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Teaching About Social Practices and Structures in Continuing Professional Development: A Multiple Case Study in
Joanne Goldman1, Farah Friesen, Tara Burra
1Dr. Goldman: Scientist, Centre for Quality Improvement and Patient Safety and Wilson Centre, and Assistant Professor, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Ms. Friesen: Manager, Research and Knowledge Mobilization, Centre for Advancing Collaborative Healthcare and Education (CACHE), Temerty Faculty of Medicine, University of Toronto at University Health Network, Toronto, Ontario, Canada. Dr. Burra: Education Lead, Centre for Quality Improvement and Patient Safety, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, and Associate Professor, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, and Medical Director, Quality, Experience and Safety, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Ms. Baker: Assistant Professor, Department of Psychiatry, and Associate Director, Curriculum Integration and Partnerships, Centre for Faculty Development, Unity Health Toronto and Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Ms. Tassone: Executive Director, Education, University Health Network (UHN), and Assistant Professor, Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto (UT), Toronto, Ontario, Canada, and Strategic Advisor, Centre for Advancing Collaborative Healthcare and Education, UHN and UT, Toronto, Ontario, Canada. Dr. Ng: Director and Education Scientist, Centre for Advancing Collaborative Healthcare and Education (CACHE), and Scientist, Wilson Centre, University Health Network/University of Toronto, Toronto, Ontario, Canada, and Professor, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.
Introduction:
Continuing professional development (CPD) about social processes and structures (eg, power relations, organizational policies) in health care has been minimally explored. This study examined the teaching of social practices and structures in the domains of interprofessional collaboration and quality improvement, and the education paradigms used, with particular attention to transformative education.
Methods:
This case study included three CPD cases at two university-affiliated Centres. Data collection included observations (n = 42.5 hours), interviews with program/Centre leads and guest presenters (n = 13), and documents. Paradigms of education informed the interpretive thematic analysis conducted.
Results:
A range of concepts related to social practices and structures were introduced across sessions (eg, systemic racism, unconscious bias). An examination of education purpose, role of teacher-learner, and teaching modalities, demonstrated that varied paradigms of education (eg, cognitivist, constructivist) were drawn on to teach these topics, with efforts toward transformative approaches. Programs were largely oriented to practical learning and application, with the teacher positioned as expert or learners being encouraged to interact with, and learn from each other. However, participants recognized additional education purposes aligned with a transformative paradigm, to question and shift learners' perspectives, making efforts to align teacher-learner roles and learning modalities. There were tensions, though, working across paradigms; session formats and learner/sponsor expectations influenced paradigms used.
Discussion:
Findings provide insights to how to incorporate content about social practices and structures into interprofessional collaboration and quality improvement CPD. Given the multiple and sometimes competing education goals, positioning paradigms of education as coexisting layers may be more effective than viewing them as mutually exclusive.
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