Learning across paradigms : towards an understanding of the development of medical teaching practice

Sammanfattning: The purpose of this thesis was to investigate how educational developers can work strategically with change to develop quality in higher education institutions in general and in medical education in particular. The thesis addresses the challenges faced by educational developers when introducing concepts that may challenge not only individuals’ but also the epistemological assumptions of different groups within different disciplines of how we learn, what constitutes knowledge and how we can explore reality. These challenges are discussed from a perspective where the research paradigms are seen as central features of the context in influencing epistemologies of knowledge and learning. Four studies were undertaken within the framework of two projects. Study I aimed to understand medical teachers’ conceptions of the development of expertise and how these conceptions relate to the core curriculum. Study II investigated how anatomy and surgery teachers conceptualise and act regarding the issue of transfer; the challenge students meet when shifting from university based medical education to clinical practice contexts. Study III and IV were carried out as part of a collaborative project within a department that aimed for enhancing the quality of teaching. This collaborative project is an example of a way of working at the group level rather than with the individual teacher, as in studies I and II. Study III explores the relationship between teaching practice and teachers’ conceptions of learning. Study IV is a qualitative analysis of how we can understand the development of teaching within a community of practice and how, through intervention, development of teaching can be enabled in a departmental context. The thesis has theoretical as well as methodological implications. The results indicate a necessity for educational developers to work with teachers as communities of practice, and thereby acknowledge the different paradigms that influence their context and, hence, their conceptions of teaching and learning. The core curriculum is suggested to be an example of a boundary object, a document that can actualize participation and dialogue between different communities within the educational program. A shift from focusing on the application of educational research results to also include the engagement of educational developers suggests the involvement in action research and the growth of a scholarship of educational development.