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Rozario SY, Farlie MK, Sarkar M, Lazarus MD. The die-hards, negotiators and migrants: Portraits of doctors' career pathways through specialisation. MEDICAL EDUCATION 2024; 58:1071-1085. [PMID: 38468409 DOI: 10.1111/medu.15368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Global workforce shortages in medical specialties strain healthcare systems, jeopardising patient outcomes. Enhancing recruitment strategies by supporting professional identity (PI) development may be one way to address this workforce gap-yet little research has explored this topic. The goal of the current study was to explore specialty-specific recruitment through considering PI. As proposed causes of workforce shortages in anatomical pathology (AP) bear similarities to many other specialties, this study uses the field of AP as a model for specialist PI development and asks: (1) why, how and when do doctors choose to pursue AP training and (2) what can be learned from this for recruitment to AP and other specialties? METHODS A qualitative research approach was undertaken using narrative inquiry. Interviews with junior doctors interested in AP, AP registrars and AP consultants from Australia and New Zealand were interpreted as stories via 're-storying'. Narrative synthesis of participants' collective stories identified chronological key events (i.e. 'turning points') in choosing AP. RESULTS Narrative synthesis resulted in identification of three portraits entering medical specialist training: (1) die-hards, deciding upon initial exposure; (2) negotiators, choosing after comparing specialties; and (3) migrants, seeking to move away from non-pathology specialties. The negotiators and migrants cemented their decision to pursue AP as a postgraduate doctor, whereas the die-hards made this decision during medical school. CONCLUSIONS Given the similarities in portrait traits between AP and other specialties across the literature, our results suggest ways to support specialty recruitment using PI development. We propose a medical specialist recruitment framework to support the PI development of doctors with die-hard, negotiator and migrant traits. Use of this framework could enhance current specialty-specific recruitment approaches, particularly in fields challenged by workforce shortages.
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Affiliation(s)
- Shemona Y Rozario
- Centre of Human Anatomy Education (CHAE), Department of Anatomy and Developmental Biology, Biomedical Discovery Institute, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Melanie K Farlie
- Department of Physiotherapy, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Mahbub Sarkar
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Monash Education Academy, Monash University, Melbourne, Victoria, Australia
| | - Michelle D Lazarus
- Centre of Human Anatomy Education (CHAE), Department of Anatomy and Developmental Biology, Biomedical Discovery Institute, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
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El-Desoky R, Diec S, Truong M, Rosario N. Who am I? Professional Identity Formation in Pharmacy Education Among Learners Underrepresented in Pharmacy. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100748. [PMID: 38944278 DOI: 10.1016/j.ajpe.2024.100748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 07/10/2023] [Accepted: 06/22/2024] [Indexed: 07/01/2024]
Abstract
Professional identity formation (PIF) throughout the pharmacy curriculum is important for learners to transform from layperson to pharmacist. To be effective, PIF activities need intentional development and support. Professional identity is often seen as the core component of PIF; however, there must be an emphasis on integrating and aligning an individual's personal identity through this process. Moreover, there has been an emphasis on upholding diversity, equity, inclusion, and antiracism efforts in pharmacy practice and education. There is a need to explore experiences of PIF among diverse populations, including learners underrepresented in pharmacy. This commentary explores the differences in PIF among underrepresented learners in health care disciplines and is a call to action to explore evidence-based interventions that are inclusive and tailored to individual learners. This commentary sets a foundation for additional scholarly work and recommendations regarding PIF among underrepresented learners.
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Affiliation(s)
- Rania El-Desoky
- University of Western Australia, Crawley, Western Australia, Australia.
