Comparación de la antigenicidad del MAP NS4B y el péptido NS4B conjugado a ABS empleando sueros humanos

In trying to ‘unpick’ the layers influencing the current position I found that ownership or rather lack of ownership by participants emerged from the focused coding as a theoretical category, and as a consequence of expectations and role conflict. In this context I use the term ownership to define who has ‘custody’ of the outcomes of the programme and so entry onto the professional register. This requires a commitment to, responsibility for and recognition of the expected outcomes of the programme. I initially defined stakeholder as ‘any group or individual who can affect or is affected by the achievement of the organisations objectives’ (Freeman, 1984, p.46) and identified four stakeholder groups represented in my enquiry in the initial conceptual framework. As I have already discussed, findings suggest that participants do not appear to see themselves as stakeholders in the programme. My initial literature review emphasised the need for a common definition and identity between

stakeholders delivering programmes linked to the professions. It was acknowledged as an essential feature for a successful outcome (Fullerton, Thompson and Johnson, 2013). Studies have highlighted difficulties in a range of professions where tensions exist around the role of the university and practitioners/mentors as the ‘professional

165

gate-keeper’ (Furness and Gilligan, 2004; Lafrance, Gray and Herbert, 2004; Pellat, 2006). In directing my questioning around this topic in focus group discussions I was able to identify confusion around ownership of the programme in terms of roles and responsibilities and who was ultimately responsible as ‘gatekeeper to the profession’. This directed me to question around this topic in more depth in the interviews.

Findings identified that the issue appears to be around whose responsibility it is to ensure that students possess the required knowledge and skills for entry onto the register and who supports the development of professional capability. A lack of clear

ownership within the programme has resulted in a lack of acknowledgement by

stakeholder groups of their role in supporting development of the capable practitioner and entry to the professional register. Training officers consistently commented that it was the role of the verifier to decide if the student was capable:

I think it is the person doing the verification. When they come around its them who is saying whether the student is suitable to be signed-off (FG1TM)

This suggests that although they are signing the portfolio to state that the student has completed tasks competently, they have delegated the judgement around the student’s ability to perform as a BMS in the laboratory environment to the verifier. They do not take responsibility for ensuring that the student is developing as a capable practitioner. The verifier’s role is to ensure that the range of evidence

gathered by the student for their portfolio is sufficient and appropriate to demonstrate that adequate training, support and assessment have occurred during the work based period of training. It is the role of the training officer who supports the student in the workplace to ultimately assess the student’s suitability for entry onto the register. A lack of ownership of the role of ‘gatekeeper’ was also demonstrated by the academics in discussions around the delivery of knowledge and the ‘type of knowledge’ delivered. When asked about supporting students to make the

166

connections between theory and practice one academic stated ‘why should we be

expected to teach them that – it’s something that once they are in practice they get (FG2SL1). This demonstrates a lack of ownership of their role within the programme

and the intended outcomes of an award linked to professional practice. Work by Fullerton, Thompson and Johnson (2013) identified that awards linked to

professional registration require a common definition and identity between

stakeholders. Questioning of the data gathered highlights a lack of role definition and shared perceptions of role which is heightened by the lack of integration of the two parts of the curriculum; workplace knowledge is separated from academic

knowledge. This perceived separation was clearly demonstrated by comments by one of the academics during the focus group:

they [academics] need to know the academic requirements and subject but not the application of them. That is where the lab comes in (FG2AM)

There is an obvious positioning of the academic role as ‘delivering knowledge’ to the student. How the student then uses that knowledge is dependent upon the student and the workplace – not the academic.

Ownership of the ‘transfer of knowledge’ and development of capability is perceived

as very firmly the responsibility of the workplace. The expectation is that once the student is in the workplace they will learn how to apply the knowledge delivered during lectures and tutorials to their job role:

We are never going to reflect all that here [range of techniques and

applications]…Why should we be expected to teach them that – it’s something that once they have been in practice they get…. this is something that the student develops whilst on placement (FG2SL1)

Most tutors articulated an assumption that students will readily make the connections between their academic studies and their application/ relevance in the workplace.

167

However, research on learning in the workplace has shown that ‘learning to practise and learning to use knowledge acquired in education settings does not happen automatically’ (Eraut, 2013 p185). This suggests that the lack of ownership of the programme results in a major challenge to supporting pre-registration training due to the separation of ‘taught’ knowledge from ‘workplace’ knowledge. Higher education has traditionally organised curricula as isolated subjects and this can be seen to be reflected in the separation of academic and practical contexts. A major challenge to any programme is for the quality and delivery of the programme to be valued and owned at all levels by technical and education based stakeholders (Chapple and Aston, 2004). Commitment at all levels is required as well as motivation from all stakeholders with a shared vision of the programme outcomes (Evans et al., 2010). Partnerships are essential to ensure that the knowledge-base from all settings are embedded in and across the programme. The building of relationships is essential, enabled by discourse between stakeholders (Evans et al., 2010).

