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Using activity theory to transform medical work and learning

Medical Teacher· 2020-07-25· article· 136 citationsgreen

Innovative Education and Learning Practices Innovations in Medical Education Health and Medical Education

Abstract

This article introduces key concepts of activity theory and expansive learning. Expansive learning builds on the foundational ideas of the cultural-historical activity theory (CHAT). It is a research approach designed for studying the complexities and contradictions in authentic workplace environments. Change Laboratory is a formative intervention method developed for studying workplaces in transition and for stimulating collaborative efforts to design improved patterns of activity. We present concrete examples of formative interventions in healthcare, where good patient care was compromised by the fragmentation of care and disturbances in collaboration between the healthcare experts. This implies that physicians are challenged to develop collaborative and transformative expertise. We present three spearheads into a zone of proximal development, representing opportunities for change of medical expertise: (1) reconceptualizing expertise as object-oriented and contradiction-driven activity systems, (2) pursuing expertise as negotiated knotworking, and (3) building expertise as expansive learning. While medical expertise needs to expand, medical education must also look for ways to evolve and meet the challenges of the surrounding society. We call for adopting an interventionist approach for developing medical education and intensifying collaboration with the practitioners in healthcare units, their patients, and target communities.

Cite this

Yrjö Engeström, Eeva Pyörälä (2020). Using activity theory to transform medical work and learning. Medical Teacher. https://doi.org/10.1080/0142159x.2020.1795105

@article{yrj2020using,
  title  = {Using activity theory to transform medical work and learning},
  author = {Engeström, Yrjö and Pyörälä, Eeva},
  year   = {2020},
  journal = {Medical Teacher},
  doi    = {10.1080/0142159x.2020.1795105}
}

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References

1978Mind in Society: The Development of Higher Psychological Processes

1978Activity, consciousness, and personality

1999Perspectives on Activity Theory

2010Studies of expansive learning: Foundations, findings and future challenges

2016Research–Practice Partnerships in Education

2012From Teams to Knots: Activity-Theoretical Studies of Collaboration and Learning at Work

2008From Teams to Knots

2016Formative Interventions for Expansive Learning and Transformative Agency

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