Workplace learning through collaboration in primary healthcare: A BEME realist review of what works, for whom and in what circumstances: BEME Guide No. 46

Mertens, Fien; Groot, Esther de; Meijer, Loes; Wens, Johan; Cherry, Mary Gemma; Deveugele, Myriam; Damoiseaux, Roger; Stes, Ann; Pype, Peter

doi:10.1080/0142159x.2017.1390216

Cited by 58 publications

(68 citation statements)

References 83 publications

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“…GP supervisors and trainees learn informally from each other while working together in the practice [12]. Presumably, EBM behaviour is also learned this way.…”

Section: Introductionmentioning

confidence: 99%

“…Presumably, EBM behaviour is also learned this way. Observation is a part of informal learning as the observer, either the supervisor or trainee, learns from viewing the other person execute a certain skill or task [12]. Medical education and cognitive psychology literature theorises that observation leads to learning by stimulating reflective and prospective deliberation: the observer reflects on the effectiveness of various strategies and thinks about this in light of their own goals and future actions [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Medical education and cognitive psychology literature theorises that observation leads to learning by stimulating reflective and prospective deliberation: the observer reflects on the effectiveness of various strategies and thinks about this in light of their own goals and future actions [13][14][15][16]. Observational, opportunistic learning can be seen as complementary to deliberative learning strategies in the workplace, such as discussing a topic or a skill [12,17,18]. One study suggests that informal learning may be even more powerful than formal learning since it leads to socialisation and tacit knowledge, which can overrule explicit knowledge [19].…”

Section: Introductionmentioning

confidence: 99%

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Applying evidence-based medicine in general practice: a video-stimulated interview study on workplace-based observation

et al. 2020

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Background: Evidence-based medicine (EBM) in general practice involves applying a complex combination of bestavailable evidence, the patient's preferences and the general practitioner's (GP) clinical expertise in decision-making. GPs and GP trainees learn how to apply EBM informally by observing each other's consultations, as well as through more deliberative forms of workplace-based learning. This study aims to gain insight into workplace-based EBM learning by investigating the extent to which GP supervisors and trainees recognise each other's EBM behaviour through observation, and by identifying aspects that influence their recognition. Methods:We conducted a qualitative multicentre study based on video-stimulated recall interviews (VSI) of paired GP supervisors and GP trainees affiliated with GP training institutes in Belgium and the Netherlands. The GP pairs (n = 22) were shown fragments of their own and their partner's consultations and were asked to elucidate their own EBM considerations and the ones they recognised in their partner's actions. The interview recordings were transcribed verbatim and analysed with NVivo. By comparing pairs who recognised each other's considerations well with those who did not, we developed a model describing the aspects that influence the observer's recognition of an actor's EBM behaviour.Results: Overall, there was moderate similarity between an actor's EBM behaviour and the observer's recognition of it. Aspects that negatively influence recognition are often observer-related. Observers tend to be judgemental, give unsolicited comments on how they would act themselves and are more concerned with the trainee-supervisor relationship than objective observation. There was less recognition when actors used implicit reasoning, such as mindlines (internalised, collectively reinforced tacit guidelines). Pair-related aspects also played a role: previous discussion of a specific topic or EBM decision-making generally enhanced recognition. Consultation-specific aspects played only a marginal role.Conclusions: GP trainees and supervisors do not fully recognise EBM behaviour through observing each other's consultations. To improve recognition of EBM behaviour and thus benefit from informal observational learning, observers need to be aware of automatic judgements that they make. Creating explicit learning moments in which EBM decisionmaking is discussed, can improve shared knowledge and can also be useful to unveil tacit knowledge derived from mindlines.

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“…GP supervisors and trainees learn informally from each other while working together in the practice [12]. Presumably, EBM behaviour is also learned this way.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Applying evidence-based medicine in general practice: a video-stimulated interview study on workplace-based observation

et al. 2020

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“…Alternatively, panel management education can be formally integrated into primary care training as an interprofessional practice-based curriculum where working together merges with learning together (Mertens et al, 2017). Furthermore, dedicated resources including time, space, and strong facilitation have been shown to improve learner and patient outcomes in interprofessional education (Brewer, Flavell, & Jordon, 2017).…”

Section: Introductionmentioning

confidence: 99%

Interprofessional population health advocacy: Developing and implementing a panel management curriculum in five Veterans Administration primary care practices

Dulay

Bowen

Weppner

et al. 2018

Journal of Interprofessional Care

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Health care systems expect primary care clinicians to manage panels of patients and improve population health, yet few have been trained to do so. An interprofessional panel management (PM) curriculum is one possible strategy to address this training gap and supply future primary care practices with clinicians and teams prepared to work together to improve the health of individual patients and populations. This paper describes a Veterans Administration (VA) sponsored multi-site interprofessional PM curriculum development effort. Five VA Centers of Excellence in Primary Care Education collaborated to identify a common set of interprofessionally relevant desired learning outcomes (DLOs) for the PM and to develop assessment instruments for monitoring trainees' PM learning. Authors cataloged teaching and learning activities across sites. Results from pilot testing were systematically discussed leading to iterative revisions of curricular elements. Authors completed a retrospective self-assessment of curriculum implementation for the academic year 2015-16 using a 5-point scale: contemplation (score = 0), pilot (1), action (2), maintenance (3), and embedded (4). Implementation scores were analyzed using descriptive statistics. DLOs were organized into five categories (individual patients, populations, guidelines/measures, teamwork, and improvement) along with a developmental continuum and mapped to program competencies. Instruction and implementation varied across sites based on resources and priorities. Between 2015 and 2016, 159 trainees (internal medicine residents, nurse practitioner students and residents, pharmacy residents, and psychology post-doctoral fellows) participated in the PM curriculum. Curriculum implementation scores for guidelines/measures and improvement DLOs were similar for all trainees; scores for individual patients, populations, and teamwork DLOs were more advanced for nurse practitioner and physician trainees. In conclusion, collaboratively identified DLOs for PM guided development of assessment instruments and instructional approaches for panel management activities in interprofessional teams. This PM curriculum and associated tools provide resources for educators in other settings. ARTICLE HISTORY

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“…(2018) som visat att vårdgivare i flera professioner var omedvetna om det lärande som skedde genom att samarbeta. De menade att vårdgivare behöver avsatt tid för reflektion för att lära nya sätt att interagera och utveckla sitt kliniska arbete (Mertens et al, 2018).…”

Section: Patienter Närstående Och Lärandeunclassified

Läkare, lärande och interaktion i hälso-och sjukvårdspraktiker

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Workplace learning through collaboration in primary healthcare: A BEME realist review of what works, for whom and in what circumstances: BEME Guide No. 46

Cited by 58 publications

References 83 publications

Applying evidence-based medicine in general practice: a video-stimulated interview study on workplace-based observation

Applying evidence-based medicine in general practice: a video-stimulated interview study on workplace-based observation

Interprofessional population health advocacy: Developing and implementing a panel management curriculum in five Veterans Administration primary care practices

Läkare, lärande och interaktion i hälso-och sjukvårdspraktiker

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