Lifelong Learning

终身学习
  • 文章类型: Journal Article
    背景:为痴呆症患者使用心理社会干预措施提供证据是研究的重点。这项试点研究旨在为一组结果测量提供变异性估计,这将为更广泛的对照研究的发展提供信息。这项更大的研究将寻求探索与照常接受治疗相比,对痴呆症患者进行终身学习干预的效果。这个试点和可行性阶段还分析了数据收集者和研究人员如何评估轻度至中度痴呆症患者样本中结果指标的使用。
    方法:在开始试点研究之前,与痴呆症患者进行了参与者咨询,他们参加了一个被称为痴呆症学校的终身学习服务,和他们的老师。从这次协商中,确定的研究结果是小型精神状态检查(MMSE),生活质量阿尔茨海默病(QoL-AD),一般自我效能感量表(GSE),罗森伯格自尊量表,友谊的规模。下面的研究分为两个步骤。在步骤1中,参与者是参加痴呆症学校(干预组)或常规服务(对照组)的痴呆症患者。参与者在基线和6个月随访时进行了测试。数据收集时间为2018年11月至2019年7月。在步骤2中,招募参与者的可行性和可接受性问题,数据收集过程,和结果衡量标准,在步骤1中确定的数据通过数据收集器焦点组进行评估.
    结果:55名痴呆症患者被纳入分析。步骤1提供了从基线到后续行动的变化估计,并为所有结果测量提供辅助标准偏差。步骤2对干预的可行性和可接受性进行了思考,数据收集,和结果措施。这包括对痴呆症患者如何参与测试情况的看法。
    结论:本研究提供了对结果测量的变化和变异性的估计。此外,确定了有关数据收集的问题,应在未来的研究中解决。该项目展示了如何支持痴呆症患者参与对他们有意义的研究。
    背景:根据国家立法,注册临床研究数据库是可选的,因为该研究评估了现有的活动,而不是临床干预。
    BACKGROUND: Developing evidence for the use of psychosocial interventions for people with dementia is a research priority. This pilot study aimed to provide variability estimates for a set of outcome measures that would inform the development of a more extensive controlled study. The larger study will seek to explore the effect of attending a lifelong learning intervention for people with dementia compared to receiving treatment as usual. This pilot and feasibility stage also analysed how data collectors and researchers evaluated the use of the outcome measures in a sample of people with mild to moderate dementia.
    METHODS: Before initiating the pilot study, a participant consultation was conducted with people with dementia, who attend a lifelong learning service known as a dementia school, and their teachers. From this consultation, the research outcomes identified were the mini-mental state examination (MMSE), Quality-of-Life Alzheimer\'s Disease (QoL-AD), General Self-Efficacy Scale (GSE), Rosenberg self-esteem scale, and the Friendship scale. The following study was divided into two steps. In step 1, participants were people with dementia attending a dementia school (intervention group) or usual services (control group). The participants were tested at baseline and at a 6-month follow-up. Data were collected between November 2018 and July 2019. In step 2, feasibility and acceptability issues with the recruitment of participants, data collection process, and outcome measures, identified in step 1, were evaluated through a data collector focus group.
    RESULTS: Fifty-five people with dementia were included in the analysis. Step 1 provided estimates of changes from baseline to follow-up, and ancillary standard deviations were supplied for all outcome measures. Step 2 provided reflections on the feasibility and acceptability of the intervention, data collection, and outcome measures. This included views on how people with dementia experience participating in a test situation.
    CONCLUSIONS: This study provided estimates of change and variability in the outcome measures. Additionally, issues regarding data collection were identified and should be addressed in future studies. The project demonstrated how to support people with dementia to participate in research that is meaningful to them.
    BACKGROUND: According to national legislation, registration with a database of clinical studies was optional, as the study evaluated existing activities rather than a clinical intervention.
