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2011 | 12 | 39-55

Article title

LEARNING BEHIND CURTAINS - BECOMING HEALTH CARE ASSISTANTS IN SWEDEN (Uczenie sie 'za zaslona' - o stawaniu sie opiekunka medyczna w Szwecji)

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Health care assistants are the most common occupation for women in Sweden. Yet, facts about their learning and occupational identities are quite unknown. The aim of the paper is to deepen the understanding of how health care assistants learn their occupational identities in daily work. In the theoretical framework, the interrelationship between learning and occupational identity are elaborated on. The resulting findings come from case studies of four wards at two hospitals and are based on interviews and self-observations provided in the form of diaries. The results show that the health care assistants' occupational identity is weak when compared to other professional groups, yet strong in sharing the same orientation towards patients. Moreover, the identities are learned at work, where registered nurses and physicians are of great importance to this process. Previous life and work experiences seem to have an impact on health care assistants' motivation to learn in formal settings but learning in formal settings also seems to be crucial for learning in daily work. Four contradictions have been discussed as the potentials for developing the occupational identities: formal versus informal learning, adaptive versus developmental learning, formal versus informal legitimacy and weak status versus strong identity. My conclusion is that assistant nurses seem to learn how to do things they do not talk about, while talking about things they can but are not allowed to do. They learn how to adapt to the informal order by reproducing the formal one, which leads to their learning behind the curtains.






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  • Camilla Thunborg, Stockholms Universitet, Pedagogiska institutionen, Frescativagen 54, 106 91 Stockholm, Sweden.


  • Billet S., Learning through work. Workplace participatory practices, [w:] Workplace Learning in Context, red. H. Rainbird, A. Fuller, A Munro, London 2004.
  • Billet S., Work, Subjectivity and Learning, [w:] Work, Subjectivity and Learning. Understanding Learning through Working Life, red. S. Billet, T. Fenwick, M. Somerville, Dordrecht 2006.
  • Bourdieu P., Outline of Theory and Practice, Cambridge 1977.
  • Bruner J., The acts of meaning, Cambridge 1990.
  • Burkitt I, Social Selves. Theories of the Social Formation of Personality, London 1999.
  • Collin K., Work-related identity in individual and social learning, “Journal of Workplace Learning” 2009, vol. 21, nr 1.
  • Ellström P.-E., The two logics of learning, [w:] Learning, Working and Living. Mapping the Terrain of Working Life Learning, red. E. Antonacoupoulou, P. Jarvis, V. Andersen, B. Elkjær, Høyrup, London 2006.
  • Emanuelsson A., Pionjärer i vitt. Professionella och fackliga strategier bland svenska sjuksköt- erskor och sjukvårdsbiträden, 1851-1939, Stockholm 1990.
  • Engeström Y., Learning by Expanding. An Activity Theoretical Approach to Developmental Research, Helsinki 1987; idem, Activity theory and individual and social transformation, [w:] Perspectives on Activity Theory, red. Y. Engeström, R. Miettinen, R-L Punamäki, New York 1999.
  • Fenwick T., Learning in portfolio work: anchored innovation and mobile identity, “Studies in Continuing Education” 2004 , vol. 26, nr 2.
  • Fenwick T., Tidying the territory: questioning terms and purposes in work-learning research, “Journal of Workplace Learning” 2006, vol. 18, nr 5.
  • Fuller A., Unwin L., Expansive learning environments. Integrating organizational and personal development, [w:] Workplace Learning in Context, red. H. Rainbird, A. Fuller, A. Munro, Lon- don 2004.
  • Giddens A., The Constitution of Society. Outline of the Theory of Structuration, Cambridge 1984.
  • Goffman E., The Presentation of Self in Every Day Life, New York 1959.
  • Gustafsson R.Å., Traditionernas ok. Den svenska hälso- och sjukvårdens organisering I ett historie-sociologiskt perspektiv, Stockholm 1987.
  • Herrting A., Nilsson K., Theorell T., Sätterlund Larsson U., Assistant nurses in the Swedish healthcare sector during the 1990s. A hard-hit occupational group with a tough Job, “Scandinavian Journal of Public Health” 2005, vol. 33, nr 2.
  • Hochwälder J., The psychosocial work environment and burnout among Swedish registered and assistant nurses. The main, mediating and moderating role of empowerment, “Nursing and Health Sciences” 2007, nr 9.
  • Lave J., Learning, apprenticeship, social practice, “Nordisk Pedagogik” 1997, nr 3.
  • Lave J., The practic of learning, [w:] Understanding practice. Perspectives on a Activity and context, eds. J. Lave, S. Chaiklin, Cambridge 1993.
  • Lave J., Wenger E., Situated Learning. Legitimate Peripheral Participation, Cambridge 1991.
  • Lindgren G., Doktorer, systrar och flickor, Stockholm 1988; idem, Klass, könoch kirurgi,
  • Malmö 1999.
  • Mead G.H., Mind, Self & Society from a Standpoint of a Social Behaviorist, Chicago 1934.
  • Rönnqvist D., Kompetensutveckling i praktiken – ett samspel mellan ledning, yrkesgrupper och omvärld. En studie av strategier för kompetensutveckling inom hälso- och sjukvården, Linköping 2001;
  • Sawchuk P., Adult Learning and Technology in Working-Class Life, Cambridge 2003.
  • Strauss A.L, Fagerhaugh S., Suczek B., Wiener C., Social Organization of Medical Work, New Brunswick 1997.
  • Sundin L., Hochwälder J., Bildt C., Lisspers J., The relationship between different work- related sources of social support and burnout among registered and assistant nurses in Sweden. A questionnaire survey, “International journal of Nursing Studies” 2007, nr 44.
  • Thornley C., A question of competence? Re-evaluating the roles of the nursing auxiliary and health care assistant in the NHS, “Journal of Clinical Nursing” 2000, nr 9.
  • Thunborg C., Lärande av yrkesidentiteter. En studie av läkare, sjuktsköterskor och undersköterskor, Linköping: Institutionen för pedagogik och psykologi, Linköpings 1999.
  • Wenger E., Communities of Practice: Learning, Meaning and Identity, Cambridge 1998.
  • Yin R.K., Case Study Research. Design and Methods, London 1984.

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