Marleen Ottenhoff

57 A beliefs framework 2 educator is more aware of the importance of a supportive learning environment. Other medical education literature highlights the importance of ‘nurturing’ or ‘respecting’ students,25,26 or emphasises the negative impact of learner neglect or frank mistreatment in the learning environment.27,28 However, only a single study classifying educational beliefs in the context of higher education11 has previously recognised the relevance of a conducive learning environment to the educational beliefs of educators. Secondly, within the dimension ‘Nature of knowledge’ (Dimension 4), we uncovered that a subgroup of medical educators view knowledge as externally constructed, but are also aware that the link to its applicability in the medical profession is important. This awareness may be due to the medical education context, in which most educators are often also involved in clinical work. This most likely encourages educators to link content knowledge to the practice of patient care. Relating meaning to a social reality is an important aspect of the epistemological view of knowledge as being co-constructed.29,30 The other relevant aspect of this epistemological view is that a learner conceptualises meaning from interaction with others. This view is also reflected in our data in the belief that the goal of teacher-student interaction is to negotiate meaning (D6B). Within the dimension ‘Students’ existing conceptions’ (Dimension 5) we did not find support for the belief that students’ misunderstandings should be prevented, in contrast to what was described in the original framework. Instead, we found that some medical educators rather emphasise the importance of building on students’ preconceptions to develop expertise, and sometimes also of learning from students’ conceptions themselves. We hypothesise that this difference might reflect a more current, general awareness that not all preconceptions are misconceptions.31 Our results led us to expand the belief dimension concerning the professional development of the student (Dimension 8) from two to four distinct beliefs. Although it is possible that educators in other disciplines show clear beliefs about the development of students, we favour the hypothesis that this emphasis on professional development is due to the context of medical education. Other medical education studies have highlighted beliefs about the professional development of the student. In contrast to our findings, Stenfors-Hayes et al.,32 who compared the beliefs of medical educators working in a preclinical versus clinical context, uncovered the emphasis on the professional development of the students only within the clinical but not preclinical context. In two other studies,25,33 beliefs

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