BackgroundTo prepare medical students for the growing population of older patients, an appropriate professional identity formation is desirable. The community of practice of medical school is... Show moreBackgroundTo prepare medical students for the growing population of older patients, an appropriate professional identity formation is desirable. The community of practice of medical school is primarily hospital-based and disease-oriented which will lead to the development of a physician who is mainly focused on cure. This focus alone however is not always appropriate for older persons' health care. The aim of this study is to explore the influence of participating in a nursing home community of practice on the professional identity formation of medical students.MethodsA qualitative study based on a constructivist research paradigm was conducted, using individual semi-structured, in-depth interviews and a visual narrative method (drawing) as a prompt. Thematic analysis was applied to structure and interpret the data. The study population consisted of fifth-year medical students participating in a six-week nursing home clerkship. Thirteen participants were purposefully sampled. The clerkship took place in nursing homes in the South-West of the Netherlands.ResultsThe medical students described the nursing home as the living environment of the patients. Actively participating in the patients' care and experiencing the daily life of the patients was meaningful for the physician the students want to become in five ways: (1) a physician with a complete picture; (2) a physician who is close; (3) a physician who is in dialogue; (4) a physician who is able to let go and (5) a physican who collaborates.ConclusionsCaring for older patients in the nursing home influences the professional identity formation of medical students. Patient-centeredness, personal, holistic and tailored care, approachability and collaboration are important characteristics in becoming a physician for older persons' health care. The context of this care provides relevant learning experiences for this development and the becoming of a physician in general. Show less
This dissertation takes a technological approach to ceramic production and provides a fine-grained view of the circum-Caribbean region. It discusses the usefulness of the chaîne opératoire... Show moreThis dissertation takes a technological approach to ceramic production and provides a fine-grained view of the circum-Caribbean region. It discusses the usefulness of the chaîne opératoire methodology, together with the community of practice theory, as models to potentially explore questions related to the boundedness and cultural relations of peoples during the precolonial, colonial and postcolonial periods. Each chapter tackles diverse aspects of the manufacturing process, from the procurement of the raw materials to the forming stage and provide different cases of how methodologies need to be tailored to answer specific research questions. Geochemical and petrographic analysis combined with macro and micro-observations of the ceramic materials from different sites in Nicaragua, Haiti, Dominican Republic and Puerto Rico clarify the human-environment interactions and socio-cultural aspects of communities in precolonial times, and during the colonial and postcolonial periods. Show less
By focusing on the agroecological farmers’ market of Menino Deus in Porto Alegre, Brazil, we explore how counter-hegemonic narratives and forms of knowledge are cultivated in such arenas. Informed... Show moreBy focusing on the agroecological farmers’ market of Menino Deus in Porto Alegre, Brazil, we explore how counter-hegemonic narratives and forms of knowledge are cultivated in such arenas. Informed by theories of practical knowledge as well as theoretical debates over ethics and politics of local food, we regard the farmers’ market as a community ofpractice, where direct food procurement is a social relation entailing situated identity- construction, mutual enskilment, and political negotiation. The analysis is based mainly on ethnographic fieldwork conducted in Porto Alegre between March and June 2016, which included participant observation and semi-structured in depth interviews at the market of Menino Deus. The paper elaborates on the three above-mentioned dimensions (identity- construction, mutual enskilment, and political negotiation) as central, parallel processes that take place at the market, making it an arena for debate over agri-food standards where local food, nutrition security and social justice are redefined and promoted. We highlight linkages between farmers’ histories, visions, modes of production, and the governancemechanisms, enskilment processes and other activities at the market. In this way, we suggest that in this community technical aspects of procurement are re-embedded in the social domain and translate into new ways of life and visions of the future. This paper attempts to link reflections on the market place context, skill acquisition, and collective meaning negotiations, in order to contribute to the debate on local food as emancipatory project. Show less