The mismatch between teaching and assessing professionalism: a practice architecture analysis of three professional programmes

Figures & data

Table 1. Data for the study.

	Documents	Interviews	Participant observations
Medical ed	434 pages Syllabus, study guides, lecture plans, schedules (first author)	6 teacher interviews (first author)	‘Consultation’: Training session where medical students are exposed to decision-making during difficult patient meetings. No of sessions: 5 Total: 47 h Observers: 3 (first, second and fourth author)
Social Work ed	407 pages Syllabus, study guides, lecture plans, schedules (first author)	5 teacher interviews (first author)	‘Dealing with affect’: Training session where social-work students lead social-work counselling sessions and are exposed to strong emotional outbursts from clients. No of sessions: 4 Total: 12 h Observers: 3 (first third and fourth author)
Police ed	229 pages Syllabus, study guides, lecture plans, schedules (first author)	7 teacher interviews (first author)	‘Bereavement and loss’: Training session in which police students give a death notice to a bereaved family member and are exposed to strong emotional reactions. No of sessions: 4 Total: 8 h Observers: 2 (first and second author)

Table 2. How is professionalism taught on these educational programmes?

Practice	Practice architectures
Sayings	Cultural-discursive arrangements
The subject core (empathy, interpersonal relations, self-awareness) Student activity Situational flexibility Importance of trust and benevolence	Lack of (verbalised) consensus about the subject core The idea of exposure The idea of imitating realism The idea of complexity (difficult, surprising, confusing)
Doings (implementation)	Material-economic arrangements
Reflection/discussion Scenario training Acting in realistic scenarios	Equipment Training facilities Teacher time and resources Hired actors
Relatings	Social-political arrangements
Student-centred Level of trust between students	Teacher authority (teacher to students) Deviation from higher education teaching traditions

Table 3. How is professionalism assessed?

Practice	Practice architectures
Sayings	Cultural-discursive arrangements
Assessment is detrimental to learning Exposure to uncertainty and stressful situations ‘Rites of passage’	Fairness Objectivity Professional requirements (this is what you will have to handle in the future)
Doings	Material-economic arrangements
Assessment of reflection (oral and written) Administration of active attendance Ambiguity in instructions (is this an assessment or not?)	Teacher time Resources
Relatings	Social-political arrangements
Power asymmetry between teacher and student Student group dynamics	Exercising public authority (teacher) Institutional rules for assessment