Mapping the work-based learning of novice teachers: Charting some rich terrain

Abstract

Background: Work-based non-formal learning plays a key role in faculty development yet these processes are yet to be described in detail in medical education.

Aim: This study sets out to illuminate these processes so that potential benefits for new and inexperienced medical educators and their mentors can be realised.

Method: The non-formal learning processes of 12 novice teachers were investigated across hospital, general practice and medical school settings. The research sought to describe ‘what’ and ‘how’ non-formal learning takes place, and whether these processes differ across teaching sites. Both clinical and non-clinical teachers of medical undergraduates from one inner city medical school were recruited for the study. Through semi-structured interviews and a ‘concept map’, participants were asked to identify the people and tasks which they considered central to helping them become more expert as educators.

Results: Results identified non-formal learning across a number of key dimensions, including personal development, task and role performance, and optimising clinical teaching. This learning takes place as an outcome of experience, observation, reflection and student feedback.

Conclusion: Non-formal learning is a significant aspect of the development of novice teachers and as such it needs to be placed more firmly upon the agenda of faculty development.

Introduction

Professionals learn a significant amount through their everyday practice. If learning is visualised as an iceberg, then non-formal learning is the larger part hidden from view (Coffield 2000). Indeed ‘learning from experience’ has become a central organising concept for faculty development programmes in the UK (Dennick 2004; British Medical Association (BMA) 2006). However the exact nature of such non-formal learning (Eraut 2004) is not fully understood in the development of medical educators. The BMA (2006) describes how historically researchers have focused on the impact of formal courses in improving teaching skills, and neglected how such skills are acquired in the first place, such that ‘no clear framework exists that outlines this development process’ (BMA 2006, p. 15).

In this study I aimed to describe these processes of non-formal learning – ‘how’ and ‘what’ was being learnt, and whether there were differences across settings (clinical and non-clinical). Such a fuller understanding of non-formal learning processes would inform the format and delivery of formal courses in facilitating learning from experience (MacDougall & Drummond 2005). Also, a more developed map of non-formal learning would point to ways that faculty development could be supported outside of formal courses. Such programmes are not mandatory (Towle 1998; Spencer 2003; BMA 2006) and may have limited impact (MacDougall & Drummond 2005).

So how can these non-formal developmental processes be understood? McLeod et al. (2006) refer to a process by which doctors become more expert through gaining tacit educational knowledge of basic pedagogical principles from experience, whilst MacDougall and Drummond (2005) note the importance of observation and role modelling by others. My research set out to add to such analyses by describing the non-formal learning of novice teachers of medical undergraduates. Novice teachers were identified as a suitable subject for this enquiry since according to Eraut (1994), the first few years of teaching are periods of intense professional development and thereby likely to be particularly illuminative of non-formal learning processes.

Two conceptual tools were central to my enquiry: Eraut's (2004) typology of non-formal learning, and Evans et al.'s (2006) model of ‘expansive’ and ‘restrictive’ learning environments. Eraut's (2004) typology, posited as a ‘heuristic for use’ (p. 265), comprises eight broad themes or domains of non-formal learning: task performance, role performance, awareness and understanding, personal development, teamwork, judgment, decision-making and problem-solving, and academic knowledge and skills. This model attempts to typify ‘what’ is learnt, and in so doing synthesises ‘categories of knowing’ (Knight, 2002) such as ‘procedural’ and ‘propositional’ knowledge (Eraut 2000) integral to professional action. Eraut claims his domains and sub-categories are ‘readily recognisable’ as significant aspects of workplace learning (Eraut 2004, p. 265). Importantly, this typology closely aligns with other models of the role of medical educators (Harden & Crosby 2000; Hesketh et al. 2001), including as they do, both performance of tasks and wider, less tangible, aspects of professionalism.

But ‘how’ does such learning takes place? Lave and Wenger (1991) and Eraut (2004) configure non-formal learning as an outcome of social collaboration, and usefully for research purposes, Eraut (2004) denotes activities through which such situated learning takes place in workplace settings. He proposes there are four key activities through which people learn, namely: participation in group activities, working alongside others, tackling challenging tasks, and working with clients. This fourfold model was employed in my research as a further tool to investigate non-formal learning.