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  • 文章类型: Journal Article
    目的:本研究的目的是将初步框架进一步发展为一个模型,该模型可以将机制转化为产出和影响,基于在实践中工作的人的观点和机制之间的关系:一个模型,可以告知从业者和组织必须采取什么措施来塑造护理的学习和创新环境。
    背景:学习与创新网络(LIN)是由医疗保健专业人员组成的网络,学生和教育代表聚集在一起成为护理社区的一部分,以整合教育,研究和实践,以提高护理质量。在先前的研究中,通过基于出版物的概念分析开发了初步框架。初步框架描述了输入,线性模型中的吞吐量和输出因子,不能解释组件在实践中需要什么以及组件如何协同工作。
    方法:焦点小组。
    方法:我们分四个阶段设计了变化理论(ToC)。这是基于对讲师从业者的焦点小组访谈(第1阶段);基于焦点小组访谈的主题分析的第一个概念ToC(第2阶段);三个配对访谈,其中ToC被呈现给其他讲师从业者以补充和验证ToC模型(第3阶段);并根据第3阶段的反馈调整模型(第4阶段)。
    结果:开发的ToC模型描述了启动LIN必须具备的重要先决条件:共同愿景,一个便利的支持系统和对变革持开放态度的参与者的多样性。它描述了广泛的活动可以通过实践之间的合作来提高护理质量的机制,通过工作进行教育和研究,学习,一起进行基于实践的研究和实施新方法。
    结论:本研究全面概述了“学习与创新网络”(LIN)的概念;LIN中的活动如何产生影响;以及在什么条件下。先前发表的研究结果支持ToC模型的元素。总体的ToC模型和详细的附录为从业者提供了一个基于理论和实践的模型,管理者和政策制定者。
    OBJECTIVE: The aim of this study is to further develop a preliminary framework into a model that can translate mechanisms into output and impact, based on the views of those working in practice and the relations between the mechanisms: a model that can inform practitioners and organizations on what has to be in place to shape a learning and innovating environment in nursing.
    BACKGROUND: A Learning and Innovation Network (LIN) is a network of healthcare professionals, students and education representatives who come together to be part of a nursing community to integrate education, research and practice to contribute to quality of care. In a previous study a preliminary framework was developed through a concept analysis based on publications. The preliminary framework describes input, throughput and output factors in a linear model that does not explain what the components entail in practice and how the components work together.
    METHODS: Focus groups.
    METHODS: We designed a Theory of Change (ToC) in four phases. This was based on a focus group interview with lecturer practitioners (Phase 1); a first concept ToC based on thematic analysis of the focus group interview (Phase 2); three paired interviews where the ToC was presented to other lecturer practitioners to complement and verify the ToC model (Phase 3); and adjustment of the model based on the feedback of phase 3 (Phase 4).
    RESULTS: The developed ToC model describes important preconditions that have to be in place to start a LIN: a shared vision, a facilitating support system and a diversity of participants who are open to change. It describes the mechanisms by which a wide range of activities can lead to an improvement of the quality of care through collaboration between practice, education and research by working, learning, performing practice based research and implementing new methods together.
    CONCLUSIONS: This study gives a comprehensive overview of the concept of the \'Learning and Innovation Network\' (LIN); how the activities in the LIN can lead to impact; and under what conditions. Previously published findings supported elements of the ToC model. The overarching ToC model and the detailed appendix offer a theoretical and practice-based model for practitioners, managers and policy makers.
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  • 文章类型: Journal Article
    背景:这项纵向研究报告了爱尔兰同时引入国家注册和强制性放射技师CPD之前和之后几年CPD的各个方面。
    方法:调查通过封闭和开放的问题以硬拷贝和在线格式在全国范围内分布在各种医院类型中,捕获信息。在三个时间点收集了超过8年的意见,在引入强制性变更之前,在第一个审计周期结束时的介绍后,随着社会走出大流行时期。
    结果:收到了不同年龄和年级的答复,答复率与以前的调查一致。随着时间的推移,放射技师持有CPD的总体重要性下降,虽然看到了微小的变化,放射线技师认为CPD的狭窄焦点保持不变,以出勤为基础的活动仍然是最受欢迎的。受访者表示,他们对承担CPD的热情及在工作时间以外承担CPD的意愿亦有所下降,随着CPD的主要障碍从资金转移到时间。
    结论:大多数人显然有意愿进行CPD;然而,解决诸如降低重要性水平和使用个人时间进行CPD的意愿等问题至关重要。虽然CPD的感知成本已经减少,但这是一个障碍,CPD缺乏时间现在是一个主要问题。建议进行进一步的研究,以探索时间压力的更广泛影响,并优化X射线技师的CPD。
    结论:研究结果强调了协作参与和支持的必要性,以优化未来所有放射技师的CPD机会。
    This longitudinal research study reports on aspects of CPD immediately before and in the years following the simultaneous introduction of state registration and mandatory CPD for diagnostic radiographers in Ireland.
