Platsens betydelse för lärande : Arbetsplatsens handlingserbjudanden för e-hälsa i primärvård på landsbygden

As digitalisation and organisational change reshape healthcare practice, professionals are required not only to master new technologies but also to continuously adapt their practice. In rural settings, these demands tend to be particularly pronounced. Geographical distance, ageing populations and strong community ties all intersect with national ambitions for digital transformation. The overall aim of this thesis is to advance the understanding of how opportunities for learning and co-participation – shaped by the social, organisational and geographical conditions of rural primary care – influence informal learning among healthcare professionals during the implementation and everyday use of e-health services. The research design is progressive, combining inductive, deductive and conceptual approaches across three studies. Theoretically, the thesis integrates perspectives on informal workplace learning, workplace affordances and place. Workplace affordances are conceptualised as relational possibilities for participation and learning that emerge through the interplay between professional agency, organisational arrangements, technologies and the social and geographical context of rural healthcare. Drawing on qualitative interview data collected between 2021 and 2024 at two rural primary healthcare centres in Sweden, the thesis explores how learning emerges through the interaction between healthcare professionals, patients, technologies and the affordances of place – that is, the local contexts in which care and learning take place. The empirical material consists of semi-structured interviews with healthcare professionals from multiple occupational groups (N=33) and patients aged 65 years and above (N=14). A central contribution of the thesis is the development of a place-sensitive understanding of affordances, conceptualised as learning in place. The findings show that informal learning in rural primary care is deeply embedded in everyday patient encounters and community relations. When healthcare professionals are expected to integrate e-health solutions into everyday practice, tensions arise between established values of relational care and technology. The studies further demonstrate that workplace affordances for learning are unevenly distributed across professions, tasks and technologies and that some digital affordances remain weak, constrained, or unrealised due to, for instance, lack of professional and personal legitimacy. The thesis presents an analytical framework that operationalises workplace affordances by distinguishing how technologies enable, constrain, or refuse learning in practice. By integrating insights from science and technology studies with workplace learning theory, the thesis thus provides a refined vocabulary for analysing how affordances operate, for whom and under what conditions. Overall, the thesis contributes to research on workplace learning, rural healthcare, and e-health by demonstrating that learning is not only situated in practice but also in place. Context should therefore be understood not as a passive backdrop for learning and digitalisation, but as an active condition that shapes what becomes possible in practice, giving rise to what can be understood as learning in place.