| | - Sandy Diec
- University of Houston College of Pharmacy, Houston, TX, USA
| | - Mabel Truong
- University of Houston College of Pharmacy, Houston, TX, USA
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Bloom-Feshbach K, Klimenko M, Fluet K, Lang VJ. Mentoring: Shaping the professional identity of the academic internal medicine hospitalist. J Hosp Med 2024. [PMID: 38965768 DOI: 10.1002/jhm.13452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Burnout and lagging academic productivity are pressing challenges in hospital medicine, leading to stagnation and attrition. Mentoring shapes professional identity formation and enhances faculty vitality and retention, but has not been optimized among academic hospitalists. OBJECTIVES We sought to explore how mentoring impacts academic hospitalist professional identity and to elucidate barriers to mentoring in the field. METHODS We conducted focus groups at three academic medical centers. Informed by social-constructivist theory of identity development, we coded deidentified data and performed thematic analysis. RESULTS Thirty-one academic hospitalists participated with 1 to >20 years experience. Mentoring shaped professional identity formation in six core domains: choosing academic hospital medicine, identifying and focusing on an area of interest, progressing career, navigating work-life integration, staying in academic medicine, and becoming a mentor. Distinct models included dyadic mentoring, peer mentoring, organic mentoring, and mentoring teams, each with benefits and limitations. We identified nine key mentoring actions that influenced hospitalist professional identity formation and career development. Mentoring barriers included lack of time, awareness, and access to experienced mentors, as well as poor quality mentoring and mentor-mentee malalignment. Aspects of hospitalists' professional identity also posed barriers, including ambivalence around academic identity. CONCLUSIONS Mentoring fosters academic thriving and retention in academic hospitalists. Access to effective mentoring remains lacking due to few senior mentors in the relatively new field of hospital medicine and reticence in academic identity, among other factors. Mentoring training, impact on underrepresented minority hospitalists, and integration into institutional culture should be considered for enhancing the career development of academic hospitalists.
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Affiliation(s)
| | - Maria Klimenko
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Kimberly Fluet
- Center for Professional Development and Education Reform, University of Rochester Margaret Warner Graduate School of Education, Rochester, New York, USA
| | - Valerie J Lang
- Hospital Medicine Division, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
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4
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Hoang K, Grow HM, Rooholamini SN, McPhillips H, Selling SK, Rassbach CE, Blankenburg R. Impact of Longitudinal Coaching on Pediatric Residents' Professional Identity Formation: A Multi-Institution Qualitative Study. Acad Pediatr 2024; 24:866-874. [PMID: 38729301 DOI: 10.1016/j.acap.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 03/27/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Coaching has emerged in medical education as a strategy for trainees' development and has been endorsed by the Coalition for Physician Accountability and the American Medical Association. However, there is a lack of literature on how coaching impacts residents' professional identity formation (PIF). The purpose of this study was to explore how longitudinal clinical coaching impacted the professional identity of residency graduates. METHODS In July to November 2020, we conducted an Institutional Review Board-approved qualitative study with semistructured interviews of residency graduates from 2 pediatric programs who participated in a longitudinal coaching program. We inductively analyzed the transcripts using thematic analysis, guided by the sensitizing principles of PIF. We did a member check to enhance trustworthiness. RESULTS We interviewed 34 residency graduates from 2 institutions and identified 4 themes on how coaches influenced residency graduates' PIF by 1) the presence of a trusting relationship; 2) creating trust and sense of belonging through longitudinal encounters, supportive reflection, and formative feedback; 3) integrating clinical skill, career interests, and work-life integration; and 4) reflecting on their own personal and professional identities. Residency graduates highlighted coaching strategies that coaches, coaching programs, and residents themselves can take to promote resident PIF during residency. CONCLUSIONS Residency coaches have the potential to influence residents' PIF through their longitudinal relationship grounded in trust. Coaching strategies can be used to enhance resident clinical and professional development during residency training.
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Affiliation(s)
- Kim Hoang
- Department of Pediatrics (K Hoang, CE Rassbach, and R Blankenburg), Stanford University School of Medicine, Calif.
| | - Helene Mollie Grow
- Department of Pediatrics (HM Grow, SN Rooholamini, and H McPhillips), University of Washington School of Medicine, Seattle
| | - Sahar N Rooholamini
- Department of Pediatrics (HM Grow, SN Rooholamini, and H McPhillips), University of Washington School of Medicine, Seattle
| | - Heather McPhillips
- Department of Pediatrics (HM Grow, SN Rooholamini, and H McPhillips), University of Washington School of Medicine, Seattle
| | - Sarah Kate Selling
- Department of Pediatrics, Stanford University School of Medicine (SK Selling), Calif
| | - Caroline E Rassbach
- Department of Pediatrics (K Hoang, CE Rassbach, and R Blankenburg), Stanford University School of Medicine, Calif
| | - Rebecca Blankenburg
- Department of Pediatrics (K Hoang, CE Rassbach, and R Blankenburg), Stanford University School of Medicine, Calif
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Moll-Jongerius A, Langeveld K, Tong W, Masud T, Kramer AWM, Achterberg WP. Professional identity formation of medical students in relation to the care of older persons: a review of the literature. GERONTOLOGY & GERIATRICS EDUCATION 2024; 45:424-437. [PMID: 37170948 DOI: 10.1080/02701960.2023.2210559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
With the growing population of older persons, medical students have to be well prepared for older persons' health care during medical school. Becoming a doctor is an interplay of building competencies and developing a professional identity. Professional identity formation of medical students is a relatively new educational concept in geriatric medical education. This review aims to explore the concept of professional identity formation of undergraduate medical students in relation to the care of older persons. Twenty-three peer-reviewed studies were included and summarized narratively. Patient-centeredness, caring and compassion, collaboration and holistic care are characteristics of the doctor's professional identity in relation to the care of older persons. Participating in the context of older persons' health care contributes to the becoming of a doctor in general. In this context, the building of relationships with older persons, participating in their lives and role models are important influencers of professional identity formation. Furthermore, the perceptions and expectations medical students have of future doctoring influence their feelings about the care of older persons. To prepare medical students for older persons' health care, professional identity formation seems to be a relevant educational concept.
