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Balancing medical education with service in the workplace: a qualitative case study

Rebecca Mary Fish (Medical School, Lancaster University, Lancaster, UK)
Suzanne Jane Gawne (East Lancashire Hospitals NHS Trust, Blackburn, UK)
Laura Machin (Medical School, Lancaster University, Lancaster, UK)

Journal of Workplace Learning

ISSN: 1366-5626

Article publication date: 16 August 2021

Issue publication date: 27 January 2022




Finding a balance between the provision of quality individualized care and the ongoing education of junior doctors had been flagged as a concern at a large National Health Service (NHS) teaching hospital in the north of England. In response to this, the organization introduced an intervention designed to improve educational culture by providing support to educators, leaders and clinical staff.


This paper features themed results from eight in-depth interviews with educators, consultants and junior doctors to describe and evaluate the process and impact.


Factors that contributed to a positive educational environment included trainees and educators feeling valued, the presence of supportive leaders and the provision of a safe space for learning. Perceived barriers included time constraints, differing motivation and the generic format of formal education. Participants reflected on how the Wrap Around project helped improve the workplace educational culture and offered suggestions for further improvement including the provision of ongoing feedback to learners about their performance.


Research aimed at recognizing and resolving the perceived tensions between the priorities of education and health-care delivery has been flagged as a gap in the literature. The authors argue that developing and enhancing collaborative leadership and educational culture within an organization can reduce these tensions for those working on the front line. Future work should focus on addressing the perceived distinction between the two within services.



This work was supported by the East Lancashire Hospitals NHS Trust and a small grant from Health Education England North West. The authors would like to thank all the participants for their time and for their insights.


Fish, R.M., Gawne, S.J. and Machin, L. (2022), "Balancing medical education with service in the workplace: a qualitative case study", Journal of Workplace Learning, Vol. 34 No. 2, pp. 176-187.



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