Table 3.

Cultural changes associated with workplace learning

Old think	New think
• Passive listening to lectures	• Active participation in self directed learning
• Educator decides topic	• You decide topic
• Attend continuing medical education course you know most about	• Seek out areas of ignorance and answers to your clinical questions
• Focus is on laboratory research, pathophysiology, drug mechanisms	• Focus is on what works in practice, what to do, problem solving
• Read a journal or textbook	• Carry out problem solving on real or simulated cases
• Education to learn facts, pass exams	• Learning to solve clinical problems, improve team work, clinical and information seeking skills
• Formal, timed courses	• Informal, self directed, learning in the workplace
• Get continuing medical education or postgraduate education allowance points for turning up	• Get continuing medical education or postgraduate education allowance points for participating in workplace learning, using learning materials, improving standards
• Case presentation, journal club	• Work on an educational prescription, write a critically appraised topic, use a clinical simulator
• Competition: keep knowledge to yourself	• Sharing: open learning, exchange of knowledge and understanding to benefit patients and the health system
• Knowledge belongs to the individual. Continuing medical education points accumulate to the individual. Recertify the individual	• Communities of practice: learning is an attribute of the team and organisation and is part of its quality and risk management strategies. Accredit the organisation
• Patients are passive recipients of care	• Patients are sources of questions and insights, learning collaborators
• Errors should be forgotten and denied	• Errors are a learning experience to be treasured, discussed, and understood
• Errors happen to “bad apples”	• Errors happen to everyone