@article{ref1,
title="Education and service: how theories can help in understanding tensions",
journal="Medical education",
year="2019",
author="Cleland, Jennifer and Durning, Steven J.",
volume="53",
number="1",
pages="42-55",
abstract="OBJECTIVES: This paper reviews why tensions between service and education persist and highlights that this is an area of medical education research (MER) that, to date, lacks a robust body of theory-driven research. After carrying out a review of the literature on service-education tensions in medical education and training, we turn to consider how theory can help provide new insights into service-education tensions. <br><br>METHODS: We conducted a search of the literature on service-education tensions since 1998 to examine the use of theory in studies on this topic. <br><br>RESULTS: We identified 44 out of 603 relevant papers. Their focus fell into four broad categories: time residents spent on 'service' and 'education'; perceptions of the balance between service and education; considerations of how best to define service and education, and the impact of structural and systems changes on education/training. Of the papers reporting primary research, the dominant methodology was the bespoke survey. Rarely were the precise natures of tensions or how different factors interact to cause tensions examined in detail. <br><br>DISCUSSION: Through discussion and reflection, we then agreed on the applicability of four sociocultural theories for illuminating some examples of service-education tensions. We present four sociocultural theories: Holland's figured worlds, Kemmis et al.'s practice architectures, Lave and Wenger's situated learning and Engeström's cultural-historical activity theory (CHAT or AT). We describe each and then briefly illustrate how each theory can support new ways of thinking and potential directions for research focusing on education-service tensions. <br><br>CONCLUSIONS: The use of theory in research studies will not resolve service-education tensions. However, what theory can do is illuminate and magnify different aspects of service-education tensions, to generate new insight and knowledge that can then be used to inform future research and changes in practice.<br><br>© 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.<p /> <p>Language: en</p>",
language="en",
issn="0308-0110",
doi="10.1111/medu.13738",
url="http://dx.doi.org/10.1111/medu.13738"
}