicitly. We offer suggestions for increasing the focus on learning in medical practice and further research.

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published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal.If the publication is distributed under the terms of Article 25fa of the Dutch Copyright Act, indicated by the "Taverne" license above, please follow below link for the End User

In a large-scale top-down innovation operation in the Netherlands, workplace simulations have been implemented in vocational schools, where students are required to work independently and self-direct their learning. However, research has shown that the success of such large-scale top-down innovations depends on how well their execution in schools matches the theoretical plans and goals. Given that teachers play a crucial role in translating innovative concepts to educational practice, their perceptions of teaching in these environments may provide useful information about how to best match the goals of workplace simulation to its execution. In this interview study, we therefore focussed on teachers' views of designing instructional material and providing pedagogical guidance in workplace simulations. Twenty teachers belonging to six teams participated. The results reveal that teachers face difficulties on both aspects and it became clear that the top-down innovations influenced their daily practice. Old routines and spontaneous and immediate reactions determined much of the teachers' approaches to implementation, and it appeared that they were not yet sufficiently prepared to help students develop metacognitive skills. Furthermore, self-regulation and self-direction among students are not sufficiently promoted and supported in workplace simulations. Teachers often experienced a deep conflict between maintaining control and letting go. Our results point out that teachers need to be supported and guided during the implementation process of any top-down innovation, so that they learn how to adjust their teaching to the new requirements of workplace simulations. It seems important to ensure that teachers are also well skilled for reflecting on their own practices.