Den første måned, der fulgtes jeg med 17 forskellige: Læringsprocesser i et praksisfællesskab ved specialuddannelsen i anæstesiologisk sygepleje

Abstract

Dette projekt omhandler professionsdidaktikken i specialuddannelsen i anæstesiologisk sygepleje. Det tager udgangspunk i klinisk praksis, hvor den didaktiske tilgang er mesterlære. Anæstesiafdelingens organisatoriske ramme gør, at kursisterne i uddannelsen kommer til at følge mange forskellige kliniske vejledere og kollegaer, og derved skal danne relationer med mange forskellige erfarne kollegaer i mesterlæresituationer. Flere kursister har givet udtryk for, at de bliver udfordret i deres læringen, når de skal lære fra mange forskellige erfarne kollegaer. Med baggrund i dette er problemformuleringen i projektet: Hvordan styrker jeg som uddannelsesansvarlig anæstesisygeplejerske kursisternes læringsproces i afdelingens praksisfællesskab, under de givne organisatoriske rammer? • Hvilke udfordringer kan jeg ud fra empirien identificere, at kursisterne oplever i deres læringsproces? • Hvordan synliggør jeg de ressourcer og redskaber, der er i praksisfællesskabet, som kan styrke kursisternes læringsproces? Metoden i projektet er kvalitativ med et undersøgelsesdesign, der tager udgangspunkt i interview. Der er udarbejdet en semistruktureret interviewguide. Interviewpersonerne er kursister som aktuelt er i specialuddannelsen. Den videnskabsteoretiske tilgang til interviewene er fænomenologisk, for at opnå forståelse for kursisternes oplevelse af deres livsverden i specialuddannelsen, når de skal lære fra mange erfarne kollegaer. Ved en meningskondensering af empirien fremkommer 57 kategorier, som bliver til fem analyse temaer. De fem temaer bliver analyseret ud fra et hermeneutisk videnskabsteoretisk perspektiv. Begreber fra Etienne Wengers teori Praksisfællesskaber og begreber fra Klaus Nielsen og Steinar Kvales teori Praktikkens læringslandskab, bliver anvendt til at analysere med, fordi problemstillingen er praksisnær og foregår i afdelingens praksisfællesskab. I projektet bliver der identificeret hvilke udfordringer, som kursisterne beskriver. Det er negative følelser som forvirring, sårbarhed, nervøsitet, føle sig ramt, miste fokus, kaos, uens forventninger og irritation. Det kan være dårlig stemning på operationsstuen, belæring frem for refleksion. At danne mange forskellige relationer, når de er nye i afdelingen. Forudindtaget holdning til, hvordan en kollega ønsker samarbejdet skal foregå og derved ureflekteret imitation. Nogle af de redskaber og ressourcer der allerede eksisterer i anæstesiafdelingen er ABCED, kompetencekort, forventningsafstemning, arbejdsplaner og kursistcafeerne. De handlemuligheder den uddannelsesansvarlige anæstesisygeplejerske har er, at anvende introduktionsundervisningen til at forberede kursisterne på de følelser de kan opleve i uddannelsesforløbet. Introducerer til de eksisterende redskaber der allerede findes. Når kursisterne starter i uddannelsen, så planlægge deres forløb, så de følger så få erfarne kollegaer som muligt. Være sparringspartner for kollegaer i forhold til at anvende refleksion i kliniske praksis. Bakke op om det gode praksisfælleskab, der allerede eksisterer, og bakke op på det organisatoriske plan om, at kursistcafeerne bliver bevaret i afdelingen.

This project explores professional didactics in the specialized education of anesthesiology nursing. It is focused on clinical practice, where the didactic approach is apprenticeship. The organizational framework of the anesthesia department causes trainees to interact with many different clinical supervisors and colleagues, requiring them to form relationships with various experienced colleagues during their apprenticeships. Several trainees have expressed that learning from many different experienced colleagues challenges their learning process. Based on this, the project poses the following research question: How can I, as the education coordinator for anesthesiology nursing, strengthen trainees' learning processes within the department's community of practice under the given organizational framework?  What challenges do trainees experience in their learning process, as identified through empirical data?  How can I highlight the resources and tools within the community of practice that could strengthen the trainees' learning process? The project employs a qualitative methodology with a research design based on interviews, led by a semi-structured interview guide. Participants include trainees currently enrolled in the specialized education program. The epistemological approach to the interviews is phenomenological, aiming to understand trainees' lived experiences in the program when learning from many experienced colleagues. Through a meaning condensation of the empirical data, 57 categories were identified and consolidated into five analytical themes. These themes were analyzed from a hermeneutic scientific perspective. Concepts from Etienne Wenger's theory of Communities of Practice and Klaus Nielsen and Steinar Kvale's theory of The Learning Landscape of Practice were used to analyze the findings, as the problem is practice-oriented and occurs within the department's community of practice. The project identifies several challenges described by the trainees. These include negative emotions such as confusion, vulnerability, nervousness, feeling targeted, losing focus, chaos, inconsistent 2 expectations and irritation. Additional challenges include poor atmosphere in the operating room, lack of explanation during instruction, forming too many relationships when new in the department, preconceived notions about collaboration, and imitation of colleagues' practices without sufficient understanding or reflection. Existing tools and resources in the anesthesia department include ABCED (a structured framework), competency cards, expectation alignment, work schedules, and trainee cafés. The education coordinator has the following options to address these challenges. Use introductory training to prepare trainees for the emotions they may experience during the program. Introduce trainees to existing tools and resources. Plan the training process to minimize the number of experienced colleagues each trainee interacts with. Serve as a mentor for colleagues to encourage reflection in clinical practice. Support the strong existing community of practice and advocate for maintaining trainee cafés within the department.

A master programme thesis from Aalborg University

Den første måned, der fulgtes jeg med 17 forskellige: Læringsprocesser i et praksisfællesskab ved specialuddannelsen i anæstesiologisk sygepleje

[The first month, I followed 17 different individuals: Learning processes in a community of practice during the specialized training in anesthesiology nursing]