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Affiliation(s)
- Annemarie Moll-Jongerius
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Kirsten Langeveld
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Wing Tong
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Tahir Masud
- Department of Health Care for Older People (HCOP), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Anneke W M Kramer
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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Verhees MJM, Landstra AM, Engbers R, Van De Pol MHJ, Huijbregts R, Van Meggelen RA, Kuijer-Siebelink W, Laan RFJM. Designing a Workplace-Based Learning Environment for Learning Health Promotion: A Design-Based Research. PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:357-367. [PMID: 38948402 PMCID: PMC11212777 DOI: 10.5334/pme.1203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/24/2024] [Indexed: 07/02/2024]
Abstract
Introduction The healthcare landscape has a growing emphasis on health promotion (HP), which makes HP important in the training of future physicians. This study employed design-based research to develop a clerkship focused on HP and to outline design principles for shaping workplace learning environments to promote HP learning. Methods We evaluated a nursing-home clerkship designed at Radboud University Medical Center in the Netherlands, and refined it over three rounds. Data collection involved individual and group interviews with students and supervisors, as well as observations during clerkship-related meetings and activities. These interactions also facilitated the exchange of perspectives between participants and generation of new design ideas, fostering co-creation of the clerkship design. Data were analyzed through iterative thematic inquiry to inform new design choices and develop design principles. Results Evolved clerkship designs included an app for capturing practice experiences to discuss in relation to students' professional roles, loosening the strict assessment structure, and collaborative creation of a practice assignment about 'Positive Health'. We constructed four design principles, including: to question and discuss students' professional identity, provide concrete and meaningful assignments, aim for a peer-learner role for supervisors, and foster co-creation of the workplace learning environment. Discussion Our design principles support the design of workplace-based learning for HP, a subject that is novel within healthcare practice. We find that co-creation of workplace-based learning, which requires embracing uncertainty, is pivotal in this context, for students, practitioners, and educational institutions.
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Affiliation(s)
- Myrthe J. M. Verhees
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Anneke M. Landstra
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
- Rijnstate, Arnhem, Netherlands
| | - Rik Engbers
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marjolein H. J. Van De Pol
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Renske Huijbregts
- Radboud University, she was an intern at Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Roos A. Van Meggelen
- Radboud University, she was an intern at Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Wietske Kuijer-Siebelink
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
- HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Roland F. J. M. Laan
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
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Wu X, Lu Y, Zeng Y, Han H, Sun X, Zhang J, Wei N, Ye Z. Personality portraits, resilience, and professional identity among nursing students: a cross-sectional study. BMC Nurs 2024; 23:420. [PMID: 38907353 PMCID: PMC11191206 DOI: 10.1186/s12912-024-02007-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/13/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND The lack of professional identity can impede the transition from nursing students to qualified nurses and exacerbate the shortage of health care professionals. Personality is important to resilience-building and professional identity development in nursing students. However, the associations among personality, resilience, and professional identity are less explored. The study aims to identify latent subtypes of personality, to evaluate the mediating role of resilience between personality and professional identity in nursing students, and to provide practical guidance for educators' subsequent interventions with nursing students' professional identity. METHODS 1397 nursing students were recruited from Be Resilient to Nursing Career (BRNC) between October 2020 and April 2022 by cluster sampling from 4 universities in China. NEO Five-Factor Inventory, 10-item Connor-Davidson Resilience Scale, and Professional Identity Questionnaire for Undergraduate Students were administered. Analyses of latent profiles and mediations were performed. RESULTS Three latent personality types were identified: Over-sensitivity (35.4%), Ordinary (53.8%), and Flexibility (10.8%). Nursing role model was found to be a significant indicator of personality (Ordinary as ref, Over-sensitivity: OR = 0.73, 95% CI: 0.57-0.93, P = 0.010; Flexibility: OR = 1.85, 95% CI: 1.29-2.65, P = 0.001). The association between personality portraits and professional identity were significantly mediated by resilience (P < 0.05). CONCLUSIONS There exists heterogeneity in nursing students' personality. Resilience plays a significant role in mediating the relationship between personality and professional identity.
