title: Blurring the boundaries: using institutional ethnography to inquire into health professions education and practice.
abstract: BACKGROUND
  Qualitative, social science approaches to research have surged in popularity within health professions education (HPE) over the past decade. Institutional ethnography (IE) offers the field another sociological approach to inquiry. Although widely used in nursing and health care research, IE remains relatively uncommon in the HPE research community. This article provides a brief introduction to IE and suggests why HPE researchers may wish to consider it for future studies.
  
  
  METHODS
  Part 1 of this paper presents IE's conceptual grounding in: (i) the entry point to inquiry ('materiality'), (ii) a generous definition of 'work' and (iii) a focus on how 'texts' such as policies, forms and written protocols influence activity. Part 2 of this paper outlines the method's key features through exemplars from our own research. Part 3 discusses the ways in which research that blurs the lines between educational and clinical practice can be both generative for HPE and accomplished using IE.
  
  
  RESULTS
  The authors demonstrate the usefulness of IE for studying complex social issues in HPE. It is posited that a key added value of IE is that it goes beyond individual-level explanations of problems and phenomena, yet also closely studies individuals' activities, rather than remaining at an abstract or distant level of analysis. Thereby, IE can result in feasible and meaningful social change at the nexus of health professions education and other social systems such as clinical practice.
  
  
  CONCLUSIONS
  IE adds to the growing qualitative research toolkit for HPE researchers. It is worth considering because it may enable change through the study of HPE in relation to other social processes, structures and systems, including the clinical practice world. A particular benefit may be found in blending HPE research with research on clinical practice, toward changing practice and policy through IE, given the interrelated nature of these fields.
authors: Centre for Faculty Development, St Michael's Hospital, Toronto, Ontario, Canada.|Centre for Ambulatory Care Education, Women's College Hospital, Toronto, Ontario, Canada.|Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.|Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada.
authors: Stella L
authors: SL
authors: Ng
authors: Health Studies, University of Toronto Scarborough, Toronto, Ontario, Canada.|Centre for Criminology and Sociolegal Studies, University of Toronto, Toronto, Ontario, Canada.|Centre for Critical Qualitative Health Research, University of Toronto, Toronto, Ontario, Canada.
authors: Laura
authors: L
authors: Bisaillon
authors: Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada.|Centre for Critical Qualitative Health Research, University of Toronto, Toronto, Ontario, Canada.|Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Fiona
authors: F
authors: Webster
mesh_terms: D000884:Anthropology, Cultural; D006281:Health Occupations / Q000193:education*; D006801:Humans; D036301:Qualitative Research; D012107:Research Design; D066269:Social Theory