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  • Uddannelse og arbejdstilrettelæggelse Det Regionale Råd for Lægers Videreuddannelse, Region Nord

    23.09.14

    Mads Skipper

    Ph.d.-studerende, 1.reservelæge

    Oversigt

    • Bekymringer

    • Det kliniske læringsmiljø

    • Ph.d.-studie

    Bekymringer

    • For mange uddannelsesmæssige uproduktive opgaver

    • Risiko for ”fluebens”-mentalitet til uddannelse

    • Uforholdsmæssig stor og koncentreret arbejdsbyrde

    • Utilstrækkelig tid til rådighed til refleksion

    • Utilstrækkelig klinisk supervision

    • Intensiteten af ​​arbejdet • Transition og introduktion

    Portræt af det kliniske læringsmiljø

    • Det er en overforenkling at se hospitalsmiljøet som en enkelt enhed.

    • Der er forskelle i dynamikken og intensiteten i

    • menneskernes relationer til hinanden,

    • typen af adfærd som tilskyndes,

    • vigtigheden tillagt forskellige aktiviteter og

    • allokationen af indsatser og ressourcer.

    Rotem et.al., 1996

  • Ph.d.-projekt – uddannelse og arbejdstilrettelæggelse

    • Feltstudie (observationer) inkl. fokusgruppe interview

    • 3-timersmøder – tekstanalyse og outcome (initiativer) over tid

    • Interventionsstudie – Change Lab

    Residents create educational and organisational change – in a paediatric department

    Skipper, M & Nøhr, SB: Three-hour meetings – junior doctors creating educational and organisational changes in a paediatric department in DK, AMEE 2014

    Quantitative inventory of initiatives for change with follow up on initiatives

    Skipper, M & Nøhr, SB: Three-hour meetings – junior doctors creating educational and organisational changes in a paediatric department in DK, AMEE 2014

    ”…it is crucial that the junior and

    the senior doctor both have time

    – for supervision” (Resident)

    ”…it is crucial that the junior and

    the senior doctor both have time

    – for supervision” (Resident)

    ”…it is easier to recall

    something you’ve had in

    your own hands”

    (Resident)

    ”…it is easier to recall

    something you’ve had in

    your own hands”

    (Resident)

    ”…and insist that the foremost learning

    situation is bed-side, the next best thing is

    reading charts and then down at a fifth,

    sixth, seventh place comes sitting around a

    desk and being taught, going to lectures

    and the like” (Consultant)

    ”…and insist that the foremost learning

    situation is bed-side, the next best thing is

    reading charts and then down at a fifth,

    sixth, seventh place comes sitting around a

    desk and being taught, going to lectures

    and the like” (Consultant)

    “I think… well… you can’t

    think of training without

    thinking about service, and

    vice versa you can’t think of

    service without thinking

    about training” (Consultant)

    “I think… well… you can’t

    think of training without

    thinking about service, and

    vice versa you can’t think of

    service without thinking

    about training” (Consultant)

    Photo courtesy of Thomas Balslev, MD, PhD.

    Skipper M., Musaeus P. & Nøhr SB. What links the hospital Work organization with postgraduate workplace learning? A pilot case study of a university hospital paediatric department in Denmark. CCME 2014

  • ”In medical education, there will always be a tension between education and service. However, to frame it as a question of balance or trade-off is to miss the underlying premise of this perspective: education and service are

    the same thing. There is no separation between the ”pedagogic curriculum” of education and the ”work curriculum” of service. In this way, it would be wrong to ”stop and teach”. Instead, the teaching should be a part of the work as it is happening”

    Pratt et al. (2001) Spørgsmål?