A social learning perspective on the development of doctors in the UK National Health Service

How best to develop doctors is a problem for many healthcare systems. The current trend towards competence-based models, especially in UK postgraduate medical education, appears to neglect lessons emerging from social learning theories in the workplace. However, social learning itself, especially communities of practice (CoP), also has shortcomings because it needs to take into account broader social, economic and political factors. Our contribution is to show how an extended version of CoP might shed light on the education and development of doctors by drawing on data from a qualitative interview study of participants’ experiences of three eras of postgraduate medical education. We also make recommendations for further research and practice in this critical field of healthcare.

► Provides new insights into the development of doctors from a social learning perspective.
► Applies a extended version of the notion of communities of practice to the education and development of doctors.
► Draws on qualitative data from ‘trainers’ and ‘trainees’ over three eras of medical education and training in the UK.
► While our findings support the benefits of communities of practice, they also support competence-based development.
► Argues that communities of practice must be extended to take into account political and economic influences.