A final, professionally significant question is how might non-formal learning differ across sites of medical education? If learning takes place as an outcome of social activity, then logically different contexts should give rise to different types of learning. To illuminate such distinctions, I adapted Evans et al.'s (2006) concept of ‘expansive’ and ‘restrictive’ professional environments which allows measure of the degree to which they facilitate learning – similarly identified by Billet (2006) as workplace ‘affordances’. Elements of ‘expansive’ environments include:

• Close collaborative working (including team-working, observation).

• Opportunities for networking outside of the immediate environment.

I considered these descriptive statements would be helpful in determining the level of expansiveness of the workplace environment in providing non-formal learning opportunities.

Table

Practice points

Non-formal learning is a significant aspect of the development of novice teachers and should be on the agenda of all policy and practice in faculty development. It involves learning the principles, approaches and practical skills of teaching. It is especially significant in developing the skills which are prerequisite to expert practice. It can be maximised through such activities as opportunities to observe and be observed, receive feedback, and variation in tasks and experience. Steps taken to enhance work-based non-formal learning should be based upon knowledge of each individual's needs, the requirements of their teaching role, and context.

Method

I recruited 12 novice teachers from School of Medicine and Dentistry (SMD) for my study. My strategy was to achieve a purposive sample of medical teachers who reflected the ‘broader constituency’ of educators in the SMD – in Mason's (1996) words, I set out to include individuals whose characteristics made them ‘relevant … to the wider universe’ being explored. As such, I needed to include a balance of novice teachers from three settings: on campus, general practice and hospitals. I recruited participants in a number of ways. I made contact with new tutors who were undertaking the university teaching qualification. Via this method, I was able to recruit seven teachers from hospital and on campus settings. I recruited tutors from general practice via the recommendations of academic staff in community-based medical education who suggested tutors they thought might be interested, willing and likely to benefit from taking part. Finally, I achieved a balanced number of hospital doctors in my study by contacting Foundation Programme trainees in an associated hospital whom I knew had a particular interest in teaching. My final group of 12 participants consisted of five tutors who were based on campus in the medical school (the ‘medical school’ participants – three of whom were non-clinical lecturers), three GP tutors and four junior hospital doctors (Foundation Year trainees). Altogether there were seven female and five male participants. I did not specifically collect data on age but they were at the early stages of their careers and I would estimate them all to be less than 35 years old. They all had either <3 years teaching or self-reported that teaching had been a small part of their role to date. One GP volunteered that he had 5-year teaching experience but still felt himself ‘new to the game’ of teaching.

I decided to use semi-structured, in-depth interviews, since this method had been employed previously and successfully to elicit accounts of non-formal learning (Mann et al. 2001). I drew up an interview guide which sought to elucidate what the participants considered that they needed to know to be an effective teacher, how they were gaining knowledge (through which activities and in collaboration with whom), and how they could be supported to learn better about teaching – some illustrative questions are set out in Figure 1.

Figure 1. First interview guide.

My academic supervisor advised on how to encourage exploratory dialogue during interviews – to use such words and phrases as ‘tell me … ’ or ‘ … is this the case for you?’ Some of the questions had prompts – for others, I decided to improvise if and when necessary, in the light of responses. In fact I found that as our conversations developed, I was likely to ask questions in an order, style and format that seemed most appropriate to what I had just heard although I aimed to cover consistently the three areas set out earlier.

I planned to interview each participant twice over a 3- to 4-month time span in their place of work. A key methodological challenge was that much of their knowledge was likely to be tacit (Molander 1992). In order to facilitate their ‘telling,’ I devised a concept map (Miles & Huberman 1994; Novak & Canas 2006) to ‘elicit aspects of respondents’ views that are not directly articulated’ (Hakim 1987, p. 27) – see Figure 2.

Figure 2. Interview concept map: my workplace learning.

