Becoming an Anaesthetist – Making the Implicit Explicit in Specialty Training

Abstract

This thesis explores the qualitatively different ways anaesthetists understand learning—both formal and informal—within postgraduate anaesthesia education. Using a phenomenographic approach, it investigates how anaesthetists in Sweden and England experience their educational journeys, with attention to explicit, implicit, relational, and contextual aspects of learning.

The thesis comprises four studies:

• Study I identifies variation in how Swedish anaesthetists conceptualise learning, ranging from acquiring procedural competencies to developing adaptive expertise and professional judgement. • Study II explores perceptions of professional identity, revealing orientations such as striving to meet external expectations, learning through collaboration, and taking ownership as self-directed caregivers. • Study III investigates how anaesthetists in England’s competency-based training programme experience learning—ranging from structured progression through assessments, to integrated clinical learning, to reflective, experience-driven development. • Study IV examines how trainees engage with the implicit curriculum in both countries. Some focus primarily on formal structures, while others describe the importance of interpersonal dynamics, workplace culture, and unspoken norms in shaping professional growth.

Together, these studies reveal that anaesthetists experience learning not as a linear path to competence, but as a dynamic, multifaceted process shaped by social, cultural, and contextual factors. The findings highlight the critical role of the implicit curriculum and professional identity formation, offering practical implications for curriculum design, assessment strategies, and faculty development.

Keywords: Anaesthesia education, Learner experiences, Curriculum