Complexity or meaning in health professional education and practice?

Objectives: Discourses of complexity have entered health professional education. This paper explores the meaning of complexity by asking how health professionals are educated and some of the consequences of that education. Design: A qualitative study was carried out drawing on reflexivity, discourse analysis and grounded methodology. Setting: Two rural healthcare settings in Western Australia. Methods: Seventeen health professionals were interviewed using semi-structured open-ended questions based on a theoretical framework developed from the analysis of three case studies of education in healthcare practice. The interview responses were transcribed then analysed. Themes were identified using an iterative process of reflexivity. Narratives of health professional identity were explored within the context of health professional education. Results: The responses from the participants indicated that they managed discourses of autonomy, control and empowerment alongside their own narratives of passivity and powerlessness. Management of different discourses seemed to make other discourses recede. For example, reference to broader issues such as race, gender, ethnicity, socioeconomic determinants of health and age were minimal. Conclusions: Health professional education discourses could be seen as obscuring broader issues that impact on healthcare practice. Health professional curricula occupy a privileged location within society and as such need to provide a socially accountable practice. Ways to develop socially accountable practices are explored within the context of the widening gap between disadvantaged and advantaged people on a global level.