Using Activity Theory to transform medical work and learning

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.Peer reviewe

Alkoholinkulutus ja köyhäinapu 1900-luvun alun Helsingissä

Summary: Alcohol consumption and poor relif in early 20th century Helsinki

Potilaan näkökulmia terveydenhuollon digitaalisiin palveluihin

Peer reviewe

Kauppaoppilaiden suomalainen ja espanjalainen humala

Summary: Finnish and Spanish drunkenness among commercial college students

Scholarship is not just research : Nurturing scholarship in health professions education

Peer reviewe

Destabilising institutions to make healthcare more equitable: Clinicians, educators, and researchers co-producing change

Non peer reviewe

What factors of the teaching and learning environment support the learning of generic skills? First-year students’ perceptions in medicine, dentistry and psychology

Future health professions need generic skills in their working lives, such as knowledge analysis, collaboration, communication and problem-solving skills. The teaching and learning environment is crucial in the development of generic skills when studying at university. The aim of this research was to examine students’ perceptions of learning generic skills during their first study year and how the teaching and learning environment related to their learning perceptions. The data were collected from first-year students (medicine n = 215, dentistry n = 70 and psychology n = 89) who completed a questionnaire at the end of their first study year. Two cohorts of first-year students from 2020 and 2021 were combined. The teaching and learning environments in medicine, dentistry and psychology differed from each other. The results showed that learning of problem-solving, communication and collaboration skills were emphasized more among medical and dental students, whereas analytical skills more among psychology students. There were no statistically significant differences in perceptions of the teaching and learning environment. Perceptions of generic skills and the teaching and learning environment were positively related to each other. In medicine, the strongest predictors of generic skills were peer support and feedback and in dentistry, peer support, interest and relevance. In psychology, the strongest predictors were interest and relevance. The results emphasize the relevance of the teaching and learning environment in learning generic skills.Peer reviewe

The hurdles for adopting mobile learning devices at the outset of the clinical studies

Introduction: Mobile devices provide medical students with easy access to medical information and educational resources. Since 2013, we’ve followed the study use of iPads among the medical students. In 2016, we observed a notable drop in the overall mobile device usage in the first cohort of medical students entering their clinical studies. Aim of the study: In this study, we sought to identify the hurdles for adopting mobile devices among three consecutive cohorts of medical students at the beginning of their clinical studies. We sought to answer the following questions: (1) How did the students assess their own and their clinical teachers’ ability to use iPads in learning and teaching? (2) How did the clinical before-class and in-class assignments support the students’ use of the new technology? (3) How did students use the mobile device with patients? Material and methods: The data were collected with online surveys among the first three cohorts of medical students who had studied with iPads and started their clinical studies in the spring of 2016, the autumn of 2016 and the autumn 2017. In this study we focused on the closed-ended multiple choice and 5-point Likert scale questions which we analysed by the distribution frequencies in the three cohorts. Results: The response rates ranged from 67.5% (3rd cohort) to 90.8% (1st cohort). Students rated their own ability of using the iPad in studies as good or excellent whereas their teachers’ ability to use these devices relatively low. The students wished for more pre-assignments (tests and videos) and in-class assignments (voting, tests and tasks) to stimulate their learning. Furthermore, they reported that clinical teachers seldom told them about applications related to their clinical field. The students primary use of mobile devices was for seeking information online. Students were hesitant in using the device in direct patient contact. Discussion: Our findings were consistent with previous research in observing a notable hesitance in using the mobile device with patients. These concerns were raised both among students and teachers. Furthermore, the teachers seldom communicated about suitable and quality medical applications. The clinical teachers require support and training in adopting mobile device compatible pre-class and in-class assignments in their instruction.Inledning: Mobila enheter tillgodoser medicinstuderanden med enkel åtkomst till information och undervisningskällor. Vi har följt studerandes användning av iPads inom studierna fr.o.m. 2013. År 2016 observerades en märkbar minskning i allmänna användningen av mobila enheter i den första kohorten då de inledde sina kliniska studier. Avhandlingens mål: I denna studie sökte vi efter hinder i ibruktagandet av mobila enheter för tre på varande följande årskurser vid inledningen av sina kliniska studier. Vi ville med studien besvara följande frågor: (1) Hur bedömde studerandena sina egna och sina lärares förmågor att använda iPads i inlärning och undervisning? (2) Hur stödde kliniska förhands- och lektionsuppgifter studerandenas användning av den nya teknologin? (3) Hur använde studerandena sina mobila enheter med patienter? Material och metod: Data samlades med nätbaserade frågeformulär från de tre första årskurserna som hade studerat användandes iPads och inlett sina kliniska studier våren 2016, hösten 2016 och hösten 2017. Vi fokuserade i denna studie på slutna flervalsfrågor och påståenden graderade enligt en 5-stegs Likert-skala vars svar analyserades enligt frekvensfördelningen för de tre årskurserna. Resultat: Svarsandelarna varierade från 67,5% (årskursen 2018) till 90,8% (årskursen 2016). Studerandena uppgav sin egen förmåga att använda iPads i studier som god eller utmärkt medan de bedömde sina lärares förmågor som relativt svaga. Studerandena önskade fler förhandsuppgifter (tester och videor) och lektionsuppgifter (röstningar, tester och övningar) för att stimulera sin inlärning. Vidare rapporterade de att kliniska lärare sällan berättade om applikationer relaterade till sin respektive specialitet. Studerandenas huvudsakliga användning av mobila enheter var för informationssökning på nätet. Studerandena var tveksamma när det gällde användning av iPads vid direkt patientkontakt. Diskussion: Våra observationer var i linje med tidigare forskning då det gällde tveksamheten för att använda den mobila enheten med patienter. Saken lyftes fram både bland studeranden och lärare. Vidare berättade lärare sällan om passliga medicinska applikationer av god kvalitet. Kliniska lärare behöver stöd och övning i inkorporerandet av förhands- och lektionsuppgifter som är kompatibla med mobila enheter i sin undervisning

How teaching academies promote interdisciplinary communities of practice : The Helsinki Case

Universities invest in teaching academies to reward outstanding teachers. Few studies have been published about the impact of teaching academies on teaching communities. The aim of this study was to see who excellent academic teachers spoke to when they discussed teaching and learning, and what kind of community a Teachers' Academy established in 2013 offered to its Fellows. We analysed the answers to two open-ended questions from two surveys. The first survey (2013) was addressed to first-round applicants to the Academy in 2013 (N = 46, 32%) and the second (2018) to its Fellows (N = 56, 65%). In both surveys, most teachers had meaningful discussions with their close colleagues. In the second survey, the conversations with pedagogical experts merged with the discussions at the Academy. The 2018 survey also examined how well the Academy's key objectives of providing teachers with an interdisciplinary community and peer support had been achieved in five years. The Academy had become an important community for teachers, in which teachers shared mutual appreciation for teaching and collaborated across disciplinary boundaries and campuses. A challenge for a teaching academy is to support its fellows in implementing the principles of scholarship of teaching and learning, that is, carrying out scholarly educational projects and sharing the results locally, nationally and internationally.Peer reviewe

Espanjan alkoholiolot kulttuurin, elinolojen ja talouden murroksessa

Summary: Alcohol and the revolution in culture, way of life and the economy in Spain