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The Capital Region of Denmark - a part of Copenhagen University Hospital

Praktikuddannelse, kendte og miskendte sider: observationsstudie af praktikuddannelse indenfor sygeplejerskeuddannelsen

Research output: Book/ReportPh.D. thesis


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The dissertation focuses upon practical training investigated within the area of nursing education. The study is inspired by P. Bourdieu's sociology and by the work of  M. Merleau Ponty and L. Wittgenstein. It uses direct, non-participatory, objectifying relational observation and interviews and applies a continuing and comparative perspective. Construction of object, hypotheses, focus areas and observation categories and exploratory work is also carried out. Doxa within practical training, represented by the Dreyfus brothers' learning theory and secondarily the work by Donald Schön and critical theory, is investigated, discussed and supplemented. Observations over a period of  eight months, including tape recordings "in action", focus especially on eight nursing students during their practical training periods on patient wards in two large hospitals in Copenhagen, Denmark. Data from the theoretical section of the classroom teaching as well as from diaries, evaluation discussions etc. are included.

The conventional idea of learning (from teacher to student, from idea to action, etc.) can only partly be confirmed. It is a strongly accentuated and overestimated dimension of what practical education is about. This conventional wisdom, via its ideological construction, fails to understand that practical training can also be documented to take place via other types of teachers­, in other ways and with other patterns of orientation for the person undergoing their education training.


  • Education enters as part of the family's conversion strategies to acquire or maintain capital, and the education system contributes only some technical knowledge but a far greater portion of social effect. The students perceive themselves to be and are seen as "novices" and lacking in knowledge, but in the hospital ward they are fundamentally preadapted to function in the medical field. Despite "lack" of theory, teachers, a limited overview and compulsion to act, the students generally succeed in generating an adequate practice. The professional universe which must be acquired, carries with it a structure that corresponds with the students' internal structure. It is characteristic that the professional knowledge is mainly transferred practical rather than via explicit verbal transmission.
  • The study can not confirm a genuine sequence, viewed as a linear development to the better. In the initial phase the students find themselves and are oriented "externally", i.e., in the patient wards toward the patient as physical body. In the final phase the students find themselves and are oriented "internally", in the office landscape and towards management. This process is described as two partly opposing types of professional activity and knowledge.
  • The study can not confirm differences in materialized practice which can refer to the officially expressed differences in pedagogy in the two nursing schools (subject division /

project oriented). Practical training in the hospital functions according to a medical and administrative logic. It is not the "learner" who is "in control" and the students act enmeshed within an always, already "ongoing" system having other premises. The students rather act submerged within this system, than they try to implement theory, act critically, reflect, learn, etc.

The students acquire professional knowledge via the interwoven bodily dialogue with architecture, tools and artifacts. The architecture via arrangements, installations, furniture and smells etc. places a ‘track' for professional action in various rooms which "trigger" what can then be articulated verbally and how it can eventually be "reasoned out loud" in the room.

  • The students experience to learn from legitimate masters and modes of learning, but in addition to learning via the architecture they especially learn "from below": from other students, social and health care assistants and from the patients. Practice operates via a mutual professional "back up" master system (not one personified master). The system is rather directed toward solving work tasks than educational questions.
· In the work of acquiring professional capital, the students, especially in the initial phase, are fundamentally and not consciously oriented towards avoiding making mistakes. This is a case of compromising oneself, the patients and others as little as possible. Habitus guides a seeking and defensive practice on the basis of a principle of caution. Strategies consist of asking the right questions in the right place and way, showing one's ignorance instead of doing it verbally, asking "downward" rather than "upward", doing "anything whatever" rather than being excluded from professional relations, etc.
Original languageDanish
Place of PublicationKøbenhavn
Number of pages332
ISBN (Print)87-90769-01-5
Publication statusPublished - 2000
Externally publishedYes

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