Search Results

The increasing complexity of health care practice makes continuing professional development (CPD) essential for health care professionals. Simulation-based training is a CPD activity that is often applied to improve interprofessional collaboration and the quality of care. The aim of this study is to explore simulation as a pedagogical practice for the CPD of health care professionals. Specifically, the study focuses on how a professional development activity, the simulation, is enacted to support interprofessional collaboration and learning. A practice theory perspective is used as the theoretical framework. In this, the professional practice is conceptualised as being embodied, relational and situated in sociomaterial arrangements. Ten introduction and reflection sessions following interprofessional full-scale manikin-based simulations with professionals were video-recorded. The recordings were analysed following a stepwise qualitative collaborative approach developed for the purpose.

The key findings suggest that the professional competence activity is enacted and interconnected with and governed by historical traditions of institutional teaching practices as well as simulation practices. Despite the intentions of team and interprofessional training, the institutional teaching and simulation practices constrain and hinder the intended outcomes of professional development in interprofessional collaboration.

Published abstract reprinted by permission of the copyright owner. Show less

Learning is crucial to how professionals enact practices, and to how practices change. Professionals frequently encounter uncertainty regarding what to do, requiring praxis informed by practical wisdom, which takes into account the virtues of practice. Critical praxis takes this further, questioning current norms to reduce untoward effects. A simulation-based education program for healthcare professionals was selected for study due to strong evidence of sustained improvements in handling a rare and challenging birth emergency (shoulder dystocia). Videos of simulations and debrief discussions were analysed in terms of complexes of sayings, doings and relatings.

Practitioners learned to respond in agile, collective ways to specific situations, through praxis. An extension to the theory of practice architectures is offered, based on two new concepts. 'Connective enactments' involved narration, questioning, and directing actions. These contributed to 'collective accomplishments' of fluid role-switching, responsive sequencing and pacing, and producing calm. These new concepts help to theorise how professional education can contribute to practice change by fostering praxis and critical praxis, addressing the architectures that shape practices.

Published abstract. Show less