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Date of Award

2005

Document Type

Dissertation - Pacific Access Restricted

Degree Name

Doctor of Education (Ed.D.)

Department

Curriculum and Instruction

First Advisor

Marilyn Draheim

First Committee Member

Thomas Nelson

Second Committee Member

Harriett Arnold

Third Committee Member

Richard Brunader

Abstract

Over the years, graduate medical education has changed in order to create learning environments to best prepare physicians. The present system of residency and hospital affiliation was the model adopted to give students opportunities for active learning along with lecture and observation. This study investigated the varied ways residents learn the knowledge, skills, and dispositions necessary for family practice. A within-site case study approach was used since this was a study of peer learning among family practice residents at a single community based hospital in a university affiliated network having an opposed program. A purposeful and typical case sampling strategy was used so that key participants provided information about their experiences with how the peer interactions among residents contributed to learning. The study had a sample of 11 residents progressing through this program and each participant was interviewed twice. Additional data were collected through observations of the morning and teaching rounds, an observation of the orientation session for new residents, and from program requirement documents. Each interview, observation, and document underwent content analysis for the identification of any emerging central themes or patterns and patterns were grouped according to recurring categories. Of particular interest were the themes that flowed from the interview and observation analysis for each resident class and the application of these themes to major learning theories. Matrix displays of themes that emerged between resident classes, of themes within the same resident class, and of the themes demonstrating relevant learning theories were developed and presented. Data analysis revealed themes categorized by learning process, achievement, identity as a physician, competence, and program improvement. The learning process consisted of various strategies, peer interactions, and use of resources. The within class analysis found varying degrees of strategies and peer interactions for each of the classes and the between class analysis found a progression of strategies, skills, achievement, identity, and changing peer interactions. Themes analyzed according to major learning theories demonstrated similarities to activity theory, social learning theory, and communities of practice. This study revealed that peer mentoring, coaching, and learning occurred within the context of a community of practice.

Pages

148

ISBN

9780542000362 , 0542000369

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