This paper is based on a study of medical students’ possibilities of learning in a psychiatry hospital. The study is a part of an ongoing Ph.D. Project about the education of medical students and doctors in psychiatry and the use of video as a supplementary learning tool to the traditional training at the ward. The Ph.D. Project is founded on ethnographic methods and runs from spring 2016 to spring 2019.

The focus of this paper is apprenticeship, situated learning and the use of video as a supplementary tool for during medical students’ placement at the psychiatry hospital.

Research question

 How does the video library work in the real life setting of clinical psychiatry and how does the video library supplement the training of medical students at the psychiatric hospital? How will the implementation of the video library affect the overall context of learning in psychiatry?

Background

A decrease in numbers of inpatients, a growing conflict of time and demands and a shortage of doctors have become a challenge to the quality and the possibility of learning in the health sector. This is also the case in the field of psychiatry ( Holm-Petersen et al., 2006, Varma et al., 2012), in which the core concepts are known to be highly complicated, hard to understand and less tangible, than many somatic syndromes (Chur-Hansen, 2005, Parnas, 2013).

Psychiatry is a mandatory part of the medical education at the University of Copenhagen and the psychiatry module runs for four weeks. One week is structured as traditional academic lectures and three weeks are structured as a placement at a psychiatric hospital varying between apprenticeship and group lessons. The shortage of senior doctors in psychiatry and a management focus on efficiency challenges the apprenticeship. For some students it means idle time waiting for doctors to take the student along or to give the student feedback.

Studies shows that videos used in learning situations at hospitals have a great potential, that videos can fixate non-verbal communication and can help to break down the complex to less complicated parts and to take a closer look at signs and symptoms(Hammoud, 2012¸Muench, 2013, Roeske, 1979). We have earlier tested videos with medical students while they were at their placement in psychiatry (Fog-Petersen, 2014).  The students requested video clips of symptoms, interview situations ect. To meet these requests we created a library with videos of patients and a short description of the patient as well as a mental status examination. We are using the same video library for both medical students and doctors in psychiatry.

In the study the definition of apprenticeship is inspired by the theory by Lave and Wenger, who define the main elements of learning in apprenticeship as social interaction and collaboration. With the concept, situated learning, Lave and Wenger points out social relations as the essentials components for learning (Nielsen,2003, Lave, 1999, Lave 2003). Lave and Wenger’s thoughts will be related to Dewey’s ideas about learning by doing. Furthermore understanding of the principle of progression of apprenticeship in the project is based on Dreyfus’ concepts and models for skill acquisition(Borgnakke 2005, Borgnakke 2013). Dreyfus’ models describe the progression of learning through a series of levels from the stages of a novice to the stage of an expert. Though Dreyfus´ models are useful for basic descriptions, the reality is expected to be far more complex and learning progression to be what is happening in oscillation between the planned goal for learning and the practice of real life.

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