The map utilised Eraut's (2004) four key activities (participation in group activities, working alongside others, tackling challenging tasks, working with clients) but for simplicity, I reduced these to two: namely, People and Tasks. To encourage participants to visualise their own learning trajectory, I placed an arrow at the centre of the map with the terms ‘novice’ and ‘expert’ (Dreyfus & Dreyfus 1986) positioned at either end.

I piloted the interview guide and the ‘concept map’ in November 2006 with a non-clinical lecturer on campus. This pilot interview lasted 45 min and I concluded that whilst the questions were largely appropriate for generating discussion, I should be careful to avoid prompting too much descriptive detail on teaching as opposed to non-formal learning. Equally, I noted that although the ‘concept map’ was a manageable task – it was challenging to complete in the space of an interview, especially without prior warning, and I should build in time to explain the task and for participants to ‘gather their thoughts’. I decided this could be achieved by switching off the recorder for a short while during the interview to allow them a few relaxed moments to get to grips with the writing task.

In the first round I interviewed all the participants in their place of work. Each interview was recorded, transcribed and analysed using NVIVO7 and this included data from the pilot interview (although I did not interview this participant a second time). I independently began the coding process by using Eraut's typology of eight themes as a ‘start list’ (Miles & Huberman 1994, p. 58) to identify what my participants were learning. By using themes such as Role Performance, I was able to create sub-categories such as optimising clinical teaching (category 3.2), as they emerged from the analysis. One of the largest problems I faced was that of interpretation and assignment of data. For example, I found that in practice, it was difficult to distinguish effectively between the theme of Personal Development and Role Performance. Relatedly, Awareness and Understanding was in danger of becoming a residual ‘catch-all category’. I decided that rather than attempting an ‘ideal’ categorisation by subject matter, it was more important to strive for consistency in assigning data. Accordingly, I constantly checked and rechecked coding against previously coded data to make sure that material was handled in the same way.

I coded data under all Eraut's themes apart from Teamwork. I then went on the generate a completely new set of codes to consider how learning was taking place – again informed by the literature on the processes of non-formal learning (Eraut 2004; Evans et al. 2006) but in this instance without a prior set of themes. The emergent thematic framework was discussed during supervision meetings, leading me to gain new insights at a meta-level, for example, noting the degree of emotional challenge across my participants’ accounts.

As an individual researcher, it was critical that I take further steps to check the robustness of my data analysis via a transparent verification process. To examine the authenticity and credibility (Higgs 2001) of my findings, I decided to use participant validation which for some is seen as a marker of quality within qualitative research (Miles & Huberman 1994; Lacey and Luff 2001). Main themes from the initial coding of the first interview were drawn together and woven into an individual narrative – ‘a story of their learning’ which was given to each interviewee for comment. The second interview began with the participant focusing on this narrative and being asked to comment on the text in terms of accuracy, balance and omissions, thereby generating further data for analysis. They were then typically asked if they would like to add anything to the story of their learning. A question I often used was ‘would you place yourself further along the continuum (the arrow) since the last interview and if so, what have you learnt to do better and how has this learning been achieved?’

My final tally of codes amounted to 13 main themes and 84 sub-categories relating to ‘what’ and ‘how’ novice teachers were learning non-formally. Seven of the main themes reflected Eraut's typology whereas six new themes arose independently though the process of analysis. Within this overall thematic framework, I identified predominant themes and sub-categories by including those which incorporated data collected from at least four participants.

Results

‘What’ is being learnt?

The data analysis indicated that much non-formal learning takes place under four themes of Eraut's typology, that is, personal development, task performance, role performance and awareness and understanding. Within these main themes I noted 15 predominant sub-categories as set out in Figure 3.

Figure 3. ‘What’ is being learnt?