    Surveys captured information through closed and open questions distributed nationally across various hospital types in hard copy and online formats. Opinion was gathered over 8-years at three time points, prior to the introduction of mandated changes, post-introduction at the end of the first audit cycle, and as society was emerging from a period of pandemic.
    Responses were received across age and grade ranges with response rates in keeping with previous surveys. The overall importance with which radiographers held CPD decreased over time, and while small changes were seen, the narrow focus of what radiographers considered CPD had stayed the same, with attendance-based activities remaining the most popular. Respondents indicated that their enthusiasm for undertaking CPD and willingness to undertake CPD outside of working hours had also decreased, with the perceived primary barrier to CPD shifting from funding to time.
    An appetite to undertake CPD amongst the majority is evident; however, addressing issues such as decreasing importance levels and willingness to use personal time for CPD is crucial. While the perceived cost of CPD has lessened as a barrier, lack of time for CPD is now a principal concern. Further research is recommended to explore the broader impacts of time pressures and optimises CPD for radiographers.
    Findings highlight the need for collaborative engagement and support to optimise CPD opportunities for all radiographers in the future.
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  • 文章类型: Journal Article
    This research study was undertaken to elicit a group of final-year student nurses\' perceptions of their motivations and approaches to learning, and the implications of their views. It is important to explore this subject because students\' motivations and approaches to learning can potentially impact patient care. This study was part of a larger research project. The sample consisted of 18 final-year student nurses at a large UK university. Students completed semi-structured interviews that used a qualitative constructivist approach to explore their educational experience. Students described what motivated them to learn, and how they approached their learning because of their understanding of which subjects they believed were and were not important. Students felt that clinical skills were the most important subjects, and topics such as health promotion, law and ethics, were less important and therefore they approached these subjects in a superficial way, learning just enough to pass their course. Clinical skills were perceived as more useful because they would be used directly in clinical practice. The findings of this study are significant to inform nurse educators as they plan curricula and provide an insight into what may potentially adversely affect patient care when students become registered nurses.
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  • 文章类型: Journal Article
    背景:注册的澳大利亚医学放射从业人员(MRP)必须继续进行专业发展(CPD),以保持各自执业范围的能力。这项研究的目的是探索MRP的态度,对澳大利亚医学影像和放射治疗协会(ASMIRT)提供的CPD活动的意见和满意度。
    方法:通过电子邮件发送给6398名ASMIRT成员的在线横断面调查,其中包括以下问题:人口统计学,ASMIRTCPD活动,学习模式偏好,对CPD结果的障碍和看法。采用描述性统计和卡方检验对数据进行分析。
    结果:调查由1018MRP完成。尽管MRP对面对面CPD质量(n=540,58.1%)和提供(n=492,55.3%)感到满意,他们对ASMIRT提供的在线CPD活动数量(n=577,65.1%)不满意。在线学习是CPD交付的首选模式(n=749,74.2%),其次是面对面(n=643,64.0%)和协作学习(n=539,53.4%)。年轻的参与者(19-35岁)对ASMIRTCPD活动和结果有积极的看法。获得专业发展假(PDL)支持实现强制性CPD要求(P<0.001)。缺乏时间,缺乏机会和工作量是阻碍CPD参与的最高障碍。农村/偏远MRP对可用性不满意(P=0.023),接入(P<0.001)和ASMIRT的充分性提供了CPD(P<0.01),更有可能遇到CPD参与障碍(P<0.001).
    结论:许多MRP经历了阻碍他们参与CPD的障碍。ASMIRT提供更多在线CPD活动和访问PDL可以提供帮助。未来的改进将确保MRP保持参与CPD的动力,以提高临床技能,患者安全和健康结果。
    BACKGROUND: Continuing professional development (CPD) is mandatory for registered Australian medical radiation practitioners (MRPs) to maintain competence in their respective scopes of practice. The aim of this study was to explore MRPs attitudes, opinions and satisfaction towards CPD activities offered by the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT).
    METHODS: An online cross-sectional survey was emailed to 6398 ASMIRT members and included questions on: demographics, ASMIRT CPD activities, learning mode preferences, barriers and perceptions of CPD outcomes. Data were analysed using descriptive statistics and chi-square tests.
