• J Larsson, I Holmström, E Lindberg, and U Rosenqvist.
• Clinic of Anaesthesia and Intensive Care, Uppsala Academic Hospital, SE-751 85 Uppsala, Sweden. jan.larsson@trolin.net
• Br J Anaesth. 2004 Mar 1;92(3):381-7.

BackgroundTraditionally, programmes for specialist education in anaesthesia and intensive care have been based on lists of attributes such as skills and knowledge. However, modern research in the science of teaching has shown that competence development is linked to changes in the way professionals understand their work. The aim of this study was to define the different ways in which trainee anaesthetists understand their work.MethodsNineteen Swedish trainee anaesthetists were interviewed. The interviews sought the answers to three open-ended questions. (i). When do you feel you have been successful in your work? (ii). What is difficult or what hinders you in your work? (iii). What is the core of your anaesthesia work? Transcripts of the interviews were analysed by a phenomenographic approach, a research method aiming to determine the various ways a group of people understand a phenomenon.ResultsSix ways of understanding their work were defined: giving anaesthesia according to a standard plan; taking responsibility for the patient's vital functions; minimizing the patient's suffering and making them feel safe; giving service to specialist doctors to facilitate their care of patients; organizing and leading the operating theatre and team; and developing one's own competence, using the experience gained from every new patient for learning.ConclusionsTrainee anaesthetists understand their work in different ways. The trainee's understanding affects both his/her way of performing work tasks and how he/she develops new competences. A major task for teachers of anaesthesia is to create learning situations whereby trainees can focus on new aspects of their professional work and thus develop new ways of understanding it.

This article appears in the collection: Decision Making in Anaesthesia & Critical Care.

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