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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Understanding partnership practice in primary health as pedagogic work: what can Vygotsky’s theory of learning offer?

Nick Hopwood
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University of Technology, PO Box 123, Broadway, NSW 2007, Australia. Email: nick.hopwood@uts.edu.au

Australian Journal of Primary Health 21(1) 9-13 https://doi.org/10.1071/PY12141
Submitted: 25 October 2012  Accepted: 16 October 2013   Published: 12 November 2013

Abstract

Primary health policy in Australia has followed international trends in promoting models of care based on partnership between professionals and health service users. This reform agenda has significant practice implications, and has been widely adopted in areas of primary health that involve supporting families with children. Existing research shows that achieving partnership in practice is associated with three specific challenges: uncertainty regarding the role of professional expertise, tension between immediate needs and longer-term capacity development in families, and the need for challenge while maintaining relationships based on trust. Recently, pedagogic or learning-focussed elements of partnership practice have been identified, but there have been no systematic attempts to link theories of learning with the practices and challenges of primary health-care professionals working with families in a pedagogic role. This paper explores key concepts of Vygotsky’s theory of learning (including mediation, the zone of proximal development, internalisation, and double stimulation), showing how pedagogic concepts can provide a bridge between the policy rhetoric of partnership and primary health practice. The use of this theory to address the three key challenges is explicitly discussed.


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