Wednesday, 4 July 2012

Activity 8: Learning Theory

Situated learning, communities of practice & Positioning Theory
I have really enjoyed revisiting the LCL theoretical content, and applying it to my FL situation. At the time I was quite connected to the theory of andragogy (Knowles,1989) which contends that adult learners have their own perspectives and experiences to bring to their learning, are motivated and goal-oriented and therefore can practically apply their knowledge to new learning experiences. As I clicked around a bit more within the Theory into Practice Database, I was reminded about Situated Learning Theory and the idea of ‘communities of practice’.

‘Communities of practice’ have been described as “groups of people who share a concern or a passion for something they do, and learn how to do it better as they interact regularly” (Ewenger, 2006) and this idea resonates strongly within the midwifery literature. Rogers (2010) describes how interprofessional learning (IPL) gives student midwives a strong sense of who their own ‘community’ is within a multi-disciplinary setting, and explores the benefits of the sense of belonging, reaffirmation of the midwifery role and socialization students identified by being exposed to different disciplines and their processes. Social interaction and context are important parts to the jigsaw of knowledge construction, and situated learning concept of new practitioners learning in context alongside experts fits neatly with a midwifery worldview that is based on partnership and equity. In our case, the ‘expert’ is not only the experienced midwife, but also the pregnant woman, who brings her expertise about her body and her own previous experience into the student’s learning context.
Second year midwifery students learning about antenatal screening options are required to ‘engage’ on a number of different levels; learning the ‘facts’,  and the theory underpinning why screening programmes exist, and the critique attached to this. They are required to reflect on their own experiences of screening, and their philosophical views in relation to screening (is it thinly-veiled eugenics? Is it empowering for families to have access to knowledge about their babies? etc) and thus become culturally competent to provide care in the screening context. The way they learn about screening is multi-faceted, to meet the needs of their differing learning orientations, as elements of all four (behaviourist, cognitivist, humanist and situational) orientations can be discerned among our learners. They demonstrate surface learning by describing what screening tests are available, and when they are offered etc, but as they move into practice contexts deep learning becomes apparent as they are enabled to have meaningful informed choice discussions with women and their families about screening options.
Thinking about how ‘present’ the students are in this learning process led me past situated learning and communities of practice (which are undoubtedly elements of ‘how it works’ for them) but I uncovered an article which really made me prick my ears up, as it seemed to more fully capture the nature of our students’ experiences. Let me explain…
Positioning theory applied to midwifery education moves beyond the idea of reflective practice being a way of assimilating and making sense of experience in order to create new understanding (knowledge) and focuses more closely on the ‘conversations’ that are socially situated and constructed, and which lead to learning-in-context (Phillips, Fawns & Hayes, 2002). As mentioned, the students not only learn from books etc, and from midwives as they discuss/debrief practice experiences, they are also fully engaged with the women they are providing care to, and so these conversations (and the women’s knowing and experience) also contribute to the student’s learning. Positioned as women (as all our students currently are) and (for many) as mothers, and as learners, all parties to these ‘social conversations’ can explore a deeper conversation in relation to antenatal screening, in which the student midwife and the woman (and the precepting midwife) share their understandings and create a learning environment that is reciprocal. This links back to surface and deep learning too, as the student learns the technicalities around screening, but in a value-laden context honouring the woman and what she brings, and thus deep learning occurs in this space also as connections are made that solidify the concepts of partnership, professionalism and informed choice and consent.
Ewenger, (2006). Communities of practice: a brief introduction. Retrieved from
Knowles, M. (1980). The modern practice of adult education. New York: Adult Education Company.
Phillips, D. Fawns, R. & Hayes, D. (2002). From personal reflection to social positioning: the development of a transformational model of professional education in midwifery. Nursing Inquiry 9(4) 239-249.
Rogers, K. (2010). Exploring the learning experiences of final-year midwifery students. British Journal of Midwifery 18(7) 457-564.


  1. I am also a fan of situative learning design, and this along with positioning theory would work well in your teaching context. How could students safely share some of these conversations with the rest of the class? it is not going to be an option to be open on this one so a safe and trusting community of practice setting is going to be needed.

    Etienne Wenger is the Community of practice author you refer to - not ewenger as cited.

  2. Our SPF (student practice facilitator) group structure provides students with a safe space for debriefing their clinical learning experiences. In first year, I meet with my seven students once a week for four hours: usually half the time is spent practicing midwifery skills, and the rest is devoted to student-led conversation about practice experiences. The second years meet oncea week for three hours with me, and the structure and content are the same.

    These conversations are great opportunities for the students to support and encourage one another, to contribute positively to one another's learning by sharing what their own experiences may have been of the same clinical issue, to have me be able to assist them to make sense of a clinician's clinical judgment and to point them in the direction of learning resources which could further their understanding. we have well-established and onserved ground rules: confidentiality being the main one. No-one ever uses the name of the woman or the practitioner - they say 'the midwife' or 'the obstetrician'always - to protect the people involved. The students are highly reflective about what they have learned from the experience, especially in relation to how they could have done things differently, but we do strongly focus on what they have done well too!