Abstract:
Background: The Apprenticeship Model has been successfully employed by generations of teachers over many years, in many professions, including medicine, with the added benefit for students of the mentoring and modelling that is inherent in such an approach. The Apprenticeship model then largely fell out of favour in medical schools in more modern times, with a shift towards institutional and self-directed learning. However, with changes in educational thinking, particularly related to workplace learning, the Apprenticeship Model has seen a renaissance in approximately the last twenty years, but with considerable modifications, thus defining what has become known as the Cognitive Apprentice. Under the Cognitive Apprenticeship, no longer is student learning passively, but under an expert‟s guidance and facilitation - the student develops skills to direct their own learning, making them more involved in their own education process. Purpose: The aim of the study was therefore to research the understanding, in both senior and junior doctors, of the Apprenticeship Model in teaching and its perceived value as a teaching method, both relating to clinical and professional aspects of training. A secondary aim was to assess the knowledge of best practice in teaching and learning, with particular reference to the modern Cognitive Apprenticeship. Methods: Ten consultant doctors of varying experience and seven house surgeons and registrars were interviewed and answered specific questions relating to the Apprenticeship Model and also had an opportunity to talk freely in relation to clinical education. The primary aim of the interviews was to explore the utility of the Apprenticeship Model and to derive themes that might help or hinder the successful performance of clinical training via this model. Initially responses, from all participants, to each question were analysed and coded so that participant understandings and thoughts regarding the Apprenticeship Model could be clearly presented. Subsequently, the General Inductive Technique, as developed by Professor David Thomas, was applied to the transcripts to ensure meaningful themes could be derived. Results: Both senior and junior doctors interviewed thought there was considerable value in the Apprenticeship Model of teaching, particularly when compared to institutional teaching. There were caveats relating to curriculum development and the quality of both mentorship and teaching, which however related more to the older passive Apprenticeship Model than the newer and more dynamic Cognitive Model. Several recommendations were drawn from these results, including those related to short, medium and long term timeframes, describing the commitment needed from hospital boards to formally support and promote the Cognitive Apprentice model in their organisations. Conclusion: Although the Apprenticeship Model was considered of value in clinical teaching, the development of the Cognitive Apprenticeship, in which the student must play a much greater part in their own education was ill understood and not highlighted by seniors or junior doctors. Even more disturbing, no comments were made by either group in relation to the value of the old model as it applies to improving student and patient education and surprisingly patient care. The omission clearly indicates more research and explanation are required to fully understand the value, application and understanding of the Cognitive Apprenticeship model.