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Trainee anaesthetists understand their work in different ways: implications for specialist education
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
2004 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 92, no 3, 381-7 p.Article in journal (Refereed) Published
Abstract [en]

Background. Traditionally, programmes for specialist education in anaesthesia and intensive care have been based on lists of attributes such as skills and knowledge. However, modern research in the science of teaching has shown that competence development is linked to changes in the way professionals understand their work. The aim of this study was to define the different ways in which trainee anaesthetists understand their work.

Methods. Nineteen Swedish trainee anaesthetists were interviewed. The interviews sought the answers to three open-ended questions. (i) When do you feel you have been successful in your work? (ii) What is difficult or what hinders you in your work? (iii) What is the core of your anaesthesia work? Transcripts of the interviews were analysed by a phenomenographic approach, a research method aiming to determine the various ways a group of people understand a phenomenon.

Results. Six ways of understanding their work were defined: giving anaesthesia according to a standard plan; taking responsibility for the patient’s vital functions; minimizing the patient’s suffering and making them feel safe; giving service to specialist doctors to facilitate their care of patients; organizing and leading the operating theatre and team; and developing one’s own competence, using the experience gained from every new patient for learning.

Conclusions. Trainee anaesthetists understand their work in different ways. The trainee’s understanding affects both his/her way of performing work tasks and how he/she develops new competences. A major task for teachers of anaesthesia is to create learning situations whereby trainees can focus on new aspects of their professional work and thus develop new ways of understanding it.

Place, publisher, year, edition, pages
2004. Vol. 92, no 3, 381-7 p.
Identifiers
URN: urn:nbn:se:uu:diva-92049DOI: 10.1093/bja/aeh079OAI: oai:DiVA.org:uu-92049DiVA: diva2:164995
Available from: 2004-09-10 Created: 2004-09-10 Last updated: 2010-05-25Bibliographically approved
In thesis
1. Anaesthetists and Professional Excellence: Specialist and Trainee Anaesthetists’ Understanding of their Work as a Basis for Professional Development, a Qualitative Study
Open this publication in new window or tab >>Anaesthetists and Professional Excellence: Specialist and Trainee Anaesthetists’ Understanding of their Work as a Basis for Professional Development, a Qualitative Study
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Why do some anaesthetists perform a better job than others? Why do some trainees grow faster in their professional role than others? These are important questions when the education of anaesthetists is so topical. Research in work pedagogy has shown that competence is related to the way professionals understand their work; the two first interview studies of this thesis are about understanding work. Study I shows that specialist anaesthetists understand work in four different ways, representing four aspects of work. Some of them have a comprehensive understanding, seeing three or all four aspects of work, whereas others have more restricted understandings. In Study II, trainees expressed similar ways of understanding work, some comprehensive, some more restricted. It is important that trainees develop competence in all aspects of work. Therefore, trainees need not only to develop competence by deepening their present understanding, but also by change of understanding, an important but difficult step in competence development.

Reflection is important in professional training. The reflection process should encompass all aspects of work, to enable trainees to develop a broad competence. However, only anaesthetists with a comprehensive way of understanding work have the prerequisites for facilitating trainees’ reflection in all aspects of work.

Study III, focussing on the learning environment, shows that two important principles of professional training are often violated for trainee anaesthetists: making use of the trainee’s curiosity and reducing trainees’ stress level. Trainees very much need support from well educated mentors.

Teachers should not only facilitate trainees’ development of competence but also support young trainees to develop into anaesthetists who enjoy work. Study IV shows that some experienced anaesthetists still enjoy work very much after years of practice. Their advice about how to get to terms with work should be shared with young trainees.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2004. 66 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1369
Keyword
Health services research, Professional training, competence, anaesthesiology, phenomenography, phenomenology, Hälso- och sjukvårdsforskning
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-4518 (URN)91-554-6023-2 (ISBN)
Public defence
2004-10-01, Fåhraeussalen, Rudbecklaboratoriet, Dag Hammarskjölds väg 20, Uppsala, 13:15
Opponent
Supervisors
Available from: 2004-09-10 Created: 2004-09-10Bibliographically approved

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Larsson, JanHolmström, IngerLindberg, EvaRosenqvist, Urban

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