The entrance of newly qualified medical specialists into daily practice is considered to be a stressful period in which curriculum support is absent. Although engaging in both personal and professional learning and development activities is recognized fundamental for lifelong professional competence, research on medical professionals' entrance into practice is scarce. This research aims to contribute to the framework of medical professionals' informal learning and outlines the results of an exploratory study on the nature of learning in daily practice beyond postgraduate training. Eleven newly qualified physicians from different specialized backgrounds participated in a phenomenographic study, using a critical incident method and a grounded theory approach. Results demonstrated that learning in the workplace is, to a large extent, informal and associated with a variety of learning experiences. Analysis shows that experiences related to diagnostics and treatments are important sources for learning. Furthermore, incidents related to communication, changing roles, policy and organization offer learning opportunities, and therefore categorized as learning experiences. A broad range of learning activities are identified in dealing with these learning experiences. More specifically, actively engaging in actions and interactions, especially with colleagues of the same specialty, are the most mentioned. Observing others, consulting written sources, and recognizing uncertainties, are also referred to as learning activities. In the study, interaction, solely or combined with other learning activities, are deemed as very important by specialists in the initial entrance into practice. These insights can be used to develop workplace structures to support the entrance into practice following postgraduate training.
Purpose
This study aims to unravel the dynamic nature of the process of self-regulated learning (SRL) of medical specialists as it actually unfolds over time in the authentic clinical environment.
Design/methodology/approach
A longitudinal multiple case-study design was used, combining multiple data-collection techniques. Long-term observations offered evidence on overt SRL strategies. Physicians’ observed behaviours were used as cues for in loco stimulated recall interviews, asking about covert SRL strategies and their thoughts regarding a situation at hand. Field notes and audiotaped stimulated recall interviews were transcribed verbatim and integrated in a longitudinal database to map SRL as it actually unfolds moment-by-moment. The transcripts were analysed from an inter- and intra-individual perspective using Nvivo 12.
Findings
Results show a variety of strategies that initiate, advance and evaluate the process of SRL. Different SRL strategies not included in contemporary frameworks on SRL are found and classified as a new category which the authors labelled “learning readiness”. Exemplary for an SRL strategy in this category is awareness of learning needs. Results show that SRL in the clinical environment is found as an interrelated, dynamic process unfolding in time with feedback loops between different SRL strategies. Performance is found to play a leading role in driving SRL.
Originality/value
This study contributes empirically to the conceptual understanding of SRL in the clinical environment. The use of a situated, longitudinal methodology, which goes beyond the common path of retrospective self-report questionnaires, adds to the disentanglement of the process of SRL as it actually unfolds in the work environment.
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