Community of practice and student interaction at an acute medical ward: An ethnographic study.

COMMUNITIES of practice; ETHNOGRAPHIC analysis; MEDICAL students; INTERPERSONAL relations research; NURSING students; WORK environment; PROFESSIONAL education; SOCIAL conditions of students; ACADEMIC medical centers; CLINICAL medicine; CORPORATE culture; CRITICAL care medicine; INTERNSHIP programs; INTERPROFESSIONAL relations; JOB stress; MEDICAL personnel; SCIENTIFIC observation; RESEARCH funding; SCHOOL environment; ETHNOLOGY research; OCCUPATIONAL adaptation; FIELD notes (Science)

Background:A deeper understanding is needed of the acute medical care setting as a learning environment for students. Aim:To explore workplace culture of an acute medical ward and students’ interactions within this community. Method:An ethnographic design was applied. Medical and nurse students’ interactions were observed and informal questioning performed. Field notes were transcribed and analysed qualitatively, inspired by Wengers’ “Community of practice” theory. Results:We identified four characteristics that regulated howstudents adapt and interact in the community of practice. Complex and stressful situationswere stabilized by routines and carriers of culture.Variable composition and roles of community memberswere a part of the daily routine but did not seam obvious to students.Transitions through community boundarieswere confusing especially for new students.Levels of importance and priority: Hierarchies and orders of priority were present as regulators of roles, routines and interactions, and of how staff approach different patient groups. Conclusion:The culture shaped a pattern for, and created prerequisites that challenged students’ adaptation and created a space for learning. Students’ task on arrival was to enter the semipermeable membrane of the community of practice and to understand and adapt to its culture, and try to become accepted. [ABSTRACT FROM PUBLISHER]