Landscapes of practice in medical education
Landscapes of practice in medical education
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DOI：
10.1111/medu.14061
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发表时间：
2020-06-01
影响因子：
6
通讯作者：
Hodson, Nathan
中科院分区：
文献类型：
--
作者：
Hodson, Nathan
社会文化学习理论在医学教育中发挥着重要作用。当Etienne Wenger-Trayner描述以三个共同特征(相互参与、联合企业、共享剧目)为导向的“实践社区”时，他的方法在包括临床医学和医学教育在内的一系列领域受到热烈欢迎。然而，这种模式因其关注单一社区而受到限制。最近，包括温格-特雷纳在内的主要社会文化学习理论家提出将实践图景作为学习者身份发展的模型，但这一理论尚未应用于医学教育。在这篇交叉前沿的论文中，我描述了实践景观的主要特征。实践的场景涵盖了所有的实践社区，学习者可以在这些社区之间移动。实践社区之间的边界是特别肥沃的学习环境，无论是通过偶尔跨越边界的尝试，还是通过两个或更多实践社区的完全多成员关系。因此，在整个环境中驾驭知识获取和身份形成的能力，也就是所谓的“知识性”，变得至关重要。本文最后描述了实践景观模式在医学教育实践和研究中的可能应用。该模式为跨学科学习提供了一个丰富的框架，尽管有人批评它未能解决社区内部权力差距巨大造成的困难，以及对边界关系不切实际的合作(而不是竞争)观点。然而，它为理解医学实习生和学生的身份形成提供了一种新的方法。
Sociocultural learning theories play an important part in medical education. When Etienne Wenger-Trayner described 'communities of practice' oriented around three common features (mutual engagement, joint enterprise, shared repertoire), his approach was enthusiastically embraced across a range of fields, including those of clinical medicine and medical education. However, this model is limited by its focus on a single community. Recently, leading sociocultural learning theorists including Wenger-Trayner have proposed the landscape of practice as a model for how learner identities develop, but this theory has not yet been utilised in medical education. In this Cross-cutting Edge paper, I describe the key features of landscapes of practice. The landscape of practice encompasses all the communities of practice, and learners can move between these. The boundaries between communities of practice are particularly fertile settings for learning, either through occasional forays across borders or through complete multimembership of two or more communities of practice. The capacity to navigate knowledge acquisition and identity formation across the landscape, known as 'knowledgeability,' therefore becomes crucial. This paper concludes by describing possible applications of the landscapes of practice model in medical education practice and research. The model provides a rich framework for approaching cross-discipline learning, although it has been criticised for failing to address the difficulties created by wide disparities in power within communities and for an unrealistically collaborative (rather than competitive) view of boundary relations. Nevertheless, it provides a novel way of understanding the identity formation of medical trainees and students.