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Inter-professional working and learning: instructional actions and boundary crossing or boundary making in oral healthcare

Inter-professional teams are typical in health care, and inter-professional education has thus become more common. This empirical study explores the instruction-related challenges when students of dentistry and oral hygiene collaborate during their internship in caring for the oral health of patients. The conceptual framework of the study stems from cultural-historical activity theory, the aim being to explore the instructional actions and boundary crossing of clinical instructors while they were supervising the students. The main data comprise 17 videotaped treatment sessions, which were organised three-dimensionally in sequences, themes and topics, and analysed in terms of the instructional and boundary-crossing actions. The results reveal chains of subtle and rich instructional actions classified as instructive, evaluative and collaborative. Instructional boundary crossing occurred rarely and was also boundary-making: positioning, moving and communicating. It should be taken into account in the field of inter-professional working and learning that instructional boundaries seem easier to maintain than to cross, and professional teachers at educational institutions and instructors in workplaces need to be aware of this.