Keele Research Repository

Authentic early experience describes new medical students undertaking ‘human contact in a social or clinical context that enhances learning of health, illness or disease, and the role of the health professional’ (Littlewood et al. 2005). This thesis provides three original research contributions: a critical analysis of the application of socio-cultural and educational theories to authentic early experience; empirical data addressing two inter-related research questions; ‘How and why do students construct useful knowledge and meaning-making from authentic early experience?’ and ‘How and why do students make authentic early experiences work for them?’; and an interpretation of social processes and resultant consequences embedded in authentic early experience. Multiple theoretical perspectives were used to create a framework incorporating mixed qualitative methods. Scott’s concept of Mētis (1998) guided interpretation of not only how students created meaning but also when and how they chose to use it, and value it, relative to formally recognised knowledge. The study identified six specific findings which provide understanding of the complex consequences arising from authentic early experience. (1) Faculty and placement provider expectations of students were simultaneously too high and too low. (2) Dynamic social interactions are fundamental to meaning-making and knowledge construction (which are inextricably intertwined with identity evolution). (3) Social processes influencing authentic early experience can be described through dyads of variables which form intersecting workplace and educational spectra. (4) A holistic social view identifies unpredictable and unintended consequences of authentic early experience. (5) Students do not align the locus of ‘real learning’ with the locus of ‘real practice’. (6) Students create their own Mētis which crucially includes understanding about how to handle knowledge and meaning and how to make experiences work for them. The implications and potential applications of these findings are discussed.