Abstract
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.
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.
Original language | English |
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Pages (from-to) | 56-63 |
Number of pages | 8 |
Journal | Medical Education |
Volume | 53 |
Issue number | 1 |
Early online date | 15 Nov 2018 |
DOIs | |
Publication status | Published - 01 Jan 2019 |
ASJC Scopus subject areas
- Education