Can the tools of activity theory help us in advancing understanding and organisational change in undergraduate medical education?

Continued changes to healthcare delivery in the UK, and an increasing focus on patient safety and quality improvement, require a radical rethink on how we enable graduates to begin work in challenging, complex environments. Professional regulatory bodies now require undergraduate medical schools to implement an 'assistantship' period in the final year of study, where senior medical students 'shadow' the work of junior doctors, with an expectation that they will be better 'prepared' for work. However, there is little guidance about what an 'assistantship' entails and the current emphasis on preparedness of students arguably underplays the importance of contextualised learning within the workplace environment.

Developing understandings of clinical placement learning in three professions: work that is critical to care.

Background: This study contributes further evidence that healthcare students' learning is affected by underlying assumptions about knowledge, learning and work.

Aims: To explore educators and students' understandings of early clinical placement learning in three professions (medicine, nursing and audiology) and examine the profound impacts of these understandings on students' learning and healthcare work.

Methods: Narrative interviews were undertaken with 40 medicine, nursing, and audiology students and 19 educators involved in teaching these student cohorts.

Predicting low back pain outcome following rehabilitation for low back pain.

Background: Psychosocial factors are known to play a key role in determining the progress of back pain patients. However, it is not known whether these factors are applicable to military personnel, who tend to be fitter than the general population.

Objective: The aim was to identify physical and psychological predictors in a prospective study of the outcome of back pain rehabilitation over 6 months and a longer follow-up time of between 15 and 32 months.