In at the deep end

18th February 2005 at 00:00
Trainee accountants get plenty of support. Engineers too. But nurses are left to sink or swim. Beth Noakes reports

Qualified professionals probably learn more in their first year or two at work than they ever did at college. But while some professions are structured to support this, in others it is much more haphazard.

Via its teaching and learning research programme (TLRP), the Economic and Social Research Council is funding several projects looking at how learners' skills, attitudes and values develop.

Michael Eraut and colleagues at Sussex and Brighton universities are investigating how accountants, nurses and engineers learn on the job in their first three years. They have found that while the accountancy and engineering professions have systems of organised training support, nurses tend to be left to sink or swim.

"The accountancy firms we've been looking at have a kind of apprenticeship system that works extremely well," says Professor Eraut. "Account-ants often work in small teams on clients' premises and a lot of their learning is from the person about six months or a year ahead of them. There's a kind of scaffolding formed by the nature of the work and the nature of the training."

Engineers also work in teams, with gradually increasing responsibilities, though often on long-term projects where they have little contact with clients and where it can be difficult seeing the broader picture. Many complain of a lack of challenging work. For newly qualified nurses, on the other hand, the work is often too challenging.

"Suddenly they're responsible for very important things," says Professor Eraut. "They're not allowed to be in charge of drugs until they're qualified - then suddenly they are. They have a huge work-load, and very little clue about prioritising. The level of help they get depends entirely on the ward manager and senior nurses. So you can get huge differences between two wards in the same depart-ment, regardless of what the hospital policy might be."

"You're flung in at the deep end, and you have to do it because there's only you," a newly qualified nurse told researchers.

The researchers found that social relationships are vital in all the professions. People learn more from working alongside others and asking quest-ions than from a designated mentor who may not even be on the same shift.

"Someone who is appointed mentor often doesn't know what to do with the role, and doesn't take it very seriously," says professor Eraut. "But local managers can encourage people not only to answer questions themselves but also to divert questions to other people. The trainee has several people to talk to, and the people being asked feel appreciated.'

Nursing faces the greatest challenges, and Prof-essor Eraut says that transforming the learning culture of a hospital may take about five years.

"You can try and turn round two or three wards each year by bringing in people who understand how to develop a learning culture within a ward.

People who train in that context can be promoted into those realms in other wards, so gradually they become self-sustaining. Quick-fire solutions don't work in these situations."

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