Using communities of practice as a lens for exploring experiential pharmacy learning in general practice: Are communities of practice the way forward in changing the training culture in pharmacy?

Background Currently, there is little experiential learning in general practice (GP) during UK undergraduate and postgraduate pharmacy education and training. Aim To apply educational theories to explore pharmacy stakeholders’ perceptions of placements in general practice and contribute to the development of a model of experiential learning for pharmacy. Methods Qualitative, semi-structured interviews, conducted as part of two studies exploring experiential learning in general practice, with learners and their GP based supervisors. Interviews explored experiences of learning and practice, and what aided or hindered this. An abductive approach to analysis combined inductive coding with deductive, theory-driven interpretation using Lave and Wenger’s concept of “Communities of Practice”. Results Forty-four interviews were conducted, with learners and placement supervisors. Participants valued placements for providing authentic patient-facing learning experiences in the workplace, facilitated through legitimate peripheral participation by supervisors and supported by the use of pre- and de-briefing. Learners benefitted from support from their supervisor(s) and other staff during their day-to-day learning (informal learning), whilst also having protected time with their supervisors to discuss learning needs or go through workplace-based assessments (formal learning). Lack of clarity regarding which and how competencies should be assessed / demonstrated in general practice challenged monitoring progress from peripheral to full participation. Findings suggest that GP placements provide opportunities for learning about the patient journey between care settings; to work effectively with multidisciplinary teams; and consolidation and application of consultation / communication skills learning. Conclusions The learning culture of GP supports learners’ development, providing time and opportunities for meaningful and authentic workplace learning, with healthcare professionals acting as supervisors and mentors. These findings can usefully inform implementation of meaningful learning opportunities in primary and secondary care for those involved in pharmacy education and training.

“And the Word was made flesh?” – Exploring young people’s situated learning in leadership and spirituality in a secular context

This article explores the situated learning found among 18 young volunteers taking part in an education programme about leadership and Christian spirituality in the Church of Sweden. Focus group interviews and observations are analysed in the framework of situated learning, using legitimate peripheral participation as a lens. The study shows how the young people, through the education programme, formed a safe community where new identities were shaped through participating in new ways of worship, making pilgrimages, engaging in peer dialogue, and in reflection. They also gained new perspectives and models for volunteering. The young people´s experience of living in a secular culture presents challenges to their identity formation and to their ongoing spiritual practice and development. The use of situated learning provides a deeper understanding of the process of learning in spirituality and of the problems associated with conflicting communities of practice.

It’s How We Practice That Matters: Professional Identity Formation and Legitimate Peripheral Participation in Medical Students: A Qualitative Study

BackgroundThe process of Legitimate Peripheral Participation (LPP) within a community of practice framework (CoP) was used to explore graduate entry medical students’ professional identity formation (PIF) during their first year of study. A conceptual model has been developed that can be used by medical educators to better understand PIF and to aid the explicit incorporation of PIF activity within the undergraduate curriculum. MethodsTen students from one UK medical school participated in the longitudinal study and were interviewed at three points during the first year. Semi-structured group interviews were used to explore students’ experience of the clinical environment and the nature of their interactions with both clinicians and patients in a community-based medicine practice. The interviews were audio recorded and transcribed. Thematic analysis was used to identify overarching themes which are represented as facets in the model of PIF. ResultsResults demonstrate that students are legitimately peripherally participating within both medical student CoPs and wider medical CoPs. Themes identified within the narratives have allowed the development of a new model to understand PIF within the context of LPP in a CoP. This has five facets: Awareness, Collaboration, Negotiation, Evaluation and Realisation. Sophisticated reflection-in-action is shown to be an important aspect of PIF and enables a more conscious understanding of the change that is occurring in our students. ConclusionPIF is a complex, non-linear process that is supported by reflection-in-action and early student introduction to clinical practice. It can be recognised in students’ narratives in their changing use of language, their understanding of the medical COP, and their evolving relational participation with those around them. This study adds to those that have previously explored PIF. The model of PIF developed in this study illustrates how experiences in the clinical environment support PIF. Medical educators may find this model helpful when considering how PIF can be explicitly encouraged in the medical curriculum and how reflection may be used for the purpose of identity change.

No longer a wacky foreigner

This study focuses on language socialization during study abroad and specifically second language learning in communities of practice. Based on oral interviews in French and English, written journals, and weekly surveys, this study examines one participant’s second language (L2) learning during a semester abroad during which he became a member of two communities of practice: his host family and a local gaming group. The participant negotiated and became more confident in his L2 identity and learning over time and increasingly solidified his membership within these groups. This study analyzes the steps taken by the participant using the framework of legitimate peripheral participation and considers identity and learning that develop within a community of practice.

Facilitating the Scholarship of Discovery: Using the Mini-Ethnographic Case Study Design

Background: Case study is widely used in teaching and learning literature; however, the extant literature contains few examples of student-developed case studies. This study used the situated perspective of experiential education (EE) to highlight context and legitimate peripheral participation encouraging enculturation into research communities of practice. Purpose: The purpose of this study was to evaluate the implementation of a mini-ethnographic case study (MECS) during an international service-learning (ISL) experience to transform ISL and EE pedagogy through the inquiry-as-EL approach. The MECS design is a research method that uses an ethnographic approach bounded within case study methodology. Methodology/Approach: Working collaboratively, four students designed and implemented an MECS research project during an ISL. Using the crafted profile technique, data were analyzed to evaluate the impact of the MECS design on the students’ experience and research skill development while in country. Findings/Conclusions: The MECS approach helped students develop their own exploratory research framework and have real-world experiences with data collection, analysis, and dissemination as emerging researchers. Implications: This study describes how the MECS design can be used as a tool to enhance service-learning experiences for students, especially during graduate education.