Personal development

Developing confidence was a key sub-category in the non-formal learning of nine participants across all three settings. This confidence was gained from facing and overcoming challenges in everyday practice. One participant's fears were connected to public performance:

I was nervous before I gave the lecture … lectures weren’t part of my comfort zone. (Pilot Interview)

Another medical school participant was concerned at simply being ‘the person-in-charge’, a sentiment vividly expressed when she described her inner turmoil whilst facilitating a group for the first time and how she had learnt to cope:

… really, really nervous and my heart would be almost pounding out of my chest and I could feel my face reddening and it was obvious that I was nervous … Pushing through that was great. (Case 1: Int 1)

The data provided evidence that participants had increasingly learnt to attend to students’ needs and priorities for acquiring knowledge. One GP participant acknowledged coming to appreciate that students would know:

what would be useful, because ultimately it's them that can say whether that was what they needed or not. (Case 4: Int 4)

Equally, five participants across all settings had learnt the importance of keeping up-to-date in order to maintain credibility, ‘you have to know what you’re talking about before you teach’ (Case 8: Int 8). This was keenly expressed by two of the hospital doctors, who were still wrestling with their own clinical knowledge.

Task performance

Much non-formal learning appeared to be related to acquiring the skill or ‘craft’ of teaching. For example, how to lecture within a given hour slot or how to ascertain students’ needs – to ‘get the pitch right’. Learning not to overload lectures was in fact a key item of learning:

I have had some feedback over the last two years from two more experienced lecturers … to simplify the way I present the aims of the lecture in order not to make a lecture too complicated but rather aim for slightly fewer key facts. (Case 2: Int 2)

‘Getting it right’ meant learning to recognise ‘student vulnerability’ (Case 1: Int 1) and their different academic levels, so that less knowledgeable students were not made to feel inadequate. Similiarly, participants were learning about effective communication skills and questioning techniques, often through observation:

… she (another tutor) asked a very interesting question, or she just asked a very engaging question and I realised that actually it's not about me doing all the work, it's thinking of the questions to ask. (Case 1: Int 1)

At a meta-level, learning also occurred about the applicability of theory to improving performance, allowing one participant to develop her own rubric for measuring the value of theory:

(my experience) … has given me something to actually start working on and applying to my practice and learning that I can use that and that theory. (Case 1: Int 1)

Role performance

Beyond practical techniques, medical school participants described learning about the essence of teaching; that teaching is an ‘art’ above and beyond skills, and thus not easily defined:

there is an art to teaching as well that you can only pick up through experience … we all gain the knowledge but then there is the art and I think the art is in the response to what happens. (Case 1: Int 1)

Eight participants across all settings described the Versatility and Spontaneity of their colleagues, in contrast to their own more uni-dimensional performances. One medical school participant acknowledged how she tended to ‘stick to the script’ – ‘relying on PowerPoint’ (Case 10: Int 10). She recounted learning the need ‘ … to be a bit more innovative I guess’ (Case 10: Int 10) and to provide a more varied session for the students.

Awareness and understanding

There was also a good deal of non-formal learning about the context of teaching. This was most clearly identified in the accounts of hospital doctors who were learning how to optimise clinical teaching. A key issue for the hospital doctors was how to access appropriate patients. They were learning how to weigh up both what was possible and ethical as follows:

some patients would just be completely inappropriate to teach on either, you know, they can’t speak English or consent would be an issue because actually they’re really sick … so they’re completely taken out because that's just a bit unethical …. (Case 12: Int 12b)

Part of this learning related to being able to identify how patients differed in their ability to communicate their symptoms. This was put very succinctly by a GP:

Some patients are good historians, others are not, some can be long, and others can be short …. (Case 6: Int 6)

For the junior hospital doctors a key aspect of their non-formal learning was how to maintain an effective teaching role whilst working in a highly demanding environment.

How are they learning?

Data resulting from the interviews and maps showed there were four key avenues for non-formal learning. Participants learnt from varied forms of contact with colleagues (both within and external to their workplaces), interacting with and feedback from students.

