title: Organisation of workplace learning: a case study of paediatric residents' and consultants' beliefs and practices.
abstract: Several studies have examined how doctors learn in the workplace, but research is needed linking workplace learning with the organisation of doctors' daily work. This study examined residents' and consultants' attitudes and beliefs regarding workplace learning and contextual and organisational factors influencing the organisation and planning of medical specialist training. An explorative case study in three paediatric departments in Denmark including 9 days of field observations and focus group interviews with 9 consultants responsible for medical education and 16 residents. The study aimed to identify factors in work organisation facilitating and hindering residents' learning. Data were coded through an iterative process guided by thematic analysis. Findings illustrate three main themes: (1) Learning beliefs about patient care and apprenticeship learning as inseparable in medical practice. Beliefs about training and patient care expressed in terms of training versus production caused a potential conflict. (2) Learning context. Continuity over time in tasks and care for patients is important, but continuity is challenged by the organisation of daily work routines. (3) Organisational culture and regulations were found to be encouraging as well inhibiting to a successful organisation of the work in regards to learning. Our findings stress the importance of consultants' and residents' beliefs about workplace learning as these agents handle the potential conflict between patient care and training of health professionals. The structuring of daily work tasks is a key factor in workplace learning as is an understanding of underlying relations and organisational culture in the clinical departments.
authors.affiliation: Department for Postgraduate Education, Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark. mads.skipper@rn.dk.|Centre for Health Sciences Education, Aarhus University, Aarhus, Denmark. mads.skipper@rn.dk.
authors.forename: Mads
authors.initials: M
authors.lastname: Skipper
authors.affiliation: Department for Postgraduate Education, Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark.|Centre for Health Sciences Education, Aarhus University, Aarhus, Denmark.
authors.forename: Susanne Backman
authors.initials: SB
authors.lastname: Nøhr
authors.affiliation: Department for Postgraduate Education, Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark.
authors.forename: Tine Klitgaard
authors.initials: TK
authors.lastname: Jacobsen
authors.affiliation: Centre for Health Sciences Education, Aarhus University, Aarhus, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Musaeus
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007407:Interviews as Topic; D007858:Learning; D010372:Pediatrics / Q000193:education*; D017132:Workplace
keywords: Affordances; Continuing; Continuity; Education; Learning; Medical; Organization; Participation; Postgraduate; Situated learning; Workplace learning