Experience, trajectories, and reifications: an emerging framework of practice-based learning in healthcare workplaces
Open accessAbstract
Learning by working is omnipresent in healthcare education. It enables people to learn how to perform, think, and interact in ways that work for their specific context. In this paper, I review my approach to studying this process. It centers on the question why healthcare professionals do what they do and how their actions and learning are intertwined. The aim of this paper is to illustrate what I have learned from the research I have been involved in, in such a way that it enables other researchers, educators, and clinicians to understand and study practice-based learning in healthcare workplaces. Therefore, I build on a programmatic line of research to present a framework of practice-based learning consisting of three inextricably linked levels of analysis. The first level focuses on how situations lead to personal experiences, the second level looks at strings of experiences that lead to multiple trajectories, and the third level deals with reifications arising from recurrent activities. This framework, and its interrelations and inherent tensions, helps to understand why healthcare workplaces can be both a powerful learning environment and a frustratingly hard place to change.
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Feedback is part of a social interaction influenced by culture, values, expectations, personal histories, relationships, and power.
“Feedback is part of a social interaction influenced by culture, values, expectations, personal histories, relationships, and power.”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [6]
Promoting communities of practice can be a helpful approach in turning the workplace into a powerful learning environment.
“This can be a helpful approach in turning the workplace into a powerful learning environment when it can otherwise be a frustratingly hard place to change [6].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [6]
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The unbearable automaticity of being
Bargh, J. A., & Chartrand, T. L. (1999) · American Psychologist · doi:10.1037/0003-066x.54.7.462 · Cited by 3,699 · see citing works
Neural regulation of endocrine and autonomic stress responses
Ulrich-Lai, Y. M., & Herman, J. P. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2647 · Cited by 3,318 · see citing works
Informal learning in the workplace
Eraut *, M. (2004) · Studies in Continuing Education · doi:10.1080/158037042000225245 · Cited by 2,611 · see citing works
On the Functional Properties of Perceived Self-Efficacy Revisited
Bandura, A. (2012) · Journal of Management · doi:10.1177/0149206311410606 · Cited by 2,586 · see citing works
Conditions for intuitive expertise: A failure to disagree.
Kahneman, D., & Klein, G. (2009) · American Psychologist · doi:10.1037/a0016755 · Cited by 2,443 · see citing works
Cultural Studies : Theory and Practice
Barker, C. (2000) · Cited by 1,668 · see citing works
Tensegrity I. Cell structure and hierarchical systems biology
Ingber, D. E. (2003) · Journal of Cell Science · doi:10.1242/jcs.00359 · Cited by 1,266 · see citing works
Cultural Influences on Personality
Triandis, H. C., & Suh, E. M. (2002) · Annual Review of Psychology · doi:10.1146/annurev.psych.53.100901.135200 · Cited by 1,216 · see citing works
Deep-level composition variables as predictors of team performance: A meta-analysis.
Bell, S. T. (2007) · Journal of Applied Psychology · doi:10.1037/0021-9010.92.3.595 · Cited by 1,137 · see citing works
Explaining Creativity: The Science of Human Innovation
Sawyer, R. K. (2006) · Cited by 1,080 · see citing works
The perception-behavior expressway: automatic effects of social perception on social behavior.
