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How Professional Education Can Foster Praxis and Critical Praxis: An Example of Changing Practice in Healthcare

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Abstract

Learning is crucial to how professionals enact practices, and to how practices change. Professionals frequently encounter uncertainty regarding what to do, requiring praxis informed by practical wisdom, which takes into account the virtues of practice. Critical praxis takes this further, questioning current norms to reduce untoward effects. A simulation-based education program for healthcare professionals was selected for study due to strong evidence of sustained improvements in handling a rare and challenging birth emergency (shoulder dystocia). Videos of simulations and debrief discussions were analysed in terms of complexes of sayings, doings and relatings. Practitioners learned to respond in agile, collective ways to specific situations, through praxis. An extension to the theory of practice architectures is offered, based on two new concepts. ‘Connective enactments’ involved narration, questioning, and directing actions. These contributed to ‘collective accomplishments’ of fluid role-switching, responsive sequencing and pacing, and producing calm. These new concepts help to theorise how professional education can contribute to practice change by fostering praxis and critical praxis, addressing the architectures that shape practices.

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Acknowledgements

Approval of the study was obtained from the Regional Ethical Review Board in Linkop̈ing (Dnr 2016/177–31). Written informed consent was obtained from the health care professionals involved in the study. The authors wish to thank all participants involved, reviewers for their helpful comments on previous drafts. Our thinking has also been supported by regular discussions of the theory of practice architectures members of the Sydney/Wollongong Pedagogy Education and Praxis (PEP) group, and PEP International.

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Authors and Affiliations

  1. School of International Studies and Education, University of Technology Sydney, Sydney, Australia

    Nick Hopwood

  2. Department of Curriculum Studies, Stellenbosch Universiteit, Stellenbosch, South Africa

    Nick Hopwood

  3. Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden

    Marie Blomberg

  4. Department of Health, Medicine and Caring Sciences , Linköping University, Linköping, Sweden

    Johanna Dahlberg & Madeleine Abrandt Dahlgren

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  1. Nick Hopwood
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Correspondence to Nick Hopwood.

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Hopwood, N., Blomberg, M., Dahlberg, J. et al. How Professional Education Can Foster Praxis and Critical Praxis: An Example of Changing Practice in Healthcare. Vocations and Learning 15, 49–70 (2022). https://doi.org/10.1007/s12186-021-09277-1

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