Análisis de las problemáticas básicas de las relaciones de los actores

The overall context of LSO IPE is within an orthodontic clinical environment. Knowles (1990) theory of andragogy states that the learner needs to be able to see applications for new learning. All LSO education is related to clinical practice and geared to the professional role for which the student is preparing. The integration of the clinical environment and the learning processes ensure all is contextualised and bears similarities to traditional apprenticeship training, as described by (Brown et al., 1989). Since the first formal course in 2005, education has become more student centred, with changes in the style of teaching, structure of courses, development of facilities, including a wider range of educational tools and assessments and, importantly, development and involvement of the LSO team. This student centred approach is supported by Schön (1983), who suggests that, to maximise learning, students need to know why and how they learn and that learning can be more effectively achieved by active engagement.

Scholars have never stopped debating which learning theories are superior to others for a certain group of learners (Wang, 2012). Integral to all LSO learning processes is the principal of reflective practice. Dewey’s reflective

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thinking theory supports this (Dewey, 1933), so the theory behind LSO’s use of clinical reflective portfolios in its assessments for all student groups appears to have support from other sources. Reflection as a core LSO philosophy is also demonstrated by regular team appraisals centred on each member self-appraising both past performance and continuing aspirations. This developmental process of learning by returning to thoughts and actions also finds support from Dreyfus and Dreyfus (1986).

Wang (2012) discusses the concept that humans learn in relationship with others. The involvement of the LSO team as facilitators, mentors and assessors is proposed to enhance learning. There must be a change from the traditional views of learning as a solitary and isolated activity that allows for the recognition and acceptance of students becoming directly involved in peer tutoring (Falchikov, 2001), assessment (Falchikov, 2005) and also research (Jenkins et al., 2003). LSO team members choose which aspects of education they wish to deliver. As such, they presumably involve themselves in subjects in which they feel most proficient. This process is supported by the recognition that, at an organisational level, dental tutors need to be appropriately matched to different clinical situations and that, if properly channelled, the range of different skills will enhance students’ learning experiences (Sweet et al., 2008b).

Behaviourism as a paradigm assumes that a learner starts with a clean slate; this view would not be supported by observation of adult learners in LSO, who bring a variety of past experience with them. However, the behaviourist

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view of Bandura’s Social Learning theory finds support at LSO when learners are taught new skills (Competency Based Training). This is seen when nurses with very little previous experience learn new clinical skills. It is less obvious in more mature students with previous experience of certain tasks and would potentially therefore have to unlearn first.

In considering the development of LSO as an IPE environment, the development and progression of individuals but, within the wider team infrastructure, is potentially a key factor. As individuals have become more professionally qualified and experienced, so they have seemingly become more confident to impart their knowledge, initially to LSO team members but progressively with students from outside. The more the educational involvement, so their capacity to reflect may have improved and set in motion a self-perpetuating development process, including influencing its further progression. This process could be explained by the theory that shared experiential learning occurs where shared experience is translated through reflection into concepts, which in turn are used as guides for active experimentation and the choice of new experiences (Cox, 1984).

Team members within LSO now potentially see educational involvement as a personal goal; it may be seen as recognition of their own competence and ability. This could stimulate them to become actively involved in not only carrying out their own team duties but in seeking to help others educationally. As such, the IPE process has evolved. Physical developments such as the clinical skills laboratory and improved audio-visual links have

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aided this process but are suggested to be secondary in importance. Different theories may underpin this team involvement in LSO education. Social learning (Bandura, 1977) and situated learning (Lave & Wenger, 1991) are both but two viable explanations of the progression.

The importance of interrelationships has been documented; the creation of an atmosphere of enthusiasm by the LSO educators may be a key factor in learning. There is theoretical support for this hypothesis. Learning is seen not only to be based on activation of past knowledge (Schmidt, 1993) but is also socially and culturally determined (Bruffee, 1995). Bruffee (1995) also recognises the added value of small group working in co-operation and collaboration; Sweet (2009) suggests that learning is about the process of social adaptation - of adopting the accepted patterns of behaviour of a discipline or profession. Successful teaching needs to take place as an open dialogue, in a supportive environment that enables critical constructive feedback to be both given and received (Jarvis et al., 2002). These theories all underpin the LSO environment seemingly created by the educator team.

Part of this evolution may be due to educators becoming progressively more aware of student needs; this may have improved as the LSO team, as previous students, become more influential in the educational process. Empowering individuals in this way potentially encourages them to mind map their way through a process, consider alternatives and to offer full solutions. Thinking through and visualising a process to completion will lead to a better understanding and the ability to communicate this better to students. This

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visualisation of sequential steps or a knowledge of the expected range of common errors related to a skill is important in PBL (Mayberry et al., 1993).

LSO education started as an intuitive model, as described by Minter (2011). It is suggested that: LSO has evolved through a community of practice, into an IPE environment, where the student is at the centre of the process. Indeed, this may be a pre-requisite for all IPE. There is seemingly a significant element of PBL and CBL embedded in teaching, with the teachers facilitating this process. Self-direction is required for PBL to be successful. The time spent and level of immersion in LSO may be critical to this progression and to learning. Motivation is not only essential to the learner (Wang, 2012) but also to the teacher. The core philosophy must allow individuals to develop and not be limited by senior figures being protective of their own status, which may be important in LSO education. Wang (2012) suggests learner energy must be released for self-direction; the energy of teachers to be also self-directing must also be released in IPE. If this is not present, then there may not be a true IPE environment. Indeed, IPE potentially could be seen as a paradigm in its own right.

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Initial programme theories