Professionalism: Tension Field of Learning During Dental Education

Objectives:
To explore dental students’ views on what influences development of professionalism
Methods:
The study was sited at an inner-city UK dental school, linked to an extensive network of the dental school and outreach clinics. Six focus groups were conducted: one for each of the five years of study in the Dental Education programme and one mixed year group. Data collection was guided by Social Constructionism. The data analysis began with a preliminary inductive thematic analysis, which was compared to theories of learning: the Illeris’ model of learning (2004) was identified as offering an appropriate theoretical lens. Ethical approval for the study was obtained from the ethics board (QMREC2011/93).
Results:
Forty-eight dental students participated. Analysis revealed three major themes: curriculum content, learning experiences which generated emotions, and the behaviours of individuals in the clinical environments.
Content: Students discussed the impact of teaching of professional ethics, communication skills and clinical care of patients as important.
Emotions: Students had constructive and adverse experiences which triggered powerful emotions and helped develop their understanding of professionalism.
Environment: The behaviour of individuals in clinical environments affected students’ development. Students identified inspirational role models, however some experienced belittling behaviours and attitudes which affected confidence. An unanticipated finding was the role of patients as mentors in the development of professionalism.

Conclusions:
A theoretical and multidimensional model of learning described by Illeris (Illeris, 2004) offered the basis for scrutiny of the development of professionalism, since the model considers the interplay (termed a ‘tension field’) of curriculum content, the learners’ psychological emotions, as well as the social environment in which learning occurs. The students’ engagement in these multiple interactions generated a creative tension field which stimulated learning of professionalism.