Dijksterhuis, A., & Bargh, J. A. (2001) · Advances in Experimental Social Psychology · doi:10.1016/s0065-2601(01)80003-4 · Cited by 1,052 · see citing works
Tensegrity II. How structural networks influence cellular information processing networks
Ingber, D. E. (2003) · Journal of Cell Science · doi:10.1242/jcs.00360 · Cited by 839 · see citing works
Meltzoff, A. N., & Jean Decety, A. (2003) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2002.1261 · Cited by 713 · see citing works
Experiential learning: AMEE Guide No. 63
Yardley, S., Teunissen, P. W., & Dornan, T. (2012) · Medical Teacher · doi:10.3109/0142159x.2012.650741 · Cited by 639 · see citing works
Self-citationDornan, T., Boshuizen, H. P. A., KING, N. M., & Scherpbier, A. J. J. A. (2006) · Medical Education · doi:10.1111/j.1365-2929.2006.02652.x · Cited by 625 · see citing works
Team Communications in the Operating Room
Lingard, L. A., Reznick, R. K., Espin, S., et al. (2002) · Academic Medicine · doi:10.1097/00001888-200203000-00013 · Cited by 442 · see citing works
How the mind explains behavior: folk explanations, meaning, and social interaction
(2005) · Choice Reviews Online · doi:10.5860/choice.42-6170 · Cited by 436 · see citing works
Social Learning Systems and Communities of Practice
Blackmore, C. (2010) · Springer eBooks · doi:10.1007/978-1-84996-133-2 · Cited by 380 · see citing works
How the Mind Explains Behavior
Malle, B. F. (2004) · The MIT Press eBooks · doi:10.7551/mitpress/3586.001.0001 · Cited by 357 · see citing works
Opportunity or threat: the ambiguity of the consequences of transitions in medical education
Teunissen, P. W., & Westerman, M. (2011) · Medical Education · doi:10.1111/j.1365-2923.2010.03755.x · Cited by 342 · see citing works
Self-citationSituated learning: Bridging sociocultural and cognitive theorising
Billett, S. R. (1996) · Learning and Instruction · doi:10.1016/0959-4752(96)00006-0 · Cited by 331 · see citing works
How residents learn: qualitative evidence for the pivotal role of clinical activities
Teunissen, P. W., Scheele, F., Scherpbier, A. J. J. A., van der Vleuten, C. P. M., Boor, K., van Luijk, S. J., & van Diemen-Steenvoorde, J. A. A. M. (2007) · Medical Education · doi:10.1111/j.1365-2923.2007.02778.x · Cited by 298 · see citing works
Self-citationLearning from clinical work: the roles of learning cues and credibility judgements
Watling, C., Driessen, E., van der Vleuten, C. P. M., & Lingard, L. (2012) · Medical Education · doi:10.1111/j.1365-2923.2011.04126.x · Cited by 261 · see citing works
Medical Education: Theory and Practice
Dornan, T., Mann, K. V., Scherpbier, A. J. J. A., & Spencer, J. (2010) · Newcastle University ePrints (Newcastle Univesity) · doi:10.25405/ncl.34176165 · Cited by 227 · see citing works
Research in Medical Education: Balancing Service and Science*
Albert, M., Hodges, B. D., & Regehr, G. (2006) · Advances in Health Sciences Education · doi:10.1007/s10459-006-9026-2 · Cited by 213 · see citing works
Phillips, D. C., & Soltis, J. F. (2010) · Teachers College Press eBooks · doi:10.65528/9780807771204 · Cited by 201 · see citing works
van der Zwet, J., Zwietering, P. J., Teunissen, P. W., van der Vleuten, C. P. M., & Scherpbier, A. J. J. A. (2010) · Advances in Health Sciences Education · doi:10.1007/s10459-010-9268-x · Cited by 179 · see citing works
Self-citationWenger, É. (2010) · Springer eBooks · doi:10.1007/978-1-84996-133-2_8 · Cited by 178 · see citing works
Sargeant, J., Mann, K., & Ferrier, S. (2005) · Medical Education · doi:10.1111/j.1365-2929.2005.02124.x · Cited by 174 · see citing works
Clarifying students’ feedback‐seeking behaviour in clinical clerkships
Bok, H. G. J., Teunissen, P. W., Spruijt, A., Fokkema, J. P. I., van Beukelen, P., Jaarsma, D. A. D. C., & van der Vleuten, C. P. M. (2013) · Medical Education · doi:10.1111/medu.12054 · Cited by 155 · see citing works
Self-citationThe Significance of Workplace Learning for Individuals, Groups and Organisations
Eraut, M. R., & Hirsch, W. (2007) · Cited by 154 · see citing works
Features of assessment learners use to make informed self-assessments of clinical performance.
