Work-integrated learning in a hospital ward setting : Exploring the interdependency between the professions and the organization

Abstract: Introduction:Contemporary hospital settings are a challenging learning and working environment for healthcare professionals. The challenges are largely related to the increasing need for healthcare caused by an ageing population, a lack of personnel resources, and demands for time efficiency. Therefore, it is of interest to study how individuals and teams learn during these working conditions. Nurses are especially exposed when entering working life, why this profession has been of interest to explore further in this thesis. Furthermore, the interprofessional team is significant in providing qualitative care at the hospital wards, which could be affected by the lack of nurses and demands for efficiency. Aim: To explore work integrated learning from an individual nurse and interprofessional team learning perspective in a contemporary hospital ward setting.Methodology:Two qualitative approaches were used in this thesis. Study I was a qualitative content analysis based on individual interviews with 10 nurses within hospital ward care. Study II was an insider action research project (IAR) within a specific hospital ward. Data from the project in Study II were analyzed using the cycle of expansive learning.Results:Study I showed that, during their early working life, newly graduated nurses learned their profession by developing and using different learning strategies. Their initial strategy was to learn how to perform daily tasks as safely and effectively as possible. However, in learning how to provide qualitative care, the nurses realized the importance of participating in bedside care to gain clinical experience. Opportunities to learn from clinical experiences and reflection were essential for developing as a new nurse.Study II explored work integrated learning in an interprofessional ward team. The learning process resulted in the establishment of a digital planning board to illustrate the patients’ recovery process during their stay at the ward. This board opened an opportunity to learn about core values and goals for discharge, but also contributed to boundary awareness between the professionals, which was important for collaboration to improve patient safety in daily work. Discussion: The results reveal that work-integrated learning was manifested in an interdependency between the professionals and the health-care organization. The interdependency was multifaceted as the professionals were dependent on each other to learn as individuals in relation to each other, and to develop their joint work processes. The professionals were also dependent on the organizational prerequisites to learn. This result shows the need for the professionals to develop their own learning strategies to manage daily work, which was associated with the professional’s motivation in leading their own professional development towards qualitative and safe care.Conclusion:The results of this thesis reveal that the professions within a hospital ward setting are largely dependent on each other to create conditions for work integrated learning. The individuals and the team both had strong determination, will, and desire to learn to provide patients with care that was as qualitative and safe as possible. The quality of work-integrated learning was found to be related to the professions’ awareness of boundaries, knowledge, and responsibilities related to each other within the interprofessional team.