54 Chapter 2 What I know about adult learning is that they do best when they are focused on what is important to them, and so if they have identified their own specific learning objectives, and we as the facilitator-teacher help them with that, then that is reinforcing and motivating. (D9B; S11) Belief orientations in the new framework The original framework’s seventh, most learning-centred orientation, labelled ‘Encouraging knowledge creation’ was not observed in our data. Central to this orientation is the belief that students should be in control of the learning content; none of our participants expressed this belief. We changed the label of the learning-centred Belief Orientation V from ‘Preventing misunderstandings’ to ‘Sharing the responsibility for developing expertise.’ Since our participants with an Orientation V emphasised connecting students’ existing beliefs with the reality of the medical profession rather than correcting misconceptions, this better summarised the pattern of beliefs. As in the original framework, the medical educators’ focus in Orientations I to III was on the content and its transmission; hence, we conclude that these orientations are teaching-centred. In Orientations IV to VI the focus of the educators was on student learning and development, so we conclude these represent learningcentred belief orientations. The refinements of the dimensions resulted in a sharper demarcation between the orientations. The two belief orientations on either side of the teaching-centred versus learning-centred ‘divide,’ Orientations III and IV, share just one belief. In the original framework these two orientations shared two common beliefs. All other adjacent belief orientations share three to seven beliefs. In the original framework the other adjacent belief orientations shared six to eight beliefs. Results of quality strategies Comparison of the classification of the 18 interviews by the independent researchassistant with that of the authors resulted in a high inter-rater reliability of 0.85 (Cohen’s Kappa). Final consensus was reached for the two interview transcripts that were rated differently. This result validates the framework, supporting that it is not dependent on the perspective of a single educational researcher. As a final quality strategy we provide a thick description of two maximally contrasting belief orientations among our educators (Orientations I and VI). Only one educator in our study displayed an Orientation I; he is a clinician from
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