How Preceptors Can Cultivate Professional Identity Formation Through Meaningful Participation in Experiential Learning

When engaged in experiential learning, trainees enter a complex ecosystem where expertise relies on collaboration and the intentional use of environmental resources. To better explain this learning environment, this paper will define and describe concepts of educational theory related to situativity theory and the cognitive ecosystems perspective and offer ways to apply them to experiential learning design using an intensive care unit (ICU) as an example practice setting. By viewing the ICU as a cognitive ecosystem, we highlight how recognition and use of available resources and opportunities can support trainee growth and development of a contextualized, or situated, professional identity. Traditionally, experiential learning has emphasized internal mental processes, focusing on how trainees assess patients and recognize medication-related problems. However, expertise extends beyond individual knowledge and includes the ability to recognize and interact with the physical and social elements that exist within the clinical environment. Although the interconnected nature of clinical practice is widely recognized, limited guidance exists for applying situativity theory and cognitive ecosystems to experiential learning design. Viewing a practice setting as a cognitive ecosystem provides a lens for intentionally immersing trainees within the environment to promote meaningful participation in clinical practice. When viewed through this lens, microsystems within the practice setting emerge that support clinical reasoning, communication, and patient care. Across these microsystems, interactions with the resources and people within the environment may promote the development of clinical reasoning and situated professional identity. Intentional interactions within each microsystem can help trainees progress from an observational role to active participation in patient care, progressing beyond basic knowledge acquisition and recall. Using the ICU as an example, we argue that viewing the practice area as a cognitive ecosystem offers opportunities for experiential learning design for preceptors, along with enriching experiences for trainees that are critical for professional identity formation.