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Affiliation(s)
- Xiaona Wu
- Department of Nursing, Guangzhou Women and Children Medical Center, Guangzhou Medical University Affiliated Women and Children Medical Center, Guangzhou, People's Republic of China
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Yingzi Lu
- Department of Health Management and Promotion, Guangdong Maoming Health Vocational College, Maoming, People's Republic of China
| | - Yihao Zeng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Hui Han
- School of Marine finance and economics, Qingdao Engineering Vocational College, Qingdao, People's Republic of China
| | - Xiaoming Sun
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Jiapeng Zhang
- School of nursing, Medical College of Jiaying University, Meizhou, People's Republic of China
| | - Ning Wei
- School of nursing, Guangzhou Xinhua University, Guangzhou, People's Republic of China
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, 511495, China.
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Ryan A, Moran CN, Byrne D, Hickey A, Boland F, Harkin DW, Guraya SS, Bensaaud A, Doyle F. Do professionalism, leadership, and resilience combine for professional identity formation? Evidence from confirmatory factor analysis. Front Med (Lausanne) 2024; 11:1385489. [PMID: 38938377 PMCID: PMC11208471 DOI: 10.3389/fmed.2024.1385489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/27/2024] [Indexed: 06/29/2024] Open
Abstract
Introduction Professional identity formation (PIF) is an ongoing, self-reflective process involving habits of thinking, feeling and acting like a physician and is an integral component of medical education. While qualitative work has suggested that PIF is informed by professionalism, resilience, and leadership, there is a dearth of quantitative work in this area. Multiple methods build rigor and the present study aimed to quantitatively assess the relative psychometric contributions of professionalism, resilience, and leadership constructs to informing PIF, using a latent factor analysis approach. Methods We analyzed data from the PILLAR study, which is an online cross-sectional assessment of a pre-clinical cohort of medical students in the RCSI University of Medicine and Health Sciences, Dublin, using established and validated quantitative measures in each area of interest: PIF, professionalism, leadership and resilience. A total of 76 items, combining four validated scales, along with a selection of demographic questions, were used. The hypothesis that PIF is informed by, and correlates with, professionalism, resilience and leadership was examined by conducting a confirmatory factor analysis of a proposed three-factor higher-order model. Model estimation used Maximum Likelihood Method (MLM) with geomin rotation. The hypothesized (measurement) model was examined against an alternative (saturated) model, as well as a three-factor model. Results Latent variable analysis from 1,311 students demonstrated that a three-factor higher-order model best fit the data; suggesting PIF is informed by professionalism, resilience, and leadership, and that these constructs are statistically distinct and account for differential aspects of PIF. This higher-order model of PIF outperformed both the saturated model and the three-factor model. The analysis of which component may be the most or least influential was inconclusive, and the overall model was not influenced by year of training. Discussion Building upon existing conceptual contentions, our study is the first to quantitatively support the contribution of professionalism, resilience, and leadership to the development of professional identity, and to delineate the inter-relationships between PIF and these constructs. This information can be used by medical educators when designing curricula and educational strategies intended to enhance PIF. Future work should seek to assess the influence of these constructs longitudinally.
