Contradictions in clinical teachers’ engagement in educational development: an activity theory analysis

Abstract

Many medical universities offer educational development activities to support clinical teachers in their teaching role. Research has focused on the scope and effectiveness of such activities and on why individual teachers attend. However, systemic perspectives that go beyond a focus on individual participants are scarce in the existing literature. Employing activity theory, we explored how clinical teachers’ engagement in educational development was affected by the systems they act within. Three focus groups were held with clinical teachers from different professions. A thematic analysis was used to map the contradictions between the systems that the participants were part of and the manifestations of these contradictions in the system of education. In our model, clinical teachers were part of three activity systems directed by the objects of patient care, research and education respectively. Contradictions arose between these systems as their objects were not aligned. This manifested through the enacted values of the academic hospital, difficulties establishing educational discussions in the clinical workplace, the transient nature of educational employments, and impediments to developing a teacher identity. These findings offer insights into the complexities of engaging in educational development as clinical teachers’ priorities interact with the practices and values of the academic hospital, suggesting that attention needs to shift from individual teachers to developing the systems in which they work.

O papel do professor na percepção dos alunos de Odontologia: impacto do ensino de graduação baseado na comunidade

“…Elmberger et al 27 destacam que o desenvolvimento educacional deve ser exigido dos professores, assegurando-lhes tempo reservado para tais atividades, seja participando de workshops e cursos, seja participando de conferências educacionais ou ainda buscando desenvolvimento educacional no próprio local de trabalho.…”

Shifting to team-based faculty development: a programme designed to facilitate change in medical education

“…Other benefits were that it facilitated the implementation process, that individuals in the team felt support from each other when the project or tool was questioned by peers, and that it became easier to sustain the use of the tools developed. An important argument for targeting teams in faculty development is that higher education, and not the least clinical education, has been described as super complex (Barnett, 2000), with competing priorities between education and clinical work (Elmberger et al, 2018). In order to bring about change in complex organisations, it is beneficial to work in teams (Wheelan, 2014).…”

“…Consequently, the flexibility to cater for the needs of different types of learning environments may be low, and the research literature included in the programme unspecific. Since clinical teaching is often an additional and secondary task to that of providing medical care and creates a situation of competing priorities (Elmberger et al, 2018), the application of what was learned to local practice is particularly important for the integration of theory with practice.…”

Collaborative knotworking – transforming clinical teaching practice through faculty development

“…In line with this perspective, more theoretically informed research focusing on the interplay between faculty and their workplaces is called for when studying transfer and change following faculty development activities [ 2 , 5 , 9 , 10 ]. Adopting approaches sensitive to these interactions may be especially critical in health professions education, given the complexities of clinical workplaces in which tensions between clinical practice, research and education limit the opportunities for educational work and faculty development [ 16 ].…”