tag:blogger.com,1999:blog-8548648637110176926.post3618769345050390158..comments2024-02-22T01:06:12.834-08:00Comments on Medical Education Matters: Apprenticeship: a socio-cultural viewAnonymoushttp://www.blogger.com/profile/13539591178759056897noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-8548648637110176926.post-71412386728630479302018-07-28T05:29:05.802-07:002018-07-28T05:29:05.802-07:00شركة عزل اسطح بالرياض
افضل شركة تسليك مجاري بالدما...<br /><a href="https://www.bfirstseo.com/%D8%B9%D8%B2%D9%84-%D8%A7%D8%B3%D8%B7%D8%AD-%D8%A8%D8%A7%D9%84%D8%B1%D9%8A%D8%A7%D8%B6/" rel="nofollow">شركة عزل اسطح بالرياض</a><br /><a href="https://www.bfirstseo.com/%D8%AA%D8%B3%D9%84%D9%8A%D9%83-%D9%85%D8%AC%D8%A7%D8%B1%D9%89-%D8%A8%D8%A7%D9%84%D8%AF%D9%85%D8%A7%D9%85-%D8%A8%D8%A7%D9%84%D8%A7%D8%AD%D8%B3%D8%A7%D8%A1/" rel="nofollow">افضل شركة تسليك مجاري بالدمام</a><br /><a href="https://www.bfirstseo.com/%D8%AA%D8%B3%D9%84%D9%8A%D9%83-%D9%85%D8%AC%D8%A7%D8%B1%D9%89-%D8%A8%D8%A7%D9%84%D8%B1%D9%8A%D8%A7%D8%B6/" rel="nofollow">افضل شركة تسليك مجاري بالرياض</a><br /><a href="https://www.bfirstseo.com/%D8%AC%D9%84%D9%89-%D8%A8%D9%84%D8%A7%D8%B7-%D8%B1%D8%AE%D8%A7%D9%85-%D8%A8%D8%A7%D9%84%D8%B1%D9%8A%D8%A7%D8%B6/" rel="nofollow">افضل شركة جلى بلاط بالرياض</a><br />rokaahttps://www.blogger.com/profile/15789886689593010917noreply@blogger.comtag:blogger.com,1999:blog-8548648637110176926.post-34430393368520991662016-02-11T00:59:07.635-08:002016-02-11T00:59:07.635-08:00We don't know each other, but I'm a huge f...We don't know each other, but I'm a huge fan of your work. Thank you for amking my day! You can always read <a href="http://proof-reading.services/" rel="nofollow">more information</a> about us here. We are particularized in providing truly original academic projects! Say "Good Bye" to sleepless nights!<br />hallsarah204@gmail.comhttps://www.blogger.com/profile/15030486128395008892noreply@blogger.comtag:blogger.com,1999:blog-8548648637110176926.post-61556975905999303282012-08-06T14:56:24.967-07:002012-08-06T14:56:24.967-07:00Hi Anne Marie, so many questions and the answers a...Hi Anne Marie, so many questions and the answers are so difficult to find!<br /><br />The issue with CoP, for me at least, is that it assumes fairly stable work practices and work conditions over long periods of time. One of the difficulties with L and W work is they fail to fully delineate what constitutes a CoP or how you identify a life cycle of a CoP. For that reason, it is very difficult to a) research CoP and b) sustain CoP when there is rapid change or reform. So, the relatively stable working conditions and practices that sustained (medical) apprenticeship have been unsettled by reform, and previously tight knit firms seem to be much looser 'knots' of individual workers. I think the solution is some re-thinking. For me, as a researcher, this is where activity theory is helpful, because it is an interventionist methodology which brings practitioners together, to analyse their working practices, the contexts in which they happen, the tools they use (etc etc) and to consider what can be taken forward in new conditions, and where new, expansive forms of activity need to be developed. In my research looking at how the faculty development was being taken forward in NHS trusts, the most interesting responses were where doctors were coming together, to think through local, workable solutions - often quite creative solutions at that. I suppose, in terms of what happens on the ground, outwith a research context, there needs to be some careful thinking through about where educational interventions are best placed. Given constraints upon time, fragmented training relationships (on basis of work patterns etc) is the best use of training time that which is focussed upon meeting regulatory requirements (WPBA, sign off of competences, 'doing' reflections) or that which makes the most of every working based learning opportunity. Much more careful mapping of experiences, much more explicit work to ensure breadth of experience, adopting principles of graded responsibility so always thinking on the basis of what can I delegate in full, what can I delegate in part (and support) what needs to be observed. This is particularly vital given the squeezes on time.<br /><br />I have, in the past, challenged the 'it is all down to EWTD' kind of knee jerk response - it is clearly much more complex. However, I do think it has had a profound effect in that we can no longer rely on the 'if you do enough hours, you will get enough experience' type of opportunisitic training of the past, it has to be more purposeful. I think the issue of trust is fundamentally important - but so is the increased emphasis on consultant led/delivered service - if the expectation is the most senior doctors do the treatment, I do wonder how we manage to train the next generation of most-senior doctors!<br /><br />Lots to think about - thank you, as always, for providing the stimulus to keep the thinking going!<br /><br />BW<br />ClareAnonymoushttps://www.blogger.com/profile/13539591178759056897noreply@blogger.comtag:blogger.com,1999:blog-8548648637110176926.post-22711879728937487052012-08-06T14:43:09.650-07:002012-08-06T14:43:09.650-07:00Hi Ben
Experience is key to this way of understand...Hi Ben<br />Experience is key to this way of understanding apprenticeship i.e. over periods of time, newcomers to a community are inducted into the ways of that community, extending the range and complexity of their work activity until they become full participants - and indeed the new old timers!<br />BW<br />ClareAnonymoushttps://www.blogger.com/profile/13539591178759056897noreply@blogger.comtag:blogger.com,1999:blog-8548648637110176926.post-51352427712560824252012-08-03T05:07:12.947-07:002012-08-03T05:07:12.947-07:00So if the old model of apprenticeship- that based ...So if the old model of apprenticeship- that based in 'firms' - is unsustainable (or already gone) then what is the solution? How much have we lost? How important is what has been lost? <br /><br />Ben states that experience and exposure is what matters. But it only provides efficient opportunities for learning if it is within the context of some kind of apprenticeship, where you are learning from those with more experience than you have. <br /><br />Clare, you've stated before that EWTD is less important in the changes that have happened for specialist trainees. What are the big changes then? Why is there less experience and exposure? Is it because we are more risk averse and consultants feel uneasy entrusting activities to doctors who they know less well than in the past? If this is the case then the change in the apprenticehip model is central to why there is less oppritunities for experience and exposure for training doctors.<br /><br />I love you blog. Thank you!Anne Marie Cunninghamhttps://www.blogger.com/profile/05289974924032448531noreply@blogger.comtag:blogger.com,1999:blog-8548648637110176926.post-43940325744487137262012-08-03T03:41:20.878-07:002012-08-03T03:41:20.878-07:00Hello again!
Maximising continuity in training an...Hello again!<br /><br />Maximising continuity in training and medical care is clearly pivotal in this in order to maximise training standards and patient care standards.<br /><br />Also irrelevant to the apprenticeship argument is that massive importance of experience and exposure.benhttps://www.blogger.com/profile/16046328847880324437noreply@blogger.com