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Supporting laboratory professionals in low- and middle-income countries to learn about antimicrobial resistance on the job

Koula Charitonos

Professionals working in laboratory settings in low- and middle-income countries (LMICs) undertake a range of tasks in their day-to-day jobs. These tasks range from collecting patient specimens to performing specialised tests, communicating results to clinicians and ensuring adherence to quality standards. Having the opportunity to visit a number of laboratories – spanning human health to animal health and food safety – and to talk with professionals in three LMICs over the last few months, we were often reminded of complexities within public-health system structures in LMICs, the demands of the laboratory role, but also a prevailing ethos of care that laboratory professionals share for patients and their communities. In our work at the Open University we aim to explore what is involved in learning on the job in today’s professional settings, and expand our thinking about how this can be supported with appropriate learning designs and use of educational technology. We also seek to consider how professional practice and roles in public-health facilities could be reconfigured in light of the emergence of the global challenge of antimicrobial resistance (AMR) which will imminently bring changes in work practices in laboratories in resource-limited settings engaged in AMR Surveillance.

‘Research on technology-enhanced professional learning requires further and closer examination: learning often takes place in on-the-job settings that are dynamic and cross boundaries within and between organisations and networks.’

Prompted by the urgent need to find ways to tackle the complex issue of AMR alongside a wider discourse about rapidly changing working life and the availability of more sophisticated technology tools, research on technology-enhanced professional learning (Littlejohn & Margaryan, 2013) is a field of interest that requires further and closer examination. As educational researchers we know that learning does not always occur in stable and well-bounded situations: it often takes place in on-the-job settings that are dynamic and encompass crossing boundaries within an organisation or between organisations and networks.

Previous studies suggest a shift from learning job-specific skills towards learning general skills applicable in various contexts. They also recommend expanding the focus of workplace learning from individuals towards collaborative and networked forms of learning, also taking into account the dynamics of work activity (Gold & Bode, 2017; Hager, 2011). For example, by investigating how laboratory professionals learn to perform ‘surveillance’ through various learning approaches such as reflective guided activities, online science laboratories and facilitated interactions with networks of experts and other practitioners, we can review the effect these approaches have on learners’ work practice and discuss emerging issues on supporting professional learning in resource-limited settings.

In collaboration with partners from the UK and overseas, a team from the Professional & Digital Learning Research group at the Institute of Educational Technology and the International Development Office at the Open University is looking to address some of these challenges. The first phase of our work (April–December 2018) in this four-year project focussed on a collaborative co-design approach aiming to synthesise knowledge and develop an in-depth understanding of the characteristics of the laboratory setting as a knowledge-intense learning environment. We identified the various roles within laboratory settings and traced their working relationships with other professionals in public-health facilities. We paid particular attention to current forms of work practice in AMR surveillance and forms of professional learning that are used to build capacity, as well as the different ways in which technology is used to support professional practice, in this context.

Our analytical approach focussed on performing a thorough mapping of knowledge and skills gaps, specific to AMR, to be addressed through learning. It integrated interview transcripts (with laboratory professionals, policymakers and experts on AMR), fieldnotes and data from site observations. Our work proposes that these skills and knowledge gaps need to be dealt with collaboratively in specific work contexts, alongside a reshaping of work activity. Equipped with this analysis, we can now continue to refine our approach and work towards a principled view of technology-enhanced professional learning, arguing that advancement of knowledge and skills through training programmes will not itself be sufficient to tackle AMR in an effective way. This is critical, and will ensure that professionals in public-health facilities have the opportunity to learn the skills and knowledge they need to work effectively, and that they are supported in work environments in which existing and emerging practice in the AMR landscape are better understood and defined, and where technology can enable new working relationships between professionals.


References

Gold, R. & Bode, E. (2017). Adult Training in the digital age (Economics Discussion Paper No. 2017-54). Kiel: Kiel Institute for the World Economy. Retrieved from https://ideas.repec.org/p/zbw/ifwedp/201754.html

Hager, P. (2011). Theories of Workplace Learning. In M. Malloch, L. Cairns, K. Evans, & O’Connor, B. N. (Eds.), The SAGE Handbook of Workplace Learning (pp. 17-31). London: SAGE.

Littlejohn, A. & Margaryan, A. (Eds.) (2013). Technology-enhanced Professional Learning: Processes, Practices, and Tools. Abingdon: Routledge.