Peer-Reviewed Journal Details
Mandatory Fields
Johnston, JL;Bennett, D
2019
January
Medical Education
Lost in translation? Paradigm conflict at the primary-secondary care interface
Validated
Optional Fields
GENERAL-PRACTICE GP TRAINEES QUALITY
53
56
63
Context Historically, primary care (community and family) medicine has often been viewed as lower status than secondary care (hospital) practice. Current evidence suggests this pattern continues to impact medical practice and education. Medical education has however, yet to fully reflect this power dynamic, with undergraduate training in many institutions maintaining the hegemonic position of secondary care as the prime context for learning. Methods In this paper, we present primary and secondary care as conflicting paradigms of medical practice. Using a sociocultural lens drawing on Figured Worlds theory, implications for medical education are explored. Conclusions We outline the two paradigms as having distinct epistemologies, identities and practices. Tensions at the primary-secondary care interface can, from a sociocultural perspective, be seen to impact developing identity and day-to-day clinical practice issues such as patient safety. We offer possibilities for engaging with paradigm conflict in meaningful ways and suggest potential changes for future educational policy and practice.
HOBOKEN
0308-0110
10.1111/medu.13758
Grant Details