Abstract
Veterinary professionals are required to continue learning, and need to practice increasingly in an evidence-based manner. We investigate how continued learning takes place in communities, and explore how participation in communities might at the same time support the transition to evidence based practice. Based on social constructivist theories we assume
... read more
that critically reflective work behaviour (CRWB) is essential for learning and for evidence based practice. Our overall research question is: how can the theory of CRWB enlighten and enhance learning of veterinary professionals in communities, with regard to evidence based practice? Studying learning in communities, while making use of CRWB, adds a perspective on learning as a process, in unstructured settings and with attention to social interaction. This perspective is important because work in health care settings increasingly has a collaborative nature. CRWB consists of several aspects that help learning to occur: openness about mistakes, challenging groupthink, asking for feedback, experimentation and critical opinion sharing. We performed four studies making use of qualitative as well as quantitative research methods. Results of the first study suggest that research utilisation is also essential for CRWB, and that perceptions of the need for lifelong learning are more relevant for CRWB than qualities of the workplace. Observation studies in seven different communities resulted in a new concept: critically reflective dialogues (CRD). We developed an analytical framework with four different modes of communication within each aspect of CRD: (1) interactive and reflective (2) reflective on an individual basis (3) non-reflective and non-interactive (4) restricted. The first two levels differentiate between interaction that addresses the reasons and reflections of others, and interaction that does not; for example asking questions for new and additional information. Veterinary professionals showed aspects of CRD largely in non-interactive modes (level 2 and 3) implying that they miss opportunities for learning. From a second observation study was concluded that most aspects of CRD were fairly stable over time. Giving access to full text versions of research papers, and a short training in searching the literature proved to be insufficient to change practitioners’ degree and level of CRD aspects within the time frame measured. Hence, change does not seem to come naturally. In this study specific perceptions about knowledge (epistemologies) were identified. Finally, how autonomous professionals can be enticed into CRWB? With a Delphi study thirteen factors were found, for example; “authenticity of the topics”, “openness about mistakes” and “diversity in the group, especially in expertise, to achieve different points of view”. Moderators were found to be important for implementation of such factors. When learning communities of veterinary professionals are to fulfil their potential, it is essential to address each other’s reasons and reflections more often. Appointing moderators or adjusting parts of the curriculum are recommended; to enhance the level and frequency of CRWB. Our studies indicate, however, that attention should be paid to personal attributes such as a perceived need for lifelong learning and personal epistemologies.
show less
