Making connections is my work in this thesis, to create a feminist affirmative diffractive reading of how practices and learning'in medical work come to matter for patient safety: a policy 'special issue'. There is a burgeoning patient safety research literature, with increased attention to medical staff working in teams, and learning to work collaboratively to improve safe practices. However, no feminist work has examined critically either patient safety discourses nor learning and practice of medical staff in specialist training who move between established collaborative teams and practice communities. I do both. My approach is a feminist interdisciplinary account of relations between learning, participation, and patient safety, and draws on ethnographic data with a female specialist GP trainee and a male specialist trainee in radiology. I consider their learning of medical work, to indicate how insights from their practices and experiences highlight some limitations of patient safety discourses. I question the discourse on eradicating errors, suggesting this forecloses iii opportunities to consider how such things as caring, tinkering, interfering, or ignoring protocols can also produce safety. I detail how situated practices can be in tension with policy. I focus on sites where gender and race can intersect with practice and learning, challenging persisting hegemonic practices and andronormativity within medical work. I consider and address the lack of attention in Situated Learning Theory {SLT} to non-human actors. I make an affirmative contribution to SLT's application in complex organisations by developing further the concept of legitimate peripheral participation {LPP}. I suggest a new concept - reciprocating participation - to draw attention to specificities of LPP in medical work and learning. I show the utility of agential realism for interdisciplinary analysis of healthcare practices and policies, and the continuing need for feminist interferences in dominant NHS discourses that overlook or erase axes of difference.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:660120 |
| Date | January 2011 |
| Creators | Dudley-Swarbrick, Irene Lorraine |
| Publisher | Lancaster University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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