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Affiliation(s)
- Aine Ryan
- Centre for Professionalism in Medicine and Health Sciences at Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Catherine N. Moran
- Department of Health Psychology, School of Population Health, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - David Byrne
- Department of Health Psychology, School of Population Health, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Anne Hickey
- Department of Health Psychology, School of Population Health, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Boland
- Data Science Centre, School of Population Health, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Denis W. Harkin
- Centre for Professionalism in Medicine and Health Sciences at Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Shaista S. Guraya
- Institute of Learning, Mohammad Bin Rashid University, Dubai, United Arab Emirates
| | - Abdelsalam Bensaaud
- Centre for Professionalism in Medicine and Health Sciences at Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Frank Doyle
- Department of Health Psychology, School of Population Health, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
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Kim DT, Applewhite MK, Shelton W. Professional Identity Formation in Medical Education: Some Virtue-Based Insights. TEACHING AND LEARNING IN MEDICINE 2024; 36:399-409. [PMID: 37140086 DOI: 10.1080/10401334.2023.2209067] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/12/2023] [Indexed: 05/05/2023]
Abstract
Issue: In 2010, the Carnegie Foundation published a call to reorient medical education in terms of the formation of identities rather than mere competencies, and the medical education literature on professional identity formation (PIF) has since grown rapidly. As medical learners navigate a hectic clinical learning environment fraught with challenges to professionalism and ethics, they must simultaneously orient their skills, behaviors, and evolving sense of professional identity. The medical education literature on PIF describes the psychosocial dimensions of that identity formation well. However, in its conceptual formulations, the literature risks underappreciating the pedagogical significance of the moral basis of identity formation-that is, the developing moral agencies and aspirations of learners to be good physicians. Evidence: Our conceptual analysis and argument build on a critical review of the medical education literature on PIF and draw on relevant insights from virtue ethics to deepen the conceptualization of PIF in moral, and not just psychosocial, terms. We show that a narrowly psychosocial view risks perpetuating institutional perceptions that can conceive professionalism norms primarily as standards of discipline or social control. By drawing on the conceptual resources of virtue ethics, we highlight not just the psychosocial development of medical learners but also their self-reflective, critical development as particular moral agents aspiring to embody the excellences of a good physician and, ultimately, to exhibit those traits and behaviors in the practice of medicine. Implications: We consider the pedagogical relevance of this insight. We show that drawing on virtue theory can more adequately orient medical pedagogy to socialize learners into the medical community in ways that nurture their personal growth as moral agents-in terms of their particular, restless aspirations to be a good physician and to flourish as such.
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Affiliation(s)
- Daniel T Kim
- Alden March Bioethics Institute, Albany Medical College, Albany, New York, USA
| | - Megan K Applewhite
- Alden March Bioethics Institute, Albany Medical College, Albany, New York, USA
| | - Wayne Shelton
- Alden March Bioethics Institute, Albany Medical College, Albany, New York, USA
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Kadakia Z, Lopez A, Shahid M, Theoret A, Dass R, Dhillon S, Dhir J, Packham T. Therapists to Therapy Assistants: Experiences of Internationally Educated Physiotherapists and Occupational Therapists. Can J Occup Ther 2024:84174241255467. [PMID: 38803166 DOI: 10.1177/00084174241255467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Background: In Canada, internationally educated physiotherapists (IEPTs) and occupational therapists (IEOTs) may work as occupational/physical therapy assistants (OTAs/PTAs) while pursuing Canadian licensure. This experience presents personal and professional opportunities and challenges. Purpose: We explored a) the barriers and facilitators experienced by IEPTs and IEOTs working as OTAs/PTAs while pursuing licensure in Canada and b) how might their professional identity changes during this period. Methods: In this cross-sectional qualitative study, we sampled IEPTs and IEOTs working as assistants using online focus groups. Reflexive thematic analysis of data was used to generate themes. Findings: Fourteen IEPTs or IEOTs participated reporting barriers including financial impacts while working as an OTA/PTA, discrimination, and challenges completing licensing exams. Facilitators while working as OTA/PTAs included social support, acculturation with Canadian systems, and career opportunities. Changes to professional identity encompassed accepting a new identity, reclaiming their old identity, or having a strong sense of identity within a healthcare profession. Participants advocated for bridging programs and modifications for examination processes for IEPTs and IEOTs to improve their experiences while pursuing licensure in Canada. Conclusion: Increased advocacy is needed to address the current experiences of IEPTs and IEOTs working as OTA/PTAs after migration.