Sargeant, J., Eva, K. W., Armson, H., Chesluk, B., Dornan, T., Holmboe, E., Lockyer, J. M., Loney, E., Mann, K. V., & van der Vleuten, C. P. M. (2011) · Medical Education · doi:10.1111/j.1365-2923.2010.03888.x · Cited by 154 · see citing works
Teunissen, P. W., Stapel, D. A., van der Vleuten, C., Scherpbier, A., Boor, K., & Scheele, F. (2009) · Academic Medicine · doi:10.1097/acm.0b013e3181a858ad · Cited by 151 · see citing works
Self-citationAssessment of competence and progressive independence in postgraduate clinical training
Dijksterhuis, M. G. K., Voorhuis, M., Teunissen, P. W., Schuwirth, L., ten Cate, O., Braat, D. D. M., & Scheele, F. (2009) · Medical Education · doi:10.1111/j.1365-2923.2009.03509.x · Cited by 140 · see citing works
Self-citationWesterman, M., Teunissen, P. W., van der Vleuten, C. P. M., Scherpbier, A. J. J. A., Siegert, C. E. H., van der Lee, N., & Scheele, F. (2010) · Academic Medicine · doi:10.1097/acm.0b013e3181fa2913 · Cited by 133 · see citing works
Self-citationDevelopment and analysis of D-RECT, an instrument measuring residents’ learning climate
Boor, K., van der Vleuten, C. P. M., Teunissen, P. W., Scherpbier, A. J. J. A., & Scheele, F. (2011) · Medical Teacher · doi:10.3109/0142159x.2010.541533 · Cited by 131 · see citing works
Self-citationMasón, L. (2007) · Educational Psychologist · doi:10.1080/00461520709336914 · Cited by 120 · see citing works
How Medical Students Learn From Residents in the Workplace
Karani, R., Fromme, H. B., Cayea, D., et al. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000141 · Cited by 113 · see citing works
Teunissen, P. W., & Dornan, T. (2008) · BMJ · doi:10.1136/bmj.39434.601690.ad · Cited by 110 · see citing works
Self-citationBillett, S. R. (2010) · Springer eBooks · doi:10.1007/978-90-481-3939-2 · Cited by 110 · see citing works
General practitioners as supervisors in postgraduate clinical education: an integrative review
Wearne, S., Dornan, T., Teunissen, P. W., & Skinner, T. (2012) · Medical Education · doi:10.1111/j.1365-2923.2012.04348.x · Cited by 105 · see citing works
Self-citationDiscourse, Dynamics, and Social Change
Lemke, J. L. (1993) · Cultural Dynamics · doi:10.1177/092137409300600107 · Cited by 102 · see citing works
Weaver, S. J., Bedwell, W. L., & Salas, E. (2011) · Routledge eBooks · doi:10.4324/9780203817827 · Cited by 101 · see citing works
How Clerkship Students Learn From Real Patients in Practice Settings
Steven, K., Wenger, É., Boshuizen, H. P. A., Scherpbier, A. J. J. A., & Dornan, T. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000129 · Cited by 94 · see citing works
The Practices of Learning through Occupations
Billett, S. R. (2010) · Springer eBooks · doi:10.1007/978-90-481-3939-2_4 · Cited by 90 · see citing works
Doornbos, A. J., Bolhuis, S. M., & Simons, P. R. J. (2004) · Human Resource Development Review · doi:10.1177/1534484304268107 · Cited by 88 · see citing works
How undergraduate clinical learning climates differ: a multi‐method case study
Boor, K., Scheele, F., van der Vleuten, C. P. M., Teunissen, P. W., den Breejen, E. M. E., & Scherpbier, A. J. J. A. (2008) · Medical Education · doi:10.1111/j.1365-2923.2008.03149.x · Cited by 87 · see citing works
Self-citationThe effects of contributing to patient care on medical students' workplace learning
Smith, S. E., Tallentire, V. R., Cameron, H. S., & Wood, S. M. (2013) · Medical Education · doi:10.1111/medu.12217 · Cited by 80 · see citing works
Dijksterhuis, M. G. K., Schuwirth, L. W. T., Braat, D. D. M., Teunissen, P. W., & Scheele, F. (2013) · Medical Teacher · doi:10.3109/0142159x.2012.756576 · Cited by 79 · see citing works
Self-citationAttending doctors' perspectives on how residents learn
Teunissen, P. W., Boor, K., Scherpbier, A. J. J. A., van der Vleuten, C. P. M., van Diemen-Steenvoorde, J. A. A. M., van Luijk, S. J., & Scheele, F. (2007) · Medical Education · doi:10.1111/j.1365-2923.2007.02858.x · Cited by 77 · see citing works
Self-citationExploration of perceived effects of innovations in postgraduate medical education
Fokkema, J. P. I., Teunissen, P. W., Westerman, M., van der Lee, N., van der Vleuten, C. P. M., Scherpbier, A. J. J. A., Dorr, P., & Scheele, F. (2013) · Medical Education · doi:10.1111/medu.12081 · Cited by 49 · see citing works
Self-citationIn at the deep end: making the transition from SpR to consultant
Wilkie, G., & Raffaelli, D. N. (2005) · Advances in Psychiatric Treatment · doi:10.1192/apt.11.2.107 · Cited by 38 · see citing works