    RESULTS: The survey was completed by 1018 MRPs. While MRPs were satisfied with face-to-face CPD quality (n = 540, 58.1%) and provision (n = 492, 55.3%), they were dissatisfied with the quantity of online CPD activities (n = 577, 65.1%) delivered by ASMIRT. Online learning was the most preferred mode of CPD delivery (n = 749, 74.2%), followed by face-to-face (n = 643, 64.0%) and collaborative learning (n = 539, 53.4%). Younger participants (19-35 years) had positive opinions regarding ASMIRT CPD activities and outcomes. Access to professional development leave (PDL) supported achievement of mandatory CPD requirements (P < 0.001). Lack of time, lack of access and workload were the highest ranked barriers preventing CPD participation. Rural/remote MRPs were dissatisfied with availability (P = 0.023), access (P < 0.001) and adequacy of ASMIRT provided CPD (P < 0.01) and were more likely to encounter barriers to CPD participation (P < 0.001).
    CONCLUSIONS: Many MRPs experienced barriers which prevented them from participating in CPD. Provision of more online CPD activities by ASMIRT and access to PDL can assist. Future improvements will ensure MRPs remain motivated to engage in CPD to improve clinical skills, patient safety and health outcomes.
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  • 文章类型: Journal Article
    UNASSIGNED:定期进修技能课程是维持基本生命支持能力的必要条件。这些培训计划的使用在很大程度上取决于学习的动机。学习动机可能会受到过度自信和临床部落主义的影响,因为它们都意味着比其他人更高的能力,因此,对培训的需求较低。这项研究旨在评估对基本生活支持能力的过度自信如何影响学习动机。
    未经评估:我们进行了横截面,观察,多中心,使用经过验证的心理测验对德国的医疗保健专业人员进行匿名在线问卷调查。Further,我们测试了参与者对国际基本生命支持指南的知识和态度。该研究于2022年3月至4月进行,对来自22家德国紧急医疗服务机构和各级医院的医疗保健提供者进行了评估。
    未经评估:对2,000名医疗保健专业人员进行评估,407完成了评估(反应率,20.4%)。我们证实了407名医生中存在过度自信和临床部落主义(社会群体之间的身份差异),护士,以及完成调查的紧急医疗服务提供者。从聚类分析中出现了三个不同的学习动机组:“专家”(自信和有动力),“招聘人员”(过度自信和积极),和“不知情”(过度自信和缺乏动力)。这三个小组出现在所有专业小组中,独立于暴露于心脏骤停的频率和教育水平。
    UNASSIGNED:这些发现表明,在学习基本生活支持的个体中存在过度自信效应和不同的学习动机类型,即使是教练。
    UNASSIGNED: Regular refresher skill courses are necessary to maintain competence in basic life support. The utilization of these training programs strongly depends on the motivation to learn. Learning motivation may be affected by overconfidence and clinical tribalism, as they both imply a higher competence compared to others, and therefore, a lower demand for training. This study aimed to assess how overconfidence in basic life support competencies affects learning motivation.
    UNASSIGNED: We conducted a cross-sectional, observational, multicenter, anonymous online questionnaire survey using validated psychometric tests for healthcare professionals in Germany. Further, we tested participants\' knowledge and attitude regarding international basic life support guidelines. The study was conducted between March and April 2022, and healthcare providers from 22 German emergency medical services and hospitals at all levels were assessed.
    UNASSIGNED: Of 2,000 healthcare professionals assessed, 407 completed the assessment (response rate, 20.4%). We confirmed the presence of overconfidence and clinical tribalism (identity differentiation between social groups) among the 407 physicians, nurses, and emergency medical service providers who completed the survey. Three different learning-motivation groups emerged from cluster analysis: \"experts\" (confident and motivated), \"recruitables\" (overconfident and motivated), and \"unawares\" (overconfident and unmotivated). The three groups were present in all professional groups, independent of the frequency of exposure to cardiac arrest and educational level.
    UNASSIGNED: These findings showed the presence of overconfidence effects and different learning motivation types in individuals learning basic life support, even in instructors.