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Bransen J, Poeze M, Mak-van der Vossen MC, Könings KD, van Mook WNKA. 'Role Model Moments' and 'Troll Model Moments' in Surgical Residency: How Do They Influence Professional Identity Formation? PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:313-323. [PMID: 38800716 PMCID: PMC11122703 DOI: 10.5334/pme.1262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/15/2024] [Indexed: 05/29/2024]
Abstract
Introduction Role models are powerful contributors to residents' professional identity formation (PIF) by exhibiting the values and attributes of the community. While substantial knowledge on different attributes of role models exists, little is known about their influence on residents' PIF. The aim of this study was to explore surgical residents' experiences with role models and to understand how these contribute to residents' PIF. Methods Adopting a social constructivist paradigm, the authors used a grounded theory approach to develop an explanatory model for residents' experiences with role models regarding PIF. Fourteen surgical residents participated in individual interviews. The authors iteratively performed data collection and analysis, and applied constant comparison to identify relevant themes. Results Role model behavior is highly situation dependent. Therefore, residents learn through specific 'role model moments'. These moments arise when residents (1) feel positive about a moment, e.g. "inspiration", (2) have a sense of involvement, and (3) identify with their role model. Negative role model moments ('troll model moments') are dominated by negative emotions and residents reject the modeled behavior. Residents learn through observation, reflection and adapting modeled behavior. As a result, residents negotiate their values, strengthen attributes, and learn to make choices on the individual path of becoming a surgeon. Discussion The authors suggest a nuance in the discussion on role modelling: from 'learning from role models' to 'learning from role model moments'. It is expected that residents' PIF will benefit from this approach since contextual factors and individual needs are emphasized. Residents need to develop antennae for both role model moments and troll model moments and acquire the skills to learn from them. Role model moments and troll model moments are strong catalysts of PIF as residents follow in the footsteps of their role models, yet learn to go their own way.
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Affiliation(s)
- Jeroen Bransen
- Department of Trauma Surgery, Maastricht University Medical Center+, The Netherlands
- School of Health Professions Educations, Maastricht University, The Netherlands
| | - Martijn Poeze
- Department of Trauma Surgery, Maastricht University Medical Center+, The Netherlands
| | - Marianne C. Mak-van der Vossen
- Assistant professor in medical education, Amsterdam UMC, Department of General Practice, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Karen D. Könings
- School of Health Professions Educations, Maastricht University, The Netherlands
- School of Health Sciences, University of East Anglia, UK
| | - Walther N. K. A. van Mook
- School of Health Professions Educations, Maastricht University, The Netherlands
- Department of Intensive Care Medicine, and postgraduate dean, Academy for Postgraduate Training, Maastricht University Medical Center+, Maastricht, The Netherlands
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Chin H, Ingerman Å, Block L, Hergès HO. Navigating the complex dynamics of anesthesiologists' professional identity formation in the context of their specialty training program: a phenomenographic perspective. BMC MEDICAL EDUCATION 2024; 24:539. [PMID: 38750505 PMCID: PMC11097508 DOI: 10.1186/s12909-024-05527-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND A specialty training program is crucial for shaping future specialist doctors, imparting clinical knowledge and skills, and fostering a robust professional identity. This study investigates how anesthesiologists develop their professional identity while navigating unique challenges specific to their specialty. The formation of professional identity in anesthesiology significantly influences doctors' well-being, teamwork, and ultimately patient care, making it a crucial aspect of anesthesiology education. Utilizing a phenomenographic approach, the research explores the learners' personal experiences and perspectives of professional identity formation in their specialty training programs, providing valuable insights for enhancing future anesthetic educational programs. METHOD The data for this phenomenographic study were collected through semi-structured interviews with anesthesiology trainees and specialists, guided by open-ended questions. The interviews were conducted at a Swedish university hospital, and participant selection used purposive sampling, providing rich and diverse data for analysis after 15 interviews. Iterative analysis followed the seven-step phenomenographic approach. The research team, comprising qualitative research and anesthesiology education experts, ensured result validity through regular review, discussion, and reflective practices. RESULTS The study reveals three fundamental dimensions: 'Knowledge of Subject Matter,' 'Knowledge of Human Relations,' and 'Knowledge of Affect.' These dimensions offer insights into how anesthesiologists comprehend anesthesiology as a profession, navigate interactions with colleagues and patients, and interpret emotional experiences in anesthesiology practice - all crucial elements in the formation of professional identity. The findings could be synthesized and further described by three conceptions: The Outcome-Driven Learner, the Emerging Collaborator, and the Self-Directed Caregiver. CONCLUSION The study uncovers differing learner understandings in the development of anesthesiologists' professional identity. Varying priorities, values, and role interpretations highlight the shortcomings of a generic, one-size-fits-all educational strategy. By acknowledging and integrating these nuanced learner perspectives, as elucidated in detail in this study, the future of anesthesia education can be improved. This will necessitate a holistic approach, intertwining both natural sciences and humanities studies, focus on tacit knowledge, and flexible teaching strategies, to guarantee thorough professional development, lifelong learning, and resilience.
