Learning in health : educational foundation and practice of the Learning and Mastery Centre

Norwegian authorities have established so called Learning and Mastery Centres in order to face the increased incidences of chronic diseases. Aim: The overall aim of the thesis is, emanating from the study of a Learning and Mastery Centre, to contribute to the development of the educational foundation in health education. The thesis consists of four studies conducted at a local Learning and Mastery Centre. Study I described how user participation was practised in two courses at a local Learning and Mastery Centre. Study II aimed to analyse and discuss the theoretical principles according to which a standardised health education programme originating from a Learning and Mastery Centre was performed, and how these principles influenced practice. The aim of Study III was to explore participants’ approaches to learning, before attending a health education programme at a Learning and Mastery Centre. In Study IV the participant’s experiences of how to live with a chronic disease and their perceptions of learning needs were examined and related to Antonovskys’ dimensions of Sense of Coherence.

Methods: All four studies have used a qualitative approach and were analyzed using content analysis. Two studies (I and II) emanated from a case study that included two cases. Study III and IV emanated from five group interviews.

Results: The results showed that participation was practised as ‘taking part’ and not as ‘having an influence’. The professionals paid little attention to the participants’ beliefs and ideas as part of the learning process and did not stress reflection as a main prerequisite for learning. The participants’ learning approaches were influenced by their daily life experiences and interactions with the health care system. Salutogenesis includes the main aspects of learning and has the potential to move health education initiatives in an action oriented direction.

Conclusions: The dissertation elucidates concepts such as health promotion, active learning perspective, salutogenesis and health literacy. These key concepts may raise awareness among professionals regarding the relationship between theoretical foundation and practice and in this way contribute to further development of the educational foundation and practice of the Learning and Mastery Centre especially and health education in general.

List of scientific papers

I. Førland G., Ringsberg KC. (2011). “I hope I haven’t run over you.” A case study of user participation in practice. Health Education Journal. 70(2),160-169.
https://doi.org/10.1177/0017896910373033

II. Førland G., Ringsberg KC. (2013). Implementation of a Standardized Health Education in a local context. A case study. Scandinavian Journal of Caring Sciences. 27(3), 724-732.
https://doi.org/10.1111/j.1471-6712.2012.01081.x

III. Førland G., Silèn C., Eriksson M., Ringsberg K. C. Searching and dealing, confirmation and feeling – Participants’ approaches to learning in a Health Education setting. [Manuscript]

IV. Førland G., Eriksson M., Silèn C., Ringsberg K. C. Salutogenesis - a potential framework for health education? [Submitted]