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  • 文章类型: Journal Article
    背景:医院通常会收集大量的行政数据,例如住院时间,28天再入院,和医院获得性并发症;然而,这些数据未被用于持续专业发展(CPD)。首先,这些临床指标很少在现有的质量和安全性报告之外进行审查.第二,许多医学专家认为他们的CPD要求很耗时,对实践变化和改善患者预后的影响最小。有机会根据这些数据构建新的用户界面,旨在支持个人和群体反思。数据知情的反思性实践有可能产生关于绩效的新见解,弥合CPD与临床实践之间的差距。
    目的:本研究旨在了解为什么常规收集的管理数据尚未广泛用于支持反思性实践和终身学习。
    方法:我们对来自不同背景的思想领袖进行了半结构化访谈(N=19),包括临床医生,外科医生,首席医疗官,信息和通信技术专业人员,信息学家,研究人员,以及相关行业的领导者。访谈由2名独立编码人员进行主题分析。
    结果:受访者确定了结果的可见性,同行比较,小组反思讨论,和实践变化作为潜在的好处。主要障碍包括传统技术,对数据质量的不信任,隐私,数据误解,团队文化。受访者建议招募当地冠军进行联合设计,呈现用于理解的数据而不是信息,由专业小组组长指导,并及时反思与CPD相关,作为成功实施的推动力。
    结论:总体而言,思想领袖之间达成了共识,汇集来自不同背景和医疗管辖区的见解。我们发现,尽管对基础数据质量存在担忧,但临床医生仍有兴趣将行政数据重新用于专业发展。隐私,传统技术,和视觉演示。他们更喜欢由支持性专业小组组长领导的小组反思,而不是个人的反思。我们的发现提供了对具体益处的新颖见解,障碍,以及基于这些数据集的潜在反思性实践界面的好处。他们可以为设计与年度CPD计划-记录-反射周期相关的院内反射新模型提供信息。
    Hospitals routinely collect large amounts of administrative data such as length of stay, 28-day readmissions, and hospital-acquired complications; yet, these data are underused for continuing professional development (CPD). First, these clinical indicators are rarely reviewed outside of existing quality and safety reporting. Second, many medical specialists view their CPD requirements as time-consuming, having minimal impact on practice change and improving patient outcomes. There is an opportunity to build new user interfaces based on these data, designed to support individual and group reflection. Data-informed reflective practice has the potential to generate new insights about performance, bridging the gap between CPD and clinical practice.
    This study aims to understand why routinely collected administrative data have not yet become widely used to support reflective practice and lifelong learning.
    We conducted semistructured interviews (N=19) with thought leaders from a range of backgrounds, including clinicians, surgeons, chief medical officers, information and communications technology professionals, informaticians, researchers, and leaders from related industries. Interviews were thematically analyzed by 2 independent coders.
    Respondents identified visibility of outcomes, peer comparison, group reflective discussions, and practice change as potential benefits. The key barriers included legacy technology, distrust with data quality, privacy, data misinterpretation, and team culture. Respondents suggested recruiting local champions for co-design, presenting data for understanding rather than information, coaching by specialty group leaders, and timely reflection linked to CPD as enablers to successful implementation.
    Overall, there was consensus among thought leaders, bringing together insights from diverse backgrounds and medical jurisdictions. We found that clinicians are interested in repurposing administrative data for professional development despite concerns with underlying data quality, privacy, legacy technology, and visual presentation. They prefer group reflection led by supportive specialty group leaders, rather than individual reflection. Our findings provide novel insights into the specific benefits, barriers, and benefits of potential reflective practice interfaces based on these data sets. They can inform the design of new models of in-hospital reflection linked to the annual CPD planning-recording-reflection cycle.
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  • 文章类型: Journal Article
    数字素养已被纳入八项关键能力,这是充分享受21世纪生活所必需的。根据之前的研究,女性往往比男性拥有更低的数字能力;年龄越大的人,数字素养水平越低。迄今为止,一般来说,波兰公民的技能比欧洲平均水平差。这可能导致人们被社会排斥,容易受到网络安全威胁,特别是在COVID-19大流行的时代,这需要他们工作,使用互联网学习和购物。这项研究涉及在大学工作的波兰妇女,作为科学家和教师。他们对数字素养的感知水平已经在广泛的运动中进行了研究,以及他们对网络安全问题的认识。然后,用关联规则挖掘算法对收集的结果进行处理,揭示与它们的变化有关的因素。
    Digital literacy has been included in the set of the eight key competences, which are necessary to enjoy life to the full in the twenty-first century. According to the previous studies, women tend to possess lower digital competence than men; the older the person, the lower the level of digital literacy. To date, Polish citizens in general have worse skills than the European average. This may lead to people being socially excluded and vulnerable to cybersecurity threats, especially in the times of the COVID-19 pandemic, which requires them to work, study and shop using the Internet. The study concerned Polish women who work at universities, as scientists and teachers. Their perceived level of their digital literacy has been studied in the broad campaign, along with their awareness of the cybersecurity matters. Then, the collected results were processed with an association rules mining algorithm, uncovering the factors related to the shifts in them.