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Affiliation(s)
- Hanna Chin
- Department of Anaesthesia and Intensive Care, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Department of Anesthesiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Åke Ingerman
- Department of Pedagogical, Curricular and Professional Studies, University of Gothenburg, Gothenburg, Sweden
| | - Linda Block
- Department of Anaesthesia and Intensive Care, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Anesthesiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helena Odenstedt Hergès
- Department of Anaesthesia and Intensive Care, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Anesthesiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Guraya SS, Clarke E, Sadeq A, Smith M, Hand S, Doyle F, Kearney G, Harbinson M, Ryan A, Boland F, Bensaaud A, Guraya SY, Harkin DW. Validating a theory of planned behavior questionnaire for assessing changes in professional behaviors of medical students. Front Med (Lausanne) 2024; 11:1382903. [PMID: 38808142 PMCID: PMC11130381 DOI: 10.3389/fmed.2024.1382903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/17/2024] [Indexed: 05/30/2024] Open
Abstract
Introduction Teaching professionalism is a fundamental aspect of medical undergraduate education, delivering important domains of professional attitudes, ethics, and behaviors. The effects of educational interventions can be assessed by measuring the change in such domains, but validated assessment tools for these professionalism domains are lacking. In this study, we constructed and conducted expert validation of a modified theory of planned behavior (TPB) questionnaire to assess changes in professional behaviors (PBs) in medical students. Methods To validate that, we modified an existing TPB questionnaire, and an 18-item questionnaire was subjected to expert panel evaluation using the content validation method. The clarity and relevance of items were assessed using a four-point rating scale (i.e., 1 = not relevant to 4 = highly relevant). Ratings of experts and free-text comments were analyzed. Quantitative evaluation of relevance and clarity was undertaken through analyses of the Item-level Content Validity Index (I-CVI) and Scale-level Content Validity Index (S-CVI). A qualitative assessment of the comments of experts was conducted to refine items, any disagreements were discussed, and a consensus decision was developed among authors for item changes. Results Quantitative evaluation of the Item-level Content Validity Index (I-CVI) scored 0.9-1 for relevance and 0.7-1 for clarity. Qualitative evaluation resulted in (i) changes to the wording of items (e.g., choices such as "worthless/worthwhile" were replaced with "not important/important"); and (ii) suggestion of the addition of social media in the construct of subjective norms. Discussion The proposed tool exhibits content validity and can assess TPB constructs in professionalism education. This study of content validity may help to ensure the modified TPB questionnaire accurately measures the TPB constructs, ensuring its effectiveness in accurately measuring the TPB constructs for PB in diversified educational medical institutions.
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Affiliation(s)
| | - Eric Clarke
- Centre for Professionalism in Medicine and Health Sciences, Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Asil Sadeq
- Centre for Professionalism in Medicine and Health Sciences, Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Mary Smith
- Centre for Professionalism in Medicine and Health Sciences, Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Sinead Hand
- Centre for Professionalism in Medicine and Health Sciences, Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Frank Doyle
- Department of Health Psychology, School of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Grainne Kearney
- School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Mark Harbinson
- School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Aine Ryan
- Centre for Professionalism in Medicine and Health Sciences, Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Boland
- Data Science Centre, School of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Abdelsalam Bensaaud
- Centre for Professionalism in Medicine and Health Sciences, Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Salman Yousuf Guraya
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Denis W. Harkin
- Centre for Professionalism in Medicine and Health Sciences, Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Douglass B, Stager SL, Shaw K, Hite A, Solecki S, Stanik-Hutt J, Tufts G. Professional identity in nursing: Why it is important in graduate education. J Prof Nurs 2024; 52:50-55. [PMID: 38777525 DOI: 10.1016/j.profnurs.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 05/25/2024]
Abstract
Possessing a clear identity in nursing is a guiding principle to professional comportment. In graduate nursing education, transitioning and expanding one's professional identity requires role evolution. Nurses transitioning into the advanced professional nursing role shifts their thinking to a new level. The Conceptual Model of Professional Identity in Nursing constitutes how values and ethics, knowledge, nurse as a leader, and professional comportment are intertwined. Competency-based education requires curricular redesign. The Essentials Tool Kit aligns The Essentials with learning activities to support competency-based curriculum and assessment. The Douglass and Stager Toolkit intertwines these resources for graduate nursing educators to inform professional identity in nursing for curriculum revisions. This article aims to illustrate how faculty educate graduate nursing students in the development of professional identity using a conceptual framework to achieve competencies outlined in The Essentials (AACN, 2021).
