Developing Professional Competence: lessons from the emergency room

This article begins by reassessing the nature and value of practice-based l earning in the health professions. The role and status of work-based learni ng are then examined in the context of recent policy developments in the fi eld of health care. The authors report the findings from a 1-year qualitati ve study, of clinicians' perceptions of the workplace as an environment for learning, funded by the Scottish Council for Postgraduate in Medical and D ental Education (SCPMDE). Focusing in particular upon ill-depth interviews with junior and senior clinicians in two hospital specialties, they explore the process through which novice clinicians become part of a 'community of practice', and their senior colleagues continue to learn in an environment which poses fewer professional challenges. Finally, the implications for t he development of competent professionals are discussed.