Reconocimiento del MAP NS4B por los anticuerpos producidos contra el virus en pacientes con diagnóstico de dengue

opportunities for the current programme?

Participants in the enquiry represented four stakeholder groups; students, training officers, laboratory managers and academics. Each stakeholders’ account of their experiences revealed the daily struggles and pressures encountered. Several

barriers were perceived as hindering delivery of the current programme and although there were similarities between the experiences of individuals or groups, their

perspectives on the impact of the barriers were found to vary and highlighted the difficulties of integrating workplace learning into academic studies (Aitkins, 1999; Gibbs, 2013).

Time and the need to address the professional and regulatory requirements of the programme were recognised by each stakeholder group as barriers to supporting and facilitating learning in the workplace endorsing the findings of previous studies (Billet, 1996; Ellstrom, 2001; Flannagan, Baldwin and Clarke, 2000; Lloyd et al., 2014). Academics complained that ‘people seem to forget just how big the degree is’ (I12Ac) raising concerns around the amount of material they are expected to cover. They saw this as compounded by ever-increasing class sizes resulting in them just ‘providing a knowledge base’ (I12) which reflects Wolf’s (1990, p.41) concerns about occupational based programmes resorting to a focus upon outputs. In the workplace, an increased workload and multiple and conflicting roles ‘even the training officers

aren’t dedicated…. just doing it in their spare time’ (FG5LM), was identified as

creating a barrier of time by a laboratory manager mirroring the findings of Lloyd et

al. (2014) who found that the clinical workload of qualified nurses was prohibitive to

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Students identified how ‘doing the day-to-day work’ impacts upon their training time (Memo -Tutorial discussion). For them it is the burden of having to address the standards of proficiency packaged into the portfolio and ‘plough through it as quickly

as possible’ (I4PS), in addition to working in the laboratory that creates a barrier of

time. This positioning reflects Mitchell’s (1989, p58) discussion of the pitfalls of a narrow, task orientated approach performed in isolation to practice. The student’s comments demonstrate that there is a lack of cognitive engagement with the tasks and a surface rather than deep approach to learning (Ramsden, 2003, p43). Unsurprisingly, addressing the requirements of the portfolio was also identified by training officers and laboratory managers as a further burden for them, separate to practice, and they quite clearly identified that ‘the patient samples have always got to

come first regardless of the trainee’ (FG3LM1). Such a focus upon functional

analysis of tasks and achievement against standards has been identified by others as a major barrier to supporting workforce development (Phelps, Ellis and Hase, 2001; Torr, 2008) with attainment concentrating upon isolated competencies to address standards with a lack of integration into practice (McMullan et al., 2006; Brightwell and Grant, 2013).The ‘additional workload’ of addressing the standards in the form of the portfolio results in training being considered as a ‘drain’ on time in the workplace evidenced by one laboratory manager’s mocking comment ‘No lab tests

today – we are training’ (FG3LM1).

Another important barrier that emerged from discussions with those tasked with delivering the programme is the lack of support and training they receive for this role. Tynjala (2008) concluded that an integrated and connective pedagogy is only

feasible where there is a close partnership and collaboration between educational institutions and the workplaces. During training officer discussions I uncovered a

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focus upon career development and progression within the discipline area of biomedical science but not upon the developmental needs as a ‘teacher’ in the workplace to ‘to evidence that I am competent to train other people’ (ITO3). Academics highlighted how they have limited knowledge of professional practice, ‘when I go into a lab I see a lot of equipment, it’s just all instrumentation (FG2SL2) preventing them from supporting student transition. Similar issues have been identified in nursing where inappropriate training and preparation for workplace mentors has been shown to be problematic since support mainly focuses upon development of the individual’s clinical role (Duffy et al., 2000; Henderson and Eaton, 2013).

Many of the training officers and academics in my enquiry are very committed to the programme and demonstrated a keen interest in supporting improvements, but there is limited ‘transactional dialogue’ (Brookfield,1986, p.20) which aims to ensure that each group understands each other’s workplace culture and dominant language with a sharing of viewpoints and interpretations to develop a real partnership. Recognition of the role of the tutor, and support for tutors to perform that role, is essential for supporting programmes with integrated work based learning (Pitts, Coles and Thomas, 2001; Austin and Braidman, 2008; Bridges et al., 2011; Fullerton, Thompson and Johnson, 2013). I identified that a failure to establish this in the current programme has resulted in participants not recognising or ‘buying-in’ to the role of stakeholder, clearly evidenced in the academic group by ‘why should we be

expected to teach them that – it’s something that once they are in practice they get’ (FG2SL1). This presents a major unacknowledged barrier since a lack of ownership,

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highlighted by an academic talking about training officers, ‘I think we rarely see them

and I think it is healthy to have interaction and feedback around the course’ (I12).

Using CGTM enabled me to reveal and further interpret the complexity within this current situation. The lack of ownership emerging from a failure to establish a stakeholder community can be seen to support a focus upon a positivist

epistemology of practice. Abductive questioning identified that within the academic group, delivery of subject knowledge takes precedence and is valued over

supporting professional practice: ‘academics just need to know the academic

requirements and subject but not the application of them. That is where the lab

comes in’ (FG2AM). Although lack of time was initially attributed to this approach, the

positioning of academics within the positivist paradigm compounds the situation reflecting the technical rationality model defined by Schön (2002, p.48). There is a focus upon a positivist epistemology of practice where basic and applied science comes first. Additionally, I identified that training officers and laboratory managers perceived the role of the workplace as ensuring students could perform specific

tasks (FG5TO1), again reflecting alignment to a technical rationality model

demonstrating a positivist perception of learning within the workplace too. I found that in the more automated laboratory environments with a high throughput of

samples this attitude towards learning was more pronounced and clearly summed-up by a training manager’s expectation of learning during the placement, ‘it’s a hands-

on job, not producing reports and doing exams’ (FG1TM2).

Many layers of complexity exist around the integration of professional qualifications into degree programmes. Constructing a deeper understanding of the barriers enabled me to address the second research question.

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