Context
Over recent decades, the use of qualitative methodologies has increased in medical education research. These include ethnographic approaches, which have been used to explore complex cultural norms and phenomena by way of long‐term engagement in the field of research. Often, however, medical education consists of short‐term episodes that are not bound to single sites, but take place in a myriad of locations and contexts such as classrooms, examination stations, clinical settings and online. This calls for methodologies that allow us to grasp what is at stake in an increasingly multifaceted and diverse field.
Methods
In this article, we direct attention to focused ethnography, which has emerged as a useful, suitable and feasible applied qualitative research approach, and which uses adapted classic ethnographic methods, such as direct observation, to gain new insights and nuanced understandings of distinct phenomena, themes and interactions in specific settings in medical education (eg the learning potential of ward rounds, or how hierarchical positions affect learning situations). We introduce methodological key features of focused ethnography to give insights into how the approach can be used, and we offer examples of how the method has been used in medical education research to show how it has contributed in different ways to the field of medical education research. Furthermore, we address and discuss some of the main challenges and limitations of the approach.
Conclusions
Focused ethnography offers a methodological approach that sheds light over limited and well‐defined social episodes and interactions. Precisely because the field of medical education consists to a large degree of such fragmented interactions, focused ethnography can be seen as a methodology tailored to these characteristics and should become an integrated part of the toolkit of medical education research.
The position as "colleague" both reinforced the communication skills training and hindered it. The communication skills educational model had a flat, non-hierarchical structure which disturbed the hierarchical structure of the workplace, and its related positions.
The article investigates the role of the social in medicine through an empirical study of social technologies in Diabetes 2 and COPD patient education in Denmark. It demonstrates how the social at the same time is the cause of disease but also functions as a solution to the problem. Furthermore it suggests that the patient groups have an ambiguous role in medicine; they appear to be organized as communities of empowerment, critical of the individualizing effects of medicine, but at the same time these groups are embedded in medical practices, transferring responsibility for illness and health to the level of the citizens. The article provides an empirical analysis of how the social in patient education works. The empirical analysis challenges an existing understanding that patient groups automatically support healthy lifestyle changes. We point out the multiple ways in which the social works.
New technologies have facilitated doctor–patient email consultations (e-consultations). Guidelines for e-consultation use in Denmark state that they should be used for simple, concrete and non-urgent queries; however, a small-scale Danish study suggested that doctors encounter e-consultations that do not match the guidelines. The purpose of this article is to explore whether e-consultations in Denmark reflect recommendations that they should be simple, short, concrete and well defined, and if not, what forms of complexity are evident. We inductively analysed 1,671 e-consultations from 38 patients aged 21–91 years communicating with 28 doctors, 6 nurses, 1 medical student and 8 secretaries. Results showed both quantitative complexity in terms of number of interaction turns, communicative participants, and questions asked, and qualitative complexity relating to patients’ psychosocial contexts and GPs’ biomedical disease perspective. Thus, despite existing guidelines and the leanness associated with the email medium, multiple forms of complexity were evident. This mismatch highlights the need for theoretical development as well as the value of re-examining existing policies and guidelines regarding expectations for e-consultation use.
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