Peripheral or Marginal Participation?

For academically bound international students, university-based Intensive English Programs (IEPs) frequently function as an avenue to American undergraduate or graduate degree programs. This qualitative study examined how one university-based IEP was preparing its academically bound international students and facilitating their transitions to matriculated study. Lave and Wenger’s (1991) theory of Situated Learning was utilized to explore international students’ participation in the IEP as a community of practice and the IEP’s own marginality within the university structure. We found that university-based IEPs can play a critical role in helping international students gain the competence and knowledge necessary to begin legitimate peripheral participation in degree programs. However, the extent to which IEP students were able to participate in the larger university community was limited by the IEP’s own marginality in the university community and the fact that the IEP is ultimately not a discipline-specific community of practice.

Strengths and Challenges for Medical Students and Residents in Rural Japan

Background and Objectives: In Japan, family medicine training is driven by community-based medical education (CBME) and is often provided in rural community hospitals and clinics. Although CBME’s positive relationship to family medicine in rural community hospitals is proven, the learning processes of medical students and residents in rural community hospitals needs investigating. The objective of this study was to reveal medical students’ and residents’ changing motivations and learning behaviors, as well as the factors underpinning their transition between medical schools or tertiary hospitals and rural community hospitals. Methods: Over 2 years, the researchers conducted one-on-one interviews with 50 medical students and 30 residents participating in family medicine training at a rural community hospital, and analyzed the difficulties the participants encountered and how they overcame them. The interviews were audio recorded and transcribed verbatim. We used grounded theory in the data analysis to clarify the findings. Results: Three key themes emerged: educational background, changing environment, and factors driving the learning cycle. Participants had difficulties in overcoming differences between their previous education and their CBME, particularly regarding expected roles and the variety of medical issues. They overcame their difficulties through cognitive apprenticeships and legitimate peripheral participation enhanced by daily reflection. Conclusions: In rural community hospitals, participants struggled to adapt to the wider practice range and the more interactive relationship with educators. Cognitive apprenticeships and legitimate peripheral participation, supported by constant reflection between learners and clinical teachers, can facilitate learning, leading to more effective learning and practice of family medicine in rural areas.

A CASE STUDY ON HOW PRIMARY-SCHOOL IN-SERVICE TEACHERS CONJECTURE AND PROVE: AN APPROACH FROM THE MATHEMATICAL COMMUNITY

This paper studies how four primary-school in-service teachers develop the mathematical practices of conjecturing and proving. From the consideration of professional development as the legitimate peripheral participation in communities of practice, these teachers’ mathematical practices have been characterised by using a theoretical framework (consisting of categories of activities) that describes and explains how a research mathematician develops these two mathematical practices. This research has adopted a qualitative methodology and, in particular, a case study methodological approach. Data was collected in a working session on professional development while the four participants discussed two questions that invoked the development of the mathematical practices of conjecturing and proving. The results of this study show the significant presence of informal activities when the four participants conjecture, while few informal activities have been observed when they strive to prove a result. In addition, the use of examples (an informal activity) differs in the two practices, since examples support the conjecturing process but constitute obstacles for the proving process. Finally, the findings are contrasted with other related studies and several suggestions are presented that may be derived from this work to enhance professional development.

Etienne and Beverly Wenger-Trayner (2020). Learning to Make a Difference. Value Creation in Social Learning Spaces, Cambridge University Press, ix + 279 pages

In their work, in their leisure time – yes, indeed in all walks of life – people interact with one another, have new experiences, come to know new things, and learn new things about their environment and the world they inhabit. But how? Philosophers, psychologists, sociologists, anthropologists, cognitive scientists, and many more have theorized this fundamental question and developed theories of learning. Thirty years ago, anthropology professor Jean Lave and cognitive scientist Etienne Wenger developed a social theory of learning that conceptualize learning as a process of situated cognition – legitimate peripheral participation – in communities of practice (Lave & Wenger 1991). This theory – and specifically the concept of communities of practice (CoP) that Etienne Wenger later explored in more detail (Wenger 1998) – have become an influential theoretical and analytical inspiration for researchers in education, organization studies, sociology, social-psychology, and the entire range of disciplines that are preoccupied with the study of social life and working life. (.....) Now, 30 years after the introduction of the theory, one of its proponents and found- ers, Etienne Wenger-Trayner, together with his spouse Beverly Wenger-Trayner, propose a new – and in their view – more encompassing social learning theory.

Community by Template? Considering the Role of Templates for Enacting Membership in Digital Communities of Practice

This chapter attends to how the concept of “communities of practice” (Lave and Wenger, Situated learning: Legitimate peripheral participation, learning in doing. Cambridge University Press, Cambridge, 1991) has been taken up by managers and policy makers in trans-local contexts. Although the concept was developed for co-located communities, it was transferred to distributed settings. In such settings, the sharing of practices is not necessarily active, and the performance of community not necessarily tied to their sharing. Some of the ambiguities of the original concept became problematic. The chapter is based on two vignettes that demonstrate how community is understood by policy makers and managers as a form of organisation that needs to be cultivated and coordinated. Continuing on the success of “communities of practice”, a focus of such striving became the sharing of experiences (and “good practices”) in order to foster community building. In a trans-local context, this meant—for the actors responsible for building community—a focus on how practices may be shared actively. One answer to this challenge was to describe local practices in standardised templates. However, different ways of organising the sharing of knowledge objects (e.g. who are the actors that define the structure of templates or how do they determine what counts as ‘good practice’) resulted in different forms of communality.