This paper aims to focus on examples of the perceived tensions of the healthcare work‐based learners as they experienced paradigm shifts in both practice and education.
Examples are drawn from a qualitative study to examine work‐based learning (WBL) workshops in a Dutch healthcare setting, and a developmental project led by an academic to implement a WBL accredited programme across Acute and Primary Care Trusts in a region of England. The paper also supports the argument of Flood and Romm that within complex organisations there is a need to develop “triple loop” learning as opposed to “double loop” learning. A discussion of the tensions which relate to experience and research is presented.
The paper finds that WBL is not easy, especially in times of rapid change and resistance to new ways of working by some colleagues. Managers, academics, mentors and healthcare learners need opportunities to discuss and interpret experience in order to construct meaning and new knowledge of practice. Key to enabling the development of the work‐based inquirer to cope with change and ethical dilemmas is the commitment of facilitators to inspire learning, support the exploitation of workplace resources and encourage networking within and external to the organisation.
A benefit of the WBL approach is that it engages the learner in problem solving and enhances the skills of inquiry, networking and creativity. It is important for the learner to gain awareness of the ethical knowledge underpinning practice. Tensions can arise as paradigms shift and when boundaries are misinterpeted, and personal and organisational values and beliefs conflict.
While the focus is healthcare the discussion could be relevant and of interest to a wider international audience of WBL practitioners as it considers a topic that is undervalued in workplace learning journals but is a reality of shifting paradigms.
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