Much of the learning from internal and external colleagues came from observation. What was striking was the range of learning that occurs from observation. It can include tangible matters such as noting another's excellent use of audio-visual aids:

I think one thing that struck me in the last lecture I was in was how important it is to have good AV. (Case 2: Int 2)

It can also mean observing and learning about the possible format of sessions, how to introduce variety, and the importance of allowing students to apply knowledge. One hospital doctor described observing an ‘old age’ consultant running a workshop with a co-tutor, and her account is testament to the wide range of learning that can take place from observing an individual teaching episode. She was impressed by the sheer variety of activities they offered:

a mixture of lectures plus case discussions, plus MCQs, plus going through a mini-mental state, which is what we do in the home visit … and they showed a video which was another thing. (Case 9: Int 9)

She also noted more effective use of PowerPoint:

their slides seemed much less cluttered than mine and the points they focused on seemed much more simple than the ones I could have done in lectures. (Case 9: Int 9b)

However it also included less easily defined elements, such as the ‘artistry’ of others as described earlier. Such learning is described in vivid terms by one of the medical school participants recounting his perceptions of a presentation given at a recent conference:

The plenary speaker gave this talk and said well if you don’t mind, I’ve got another ten minutes, I’ve got a song for you and got his guitar! We were all thinking…what's this going to be and he's got this brilliant song that he’d written himself about giving seminars and it was just hilarious. (Case 3: Int 3b)

Key to this learning was the ability to make sense of their observations and experience, and the most commonly expressed way this was done was through reflecting on events after they happened in a reactive way, as expressed by two of the clinical teachers:

straight after a piece of teaching you might go away and think about how that went. (Case7: Int 7)

I tend to reflect a lot on my performance and what I’ve done and what I could have done better and what doesn’t work. (Case 9: Int 9)

Were there differences in learning between settings?

What was striking about the data in terms of ‘what’ the participants said they were learning was commonality across the medical school, general practice and hospital settings. Of the 15 predominant categories of non-formal learning in the study (Figure 3), only four did not have at least one participant from each setting make a comment in this respect. However, it was possible to identify areas of learning where reporting was low (none or only one participant). At this point, albeit based on small numbers, difference in settings began to emerge. In brief, the hospital doctors reported fewer opportunities for receiving feedback from colleagues and attendance at external events, whereas GPs reported fewer opportunities to observe teaching, engage in assessment and curriculum design, receive feedback from colleagues, and manage attendance at external events. Some of these differences are unsurprising and directly relatable to the specifics of their teaching context and their relative newness to teaching. However there may be import here for faculty development and this will be discussed in the next section.

Discussion

The findings indicate that novice teachers learn a good deal non-formally across clinical and non-clinical settings as a result of their experience and interaction with colleagues. It could be summarised that they learn both the ‘means’ and ‘ends’ of teaching through their everyday practice.

To explain further, it is possible to interpret much of their non-formal learning as ‘procedural’ knowledge (Eraut 2004), or the right ‘means’ for the job, akin to Ryle's ‘knowing how’ (cited in Becker & Hager 2002, p. 173). These novice teachers were learning aspects of Role and Task Performance: to ‘get the level right’, target their material effectively, time manage, ask questions and facilitate effectively, and optimise clinical teaching through finding the ‘right’ patients.

These findings significantly echo the types of requisite skills presented in both Harden and Crosby's (2000) and Hesketh et al.'s (2001) models of the medical educator. For example, Harden and Crosby include the roles of Information Provider and Facilitator in their scheme. They propose that effective practice involves not just conveying disciplinary knowledge but managing students’ learning and placing them central to educational activity. In a similar way, Hesketh et al.'s (2001) Technical Intelligences emphasise such procedural skills as appraising, assisting, motivating and directing learning. The results of my research serve to draw attention to the fact that it is problematic to become adept at such facilitation and that in the early stages of their professional careers, novice teachers are engaged in a struggle to learn how to be effective in these activities. For example, they need to learn how to make correct judgments about the amount and level of material to enable students to access learning. This type of prerequisite knowledge would seem to be integral to their non-formal learning, and thus it underpins and contributes to their ongoing development as expert educators.

Beyond the early practical skills of teaching and how to ‘survive’ both as a clinician and a teacher, non-formal learning is also critically about developing confidence. What was striking was the level of emotional challenge evident in the accounts of some participants. My analysis concurs with Jarvis's (2005) view that learning involves the ‘whole person’, their beliefs and emotions, articulating with Moon's (2006) treatise that emotion is an integral part of learning It is also a finding consistent with MacDougall and Drummond's (2005) proposition that the emotional dimensions of teaching are significant and currently underplayed in literature on early professional learning.

