‘Doing the Portfolio’ – Pre-registration training for biomedical scientists and developing the capable practitioner

Abstract

Integration of work-placements into undergraduate degrees is now established on awards linked to professional registration in healthcare. Pre-registration training forms the basis for development of capability and entry onto a professional register. This enquiry explores how key stakeholders on a programme leading to registration as a Biomedical Scientist (BMS) position themselves in their role and the subsequent impact of this upon the development of the capable BMS. It draws upon current knowledge of work-based pedagogy and utilises a constructivist grounded theory (CGT) approach to explore the perceptions and experiences of individuals and groups to develop an interpretative portrayal and deeper understanding of the implementation of pre-registration training in one region of England. Data gathering and analysis was divided into two stages. The first employed analysis of professional documents to provide an insight into current discourses around BMS training. This provided initial developing categories and directed the creation of a questionnaire. Questionnaire responses confirmed the relevance of the developing categories and a summary of responses provided an ‘ice-breaker’ to guide stage two of data gathering. This stage employed focus groups and interviews to enable a greater understanding of how individuals make sense of their experiences. Initial, focused and theoretical coding allowed synthesis and conceptualisation of the data gathered and presented direction for the enquiry. The findings expose the challenges of integrating professional registration training into an academic programme of study. Three theoretical categories were identified: Role conflict, Expectations and Ownership. Conceptualising the interactions and intersections of these categories enabled the recognition of ‘Doing the portfolio’ as a way of describing and conceptualising the stakeholders positioning within the current programme. The registration portfolio has become an objective reductionist measure of learning, reflecting the positivist typology of practice in this profession. This provides a theoretical explanation as to how the programme is delivered and why there is a need to rethink conceptualisation of the role of the programme in supporting pre-registration training and the development of the capable BMS. To ensure that BMS students are supported to develop not only technical skills but also professional capability there is a need for a paradigm shift from a positivist episteme to one that embraces both the positivist and socio-cultural paradigms, viewing them as complementary and parallel. The novel research approach used in this enquiry has generated rich insights into how stakeholders interact with the pressures of internal and external influences and the impact this has upon behaviours and strategies adopted. The theoretical understanding proposed, which recognises the tensions emerging from a positivist typology of practice, has a range of implications for practice and for the development of practitioner capability through pre-registration training and beyond.