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  • 文章类型: Journal Article
    医学和制药科学的不断发展以及药剂师角色的变化凸显了终身学习在其职业中的重要性。鉴于文献中已确定的关于药剂师对终身学习的偏好的知识差距,这项研究旨在评估社区药剂师对终身学习的意见和态度,包括他们以前的经历和教育需求,以提出基于证据的技巧,以面对面和在线形式为他们设计此类解决方案和干预措施。为此,使用主题指南与波兰社区药剂师进行了十次半结构化的深入访谈。随后,由两名独立研究人员使用现象学作为定性方法,对他们进行了文字转录和解释现象学分析。确定的主题涵盖了该主题与药剂师工作的相关性,以实践为导向的形式和内容,以前的学习者的经验作为进一步学习的基础,商业计划风险,动机来源,以及迄今为止参与终身学习解决方案的障碍。根据受访者提供的见解,以及科学证明的学习理论和教育原则,在药剂师的研究生终身学习框架内,为设计对接受者友好的学习解决方案和干预措施制定了十个技巧。
    The constant development of medical and pharmaceutical sciences and the changing roles of pharmacists highlight the importance of lifelong learning in their profession. Given the identified knowledge gaps in the literature in terms of pharmacists\' preferences for lifelong learning, the study aimed to evaluate the opinions and attitudes of community pharmacists towards lifelong learning, including their previous experiences and educational needs, in order to propose evidence-based tips for designing such solutions and interventions intended for them both in face-to-face and online forms. For this purpose, ten semi-structured in-depth interviews were conducted with Polish community pharmacists on the topic using a thematic guide. Subsequently, they were subjected to literal transcription and interpretative phenomenological analysis by two independent researchers using phenomenology as the qualitative approach. The identified themes covered the topic\'s relevance for pharmacists\' work, practice-oriented form and content, previous learners\' experiences as a foundation for further learning, commercial initiatives\' risks, motivation sources, and barriers for participation in lifelong learning solutions so far. Based on the insights provided by the respondents, as well as scientifically proven learning theories and educational principles, ten tips were formulated for designing recipient-friendly learning solutions and interventions within the framework of postgraduate lifelong learning of pharmacists.
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  • 文章类型: Journal Article
    医学专家“终身学习对改善患者健康至关重要”。这项研究确定了学习全科医生(GP)从事的能力,并探索是什么影响了这些负担能力的参与。采访了11名全科医生,并对采访记录进行了主题分析。StephenBillett的工作场所参与实践理论框架被用作分析视角来探讨这一主题。具有挑战性的患者病例被确定为参与学习的主要触发因素。当地,来自同一和其他专业的国家和国际同事,被发现是学习的重要手段,就像网站等书面材料一样,期刊和建议。学习的其他投入是会议和课程。对于全科医生来说至关重要的工作场所方面与以下方面有关:谈话的地点和时间,与工作相关,不同角色的机会,工作和工作量的组织,和工作环境。重要的是,这项研究确定了终身学习需要一种整体方法,包括随着时间的推移与同事互动的自发和结构化的机会,建立与同伴学习相关的激励措施和交流场所,并承认工作场所是学习和与患者有足够时间的重要场所。这项研究有助于加深对全科医生如何在工作场所内外进行现有学习能力的理解。
    Medical specialists\' lifelong learning is essential for improving patients\' health. This study identifies affordances for learning general practitioners (GPs) engage in, and explores what influences engagement in those affordances. Eleven GPs were interviewed and the interview transcripts were analysed thematically. Stephen Billett\'s theoretical framework of workplace participatory practices was used as an analytical lens to explore the topic. Challenging patient cases were identified as the main trigger for engagement in learning. Local, national and international colleagues from the same and other specialties, were found to be an important affordance for learning, as was written material such as websites, journals and recommendations. Other inputs for learning were conferences and courses. Workplace aspects that were essential for GPs to engage in learning related to: place and time to talk, relevance to work, opportunity for different roles, organisation of work and workload, and working climate. Importantly, the study identifies a need for a holistic approach to lifelong learning, including spontaneous and structured opportunities for interaction over time with colleagues, establishment of incentives and arenas for exchange linked to peer learning, and acknowledgement of the workplace as an important place for learning and sufficient time with patients. This study contributes with a deepened understanding of how GPs navigate existing affordances for learning both within and outside their workplaces.
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