49 A beliefs framework 2 Dimension 3: ‘Responsibility for transforming knowledge’ In this dimension we made changes to the description of beliefs to better fit the content of our findings. We identified that in the most learning-centred orientations (Orientations V and VI) the transformation of knowledge was seen as a joint responsibility of teacher and student. In the original framework, this was labelled as the sole responsibility of the student. Dimension 4: ‘Nature of knowledge’ This dimension needed to be expanded from two to three beliefs. We identified a further distinction between the belief of ‘knowledge being externally constructed.’ Comparable to the original framework, some educators viewed knowledge as consisting of facts only, described as a ‘database,’ as necessary ‘tools’ of factual knowledge, coming from outside sources like books or literature, and not linked to the reality of patient care (coded as D4A). Others, however, emphasised that this knowledge, even though externally constructed, should be related to patient care by the educator. They believed that the educator should explain how the ‘factual knowledge’ can be used (D4A/b): First of all you have basic factual knowledge… I would say the next step is understanding why it is important to possess this knowledge (…) that you have to make a kind of doctor’s reflection on it... like when the patient comes with this or that pain or this or that complaint, what is behind it (in basic knowledge);... the focus lies for me on the first steps. (D4A/b; L12) Dimension 5: ‘Students’ existing conceptions’ This dimension needed an adjustment in the categorisation of the beliefs. In the original framework the transition from a teaching-centred to a learning-centred belief occurs between Orientations IV and V, and in our data between Orientations III and IV. In addition, our participants with a learning-centred belief with teachingcentred aspects (D5B/a) expressed a different aim for involving students’ existing conceptions than described in the original framework. In the original framework, educators with a learning-centred belief with teaching-centred aspects (D5B/a) expressed the aim of preventing common misunderstandings by pointing them out to students and explaining why the established view is more suitable. In our data we found that educators with this belief (D5B/a) indicated instead that they involve students’ existing conceptions to further develop the students’ expertise. Thus, in comparison to the original framework, the emphasis in our findings is less on correcting misconceptions and more on activating preconceptions to develop expertise.
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