Learning in professionally 'distant' contexts: opportunities and challenges.
The changing nature of healthcare education and delivery is such that clinicians will increasingly find themselves practicing in contexts that are physically and/or conceptually different from the settings in which they were trained, a practice that conflicts on some level with socio-cultural theories of learning that emphasize learning in context. Our objective was therefore to explore learning in 'professionally distant' contexts. Using paramedic education, where portions of training occur in hospital settings despite preparing students for out-of-hospital work, fifty-three informants (11 current students, 13 recent graduates, 16 paramedic program faculty and 13 program coordinators/directors) took part in five semi-structured focus groups. Participants reflected on the value and role of hospital placements in paramedic student development. All sessions were audio recorded, transcribed verbatim and analyzed using inductive thematic analysis. In this context six educational advantages and two challenges were identified when using professionally distant learning environments. Learning could still be associated with features such as (a) engagement through "authenticity", (b) technical skill development, (c) interpersonal skill development, (d) psychological resilience, (e) healthcare system knowledge and (f) scaffolding. Variability in learning and misalignment with learning goals were identified as potential threats. Learning environments that are professionally distant from eventual practice settings may prove meaningful by providing learners with foundational and preparatory learning experiences for competencies that may be transferrable. This suggests that where learning occurs may be less important than how the experience contributes to the learner's development and the meaning or value he/she derives from it.
School of Community and Health Studies, Centennial College, P.O. Box 731, Station A, Toronto, ON, M1K 5E9, Canada. jmausz@centennialcollege.ca.|Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada. jmausz@centennialcollege.ca.|Peel Regional Paramedic Services, Regional Municipality of Peel, Brampton, ON, Canada. jmausz@centennialcollege.ca.
Justin
http://orcid.org/0000-0001-8983-8202
J
Mausz
School of Community and Health Studies, Centennial College, P.O. Box 731, Station A, Toronto, ON, M1K 5E9, Canada.|Division of Emergency Medicine, Faculty of Medicine, McMaster University, Hamilton, ON, Canada.|York Region Emergency Medical Services, Sharon, ON, Canada.|Ornge Transport Medicine, Mississauga, ON, Canada.
Walter
W
Tavares
D000488:Allied Health Personnel / Q000193:education*; D004517:Education, Professional; D004635:Emergency Medicine / Q000193:education*; D017144:Focus Groups; D006761:Hospitals; D006801:Humans; D018794:Problem-Based Learning
Clinical teaching; Context; Context-dependent; Education; Learning environment; Paramedic; Professional ‘distance’; Social learning theory; Workplace learning