Responsibility matters: putting illness back into the picture

Abstract

Purpose

The purpose of this paper is to explore specific instances of junior doctors' responsibility. Learning is often understood to be a prerequisite for managing responsibility and risk but this paper aims to argue that this is insufficient because learning is integral to the management of responsibility and risk.

Design/methodology/approach

This is a “collective” case study of doctors designed to focus on the interrelationships between individual professionals and complex work settings. The authors focussed on two key points of transition: the transition to beginning clinical practice which is the move from medical student to foundation training (F1) and the transition from generalist to specialist clinical practice.

Findings

Responsibility in clinical settings is immediate, concrete, demands response and (in) action has an effect. Responsibility is learnt and is not always apparent; it shifts depending on time of day/night and who else is present. Responsibility does not necessarily increase incrementally and can decrease; it can be perceived differently by different actors. Responsibility is experienced as personal although it is distributed.

Originality/value

This detailed examination of practice has enabled the authors to foreground the particularities, urgency and fluidity of everyday clinical practice. It recasts their understandings of responsibility – and managing risk – as involving learning in practice. This is a critical insight because it suggests that the theoretical basis for the current approach to managing risk and responsibility is insufficient. This has significant implications for policy, employment, education and practice of new doctors and for the management of responsibility and risk.

Citation

Kilminster, S. and Zukas, M. (2013), "Responsibility matters: putting illness back into the picture", Journal of Workplace Learning, Vol. 25 No. 6, pp. 383-393. https://doi.org/10.1108/JWL-08-2012-0058