There is acknowledgement that both groups support different aspects of the trainees’ development. However, it was obvious from discussions that practice-based

knowledge and the knowledge that is developed during academic studies are seen as independent of each other – separated due to this lack of collaboration between stakeholders. Those supporting learning in each domain often do not recognise the knowledge from the other or have limited experience which hinders their ability to support delivery (Lester and Costley, 2010). Close liaison is required to ensure that all aspects are covered and supported. This lack of interaction is perceived as hindering the delivery of the programme:

I think that we rarely see them [training officers] and I think that it is really healthy to have interaction and feedback around the course (I12)

168

This is a very important finding. The outcome of this lack of interaction and close liaison between those delivering the programme is an issue of negativity and lack of

ownership of outcomes of the programme. Socio-cultural learning perspectives rely

on relationships between individuals and culture, relying upon the nature of experiences and activities (Tynjala, 2008). Questioning the data allowed me to identify this deeper layer of knowledge conceptualisation and a lack of appreciation of all forms of knowledge and learning. A lack of shared ownership results in ‘two isolated parts of the programme’ and ‘two isolated groups’ delivering the programme.

However, opportunity does exist within the current programme since development of closer liaison and joint ownership emerged as something which the stakeholders were open to and recognised the need for. One academic clearly identified this need in their comments ‘I think that we need close liaison between the academics and

training officers (I12)’.

Addressing this area would enable potential development of the programme by addressing the current separations that have been identified as existing and the lack of ownership for supporting capability development.

5.6 Chapter Summary

This chapter has presented the three theoretical categories to provide an insight into the dynamics within the current programme and the circumstances by which they are shaped. The two strategies identified from the data of ‘doing the portfolio’ and

‘gaining BMS currency’ provided theoretical centrality and direction for my enquiry. I developed my analysis of supporting learning in and for the workplace starting with participants’ concerns and perspectives on the delivery of the current programme: looking at their views and positioning resulting from the range of tensions that they

169

face. The positioning of participants was identified as causing a narrow, transmission approach to teaching and learning, with the assessment of isolated performance in decontextualized tasks. This was initially attributed to ‘lack of time’ due to role

conflict presenting itself as ‘pressures of the clinical workload’ and the involvement of

support grades to deliver training. However, continual memo writing and

diagramming assisted me in interpreting the meanings behind actions and comments revealing that positioning was greatly influenced by the lack of development for role, conflicting expectations of role and lack of ownership of the programme. Importantly, it allowed me to identify that although I had initially referred to the participants in the enquiry as stakeholders, this was not a role that they acknowledged. Reviewing the findings through a socio-cultural lens allows the dichotomies within areas of the programme and between the two strategies to be understood and how these hinder the development of practitioner capability. Positioning has led to adoption of

inappropriate pedagogical approaches within the programme. Learning is

approached in a mechanistic way with separation between and within contexts. The influence of this fragmentation and disintegration is amplified by a lack of shared ‘ownership’ of the programme outcome which has led to a focus upon ‘doing the

portfolio’ as a strategy to demonstrate suitability to gain occupational status rather

than ‘gaining BMS currency’ which reflects the capable practitioner.

In the next chapter I use these findings to address my three research questions. I identify the relevance and potential impact of my findings for practice in my field and other programmes linked to pre-registration training and practitioner development. In Chapter Seven I highlight my contribution to knowledge in this field and identify the limitations before suggesting areas for further research.

170

Chapter Six – Discussion: ‘Doing the Portfolio’

6.1 Introduction

This enquiry has explored the delivery of the BSc Biomedical Science award within a framework of changes relating to awards linked to the professions and developments in the NHS driven by patient needs, advances in science and developing

technologies. Within this framework of significant challenges and demands upon the NHS workforce the role and expectations of the Biomedical Scientists who are the focus of this enquiry have evolved. The heightened need for a highly skilled and flexible workforce to deliver this advancing provision highlights the importance of supporting the development of the capable practitioner.

This chapter synthesises the findings of the enquiry presented in the previous chapter to address my three research questions and discusses how this empirical research extends current understanding around developing the capable practitioner in BMS. It summarises how dominant theories of learning and teaching within practitioner education have enabled me to theorise the current experiences and practicalities of integrating professional registration for BMS into an academic programme.

I will start by addressing the three research questions (RQ) and in addressing these questions I will highlight the two important strategies identified from the analysis of the empirical data and demonstrate how through eliciting and theorising these I extend understanding of the issues and complex layers involved in integration and delivery of professional BMS training within the current academic and work based programme.

171