On this point I note that Hesketh et al.'s (2001) model does in fact refer to the dimension of personal development with regard to teaching – included under ‘Personal Intelligences’. However, in their scheme the constituent elements are more concerned with an ‘end’ state – being able to accept and respond to evaluation and reflect upon and be aware of own strengths and weaknesses. To revisit an earlier point, such effective self-critique requires a degree of prerequisite underpinning confidence and professional autonomy, and this is the very essence of the non-formal learning of novice teachers.

Non-formal learning is also about learning some rather more abstract principles – the ‘ends’. My participants appeared to be learning about the attributes of the teacher as social ‘actor’ possessing a range of complex practical behaviours (Molander 1992), which enable him/her to better read and adapt to situations. This type of non-formal learning is best encapsulated in the sub-categories of Art of the Teacher and Versatility and Spontaneity. This learning may be understood as recognising the adaptive expertise displayed by others. Such expertise, encompassing the ability to go beyond the routine and deal with complex changing circumstances (Hatano & Oura 2003; Darling-Hammond & Bransford 2005: Kneebone 2007), is an attribute they learn to recognise and wish to emulate, thus affirming Dewey's principle that good teaching requires ‘not a method but an art’ (cited by Schon 1983, p. 65) and Eisner's (1979) concept of teaching as a form of artistic expression.

Finally, what of differences in learning across settings? In order to address this question I relate back to the two statements which I considered were conducive to an expansive learning environment (Evans et al. 2006): close collaborative working, opportunities for networking outside of immediate environment.

First, to what extent did the three settings allow for close collaborative working? Both GPs and hospital doctors reported low levels of feedback from colleagues with regard to their teaching. The inference here is that there may be room for further opportunities in hospitals and general practices to be observed and have direct feedback from colleagues. In terms of networking opportunities, again the hospital doctors and GPs reported lower levels of networking externally. This may well be an outcome of the fact they are junior doctors fully employed by the clinical task in hand. Networking at external teaching events may thus not be high on the agenda of GPs or hospital doctors. That being said, there was an overall direction to the data here, suggestive of a situation in which those participants centrally placed in medical school may have greater exposure to external activities and non-formal learning from others outside of their immediate environment. It follows that greater networking opportunities may enhance the learning of those less centrally placed, that is, in general practice and hospitals.

Some concluding points

Non-formal learning is a significant aspect of the development of all novice teachers. This small-scale study has begun to map the terrain of such non-formal learning, but further research, in a wider range of settings with increased study numbers, is needed to complete the contours. Research may also usefully focus upon the structure and bureaucracies of individual institutions and the extent to which they can facilitate and hinder non-formal learning. It is important that such learning is maximised and this means placing it firmly on the agenda of work-based mentors, medical educators and novice teachers. Steps should be taken to maximise opportunities for new teachers to observe and be observed, to co-tutor, experience a variety of tasks and network externally. Integral to any such work-based learning agenda must be knowledge of the personal development needs of each individual teacher, together with the scope and requirement of their teaching role. The nature of an individual's motivation towards teaching may lead one to pose different questions about the workplace at different times in terms of its restrictive and expansive dimensions, and maybe to draw different conclusions about how such processes may be enhanced.

Acknowledgements

The study received funding support from the Centre for Excellence in Work-based Learning for Educational Professionals at the Institute of Education, University of London. I would like to thank all the novice teachers who found time in their busy schedules to take part in the interviews.

Declaration of interest: The author reports no conflict of interest. The author alone is responsible for the content and writing of the article.

Notes

Additional information

Notes on contributors

Vivien Cook

VIVIEN COOK is a Senior Lecturer in Medical Education at Barts and the London School of Medicine and Dentistry and Co-ordinator of the Researching Medical Learning and Practice Network at the Institute of Education, University of London

Notes

1. Research conducted at Barts and the London – written up as a thesis in part completion of a Doctor in Education at the Institute of Education, University of London.