Do we form or deform? Qualitative Investigation in Public Hospitals of Madrid

Background: the creative capacities and the knowledge of the employees are components of the intellectual capital of the company; hence, their training is a key activity to achieve the objectives and business growth. Objective: To understand the meaning of learning in the hospital from the experiences of its participants through the inquiry of meanings. Method: Qualitative design with an ethnographic approach, which forms part of a wider research, on organizational culture; carried out mainly in 2 public hospitals of the Community of Madrid. The data has been collected for thirteen months. A total of 23 in-depth interviews and 69 field sessions have been conducted through the participant observation technique. Results: the worker and the student learn from what they see and hear. The great hospital offers an unregulated education, dependent on the professional, emphasizing that they learn everything. Some transmit the best and others, even the humiliating ones, use them for dirty jobs, focusing on the task and nullifying the possibility of thinking. They show a reluctant attitude to teach the newcomer, even if they do, they do not have to oppose their practice. In short, a learning in the variability, which produces a rupture between theory and practice; staying with what most convinces them, including negligence, which affects the patient's safety. In the small hospital, it is a teaching based on a practice based on scientific evidence and personalized attention, on knowing the other. Clearly taught from the reception, to treat with caring patience and co-responsibility in the care. The protagonists of both scenarios agree that teaching and helping new people establish lasting and important personal relationships to feel happy and want to be in that service or hospital. Conclusion: There are substantial differences related to the size of the center, as to what and how the student and the novel professional are formed. At the same time that the meaning of value that these health organizations transmit to their workers is inferred through the training, one orienting to the task and the other to the person, either patient, professional or pupil and therefore seeking the common benefit.