Student-Led Improvement Science Projects: a praxiographic, actor-network theory study

Improvement science methodology is promoted in the National Health Service (NHS) in Scotland for implementing rapid change in hospital practices. Student-Led Improvement Science Projects (SLISPs) have been developed as a result of this, where medical students work with clinical teams to identify, implement and monitor quality improvements in the workplace. Working with improvement science in real-life working practices in a hospital environment presents opportunities for different ways to conceptualise learning, for both educators and students. This paper draws from ethnographic and praxiographic methods combined with the sociomaterial approach of actor-network theory (ANT) to investigate the pedagogies of improvement science. The research concludes with three implications for medical education and education in general: (1) conceptualising learning as a network effect can guide educators and students towards a broader range of pedagogies for improvement science; (2) treating human and non-human elements of the network equally can lead to noticing details of practice that might otherwise be overlooked; (3), instead of collapsing improvement science into a singular meaning, multiple worlds allows for different enactments of improvement science to co-exist.