Westerman, M., Teunissen, P. W., Jørgensen, R. L., Fokkema, J. P. I., Siegert, C. E. H., van der Vleuten, C. P. M., Scherpbier, A. J. J. A., Ringsted, C. V., & Scheele, F. (2013) · Medical Teacher · doi:10.3109/0142159x.2013.774332 · Cited by 37 · see citing works
Self-citationTeunissen, P. W., Stapel, D. A., Scheele, F., Scherpbier, A. J. J. A., Boor, K., van Diemen-Steenvoorde, J. A. A. M., & van der Vleuten, C. P. M. (2007) · Advances in Health Sciences Education · doi:10.1007/s10459-007-9082-2 · Cited by 34 · see citing works
Self-citationReframing Clinical Workplace Learning Using the Theory of Distributed Cognition
Pimmer, C., Pachler, N., & Genewein, U. (2013) · Academic Medicine · doi:10.1097/acm.0b013e31829eec0a · Cited by 32 · see citing works
van der Zwet, J., Dornan, T., Teunissen, P. W., de Jonge, L. P. J. W. M., & Scherpbier, A. J. J. A. (2013) · Advances in Health Sciences Education · doi:10.1007/s10459-013-9465-5 · Cited by 27 · see citing works
Self-citationCultural diversity in Australian medical education
Klimidis, S., Minas, I. H., Stuart, G. W., et al. (1997) · Medical Education · doi:10.1111/j.1365-2923.1997.tb00045.x · Cited by 27 · see citing works
How lead consultants approach educational change in postgraduate medical education
Fokkema, J. P. I., Westerman, M., Teunissen, P. W., et al. (2012) · Medical Education · doi:10.1111/j.1365-2923.2011.04175.x · Cited by 25 · see citing works
Self-citationNew consultants mastering the role of on‐call supervisor: a longitudinal qualitative study
Westerman, M., Teunissen, P. W., Fokkema, J. P. I., Siegert, C. E. H., van der Vleuten, C. P. M., Scherpbier, A. J. J. A., & Scheele, F. (2013) · Medical Education · doi:10.1111/medu.12129 · Cited by 24 · see citing works
Self-citationCastilla, E. J. (2004) · International Sociology · doi:10.1177/0268580904047365 · Cited by 22 · see citing works
Teunissen, P. W. (2009) · Tijdschrift voor Medisch Onderwijs · doi:10.1007/bf03081775 · Cited by 13 · see citing works
Self-citationCultural Influences on Errors:Prevention, Detection, and Management
Gelfand, M. J., Frese, M. H., & Salmón, E. (2011) · Multilingual Matters (Channel View Publications) · doi:10.4324/9780203817827-18 · Cited by 9 · see citing works
Gable, E., & Handler, R. (2008) · SAGE Publications Ltd eBooks · doi:10.4135/9781848608443.n2 · Cited by 8 · see citing works
Patients and learners: time for a re‐evaluation of our goals in bringing them together
Bok, H. G. J., & Teunissen, P. W. (2013) · Medical Education · doi:10.1111/medu.12276 · Cited by 5 · see citing works
Self-citationIntroducing “I wish I knew then ...”
Regehr, G. (2007) · Advances in Health Sciences Education · doi:10.1007/s10459-006-9052-0 · Cited by 3 · see citing works
Sawyer, R. D., & Norris, J. (2012) · Oxford University Press eBooks · doi:10.1093/acprof:osobl/9780199757404.003.0001 · Cited by 3 · see citing works
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- Boor, K. (2009). The clinical learning climate: Dissertation. Amsterdam: VU University.
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Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education.
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Self-citationScaffolding the Transition to Residency: A Qualitative Study of Coach and Resident Perspectives
Park, A., Gillespie, C., Triola, M., Buckvar-Keltz, L., Greene, R. E., & Winkel, A. F. (2024) · Academic Medicine · doi:10.1097/acm.0000000000005446 · Cited by 15 · see citing works
- Authors
- Teunissen, P. W.
- Affiliations
- Maastricht University (NL)
- Corresponding author
- Teunissen, Pim W.
- ORCID
- Teunissen, Pim W.
- Venue
- Advances in Health Sciences Education
- Published
- 2014-10-01
- Volume
- 20
- Issue
- 4
- Pages
- 843-856
- ISSN
- 1382-4996 (ISSN-L)
- 1573-1677
- OpenAlex
- W2027650402
- Cited by
- 113
- References
- 66
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 11 · 2023: 18 · 2022: 6 · 2021: 14 · 2020: 9 · 2019: 9 · 2018: 14 · 2017: 11 · 2016: 5 · 2015: 6
- FWCI
- 7.26
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- Advances in Health Sciences Education (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Human Factors and Ergonomics › Innovative Education and Learning Practices
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Keywords
- hands-on learning, healthcare workplace, healthcare workers, professional experience, learning trajectories, reification, levels of analysis, workplace learning environment
- MeSH terms
- Attitude of Health Personnel, Educational Measurement, Health Occupations, Humans, Learning, Workplace, Models, Educational, Problem-Based Learning
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