ABSTRACT
Globally, healthcare is facing financial constraints, demographic changes and a need to improve care delivery. In the United Kingdom, the National Health Service must make cost savings (£22 billion by 2020) while adapting the workforce to meet changing care needs (Addicott, Maguire, Honeyman and Jabbal, 2015). The introduction of a non-registered role, the assistant practitioner, is one way that organisations have risen to this challenge. While remaining at work healthcare assistants undertake a two-year work-based learning programme to develop the required knowledge, skills and attitude to be work in a higher level role.
With the introduction of new roles and an apparent paradigm shift within the National Health Service to organisational and personal learning (Moore, 2007) there was, from a health educationalists’ perspective, a need to understand the context of the lived experience of those undertaking a work-based learning programme to ensure that they were fit for purpose. It is this alternative approach to work-based learning where the trainee assistant practitioner remains in the workplace whilst developing the knowledge, skills and attitudes to undertake a new role which was the study’s main driver. This is important as, despite a plethora of information on work-based learning from a philosophical and theoretical perspective (Dewey, 1938; Sennett, 2008; Tennant, 2004) and research studies from the wider world of work and specifically healthcare, there is a dearth of information relating to the lived experience of learners undertaking a work-based programme, especially within healthcare.
While the broad aim of the study was to gain an understanding of the trainees’ personal lived experience, sub-aims wanted to understand how the trainee experienced their journey, what it meant to them and to identify the factors which enabled the journey. Constuctivism (Lincoln and Guba, 1985; Denzin and Lincoln, 2008) allowed understandings to be constructed which related to participants’ perspectives and experiences. The theoretical perspective inherent to constructivism and ultimately the study is phenomenology.
A stepped process of analysis produced three over-arching super-ordinate themes indicating that the transition to assistant practitioner is non-linear and complex necessitating a change in knowledge and behaviour and the workplace culture must enable learning and role development. The concept, an effective journey, was explored through synthesising existing views of the concept. Fusing the lived experience with the literature informed an emerging concept framework of the attributes, enabling factors and expected consequences for describing an effective journey. The framework identifies that learners need to engage in mindful transformational learning experiences and manage the transition process through adjusting, adapting and accommodating to the new role, the learner and their mentor must use the workplace as the main resource for learning and the workplace culture needs to accommodate and learn from the development and implementation of new roles.