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Affiliation(s)
- Brenda Douglass
- Johns Hopkins School of Nursing, 525 N Wolfe St, Baltimore, MD 21205, United States of America.
| | - Sharon L Stager
- Salve Regina University, 100 Ochre Point Ave., Newport, RI 02840, United States of America.
| | - Kathy Shaw
- University of Colorado Anschutz Medical Campus, College of Nursing, 13120 E. 19th Ave.|Education 2 North|Office 4211, Aurora, CO 80045, United States of America.
| | - Amy Hite
- Pittsburg State University, Irene Ransom Bradley School of Nursing, United States of America.
| | - Susan Solecki
- Drexel University, College of Nursing and Health Professions, Division of Nursing, Graduate Nursing Programs, 60 N.36th Street, Philadelphia, PA 19104, United States of America.
| | - Julie Stanik-Hutt
- University of Iowa, College of Nursing, CNB 32850 Newton Rd., Iowa City, Iowa 52242-1121, United States of America.
| | - Gillian Tufts
- University of Utah College of Nursing, 10 South 2000 East, Salt Lake City, UT 84112, United States of America.
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Lusk P, Ark T, Crowe R, Monson V, Altshuler L, Harnik V, Buckvar-Keltz L, Poag M, Belluomini P, Kalet A. Measuring the development of a medical professional identity through medical school. MEDICAL TEACHER 2024; 46:665-671. [PMID: 37917985 DOI: 10.1080/0142159x.2023.2273218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
PURPOSE The Professional Identity Essay (PIE) is a theory and evidence-based Medical Professional Identity Formation (MPIF) measure. We describe trajectories of PIE-measured MPIF over a 4-year US medical school curriculum. METHODS Students write PIEs at medical school orientation, clinical clerkships orientation, and post-advanced (near graduation) clerkship. A trained evaluator assigns an overall stage score to narrative responses to nine PIE prompts (inter-rater ICC 0.83, 95% CI [0.57 - 0.96], intra-rater ICC 0.85). Distribution of PIE stage scores across time points were analyzed in the aggregate and individual students were classified as Increase, Stable (no score change) or Decrease based on the trajectories of PIE stage scores over time. RESULTS 202 students completed 592 PIEs from 2018-2023. There was a significant change in the proportion of PIEs in stages over time (X2 84.40, p < 0.001), 47% (n = 95) students were categorized in the Increase trajectory, 45.5% (n = 92) as Stable and 7.4% (n = 15) as Decrease. Older age and time-predicted stage scores change within trajectories (p < 0.05). CONCLUSIONS Medical students' PIE stage scores increase over time with three distinctive trajectories. Further study is needed to explore the utility of this method for formative assessment, program evaluation, and MPIF research.
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Affiliation(s)
- P Lusk
- Graduate School of Education, University of Pennsylvania, Philadelphia, PA, USA
| | - T Ark
- The Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee,WI, USA
| | - R Crowe
- Office of Medical Education, New York University Long Island School of Medicine, New York, NY, USA
| | - V Monson
- The Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee,WI, USA
| | - L Altshuler
- New York University Grossman School of Medicine, New York, NY, USA
| | - V Harnik
- New York University Grossman School of Medicine, New York, NY, USA
| | - L Buckvar-Keltz
- New York University Grossman School of Medicine, New York, NY, USA
| | - M Poag
- New York University Grossman School of Medicine, New York, NY, USA
| | - P Belluomini
- New York University Grossman School of Medicine, New York, NY, USA
| | - A Kalet
- The Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee,WI, USA
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Stelwagen M, Westmaas A, Van Kempen A, Scheele F. Rebalancing of professional identity roles in an integrated maternity and neonatal care setting designed to increase parent autonomy: a qualitative study among health professionals. J Interprof Care 2024:1-9. [PMID: 38655873 DOI: 10.1080/13561820.2024.2343843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
This case-based qualitative study explored the professional identity as experienced by health professionals working in an integrated maternal-neonatal ward when their practice changed from a "paternalistic" model, in which physicians and nurses were in charge, to a shared or "consumerist" model, to increase parent autonomy. We analyzed transcripts of focus group discussions and interviews with 60 health professionals on their experiences with empowering parents and described factors associated with themes of professional identity. The changes most affecting professional identity were the constant proximity of parents to their newborns and the single-family room design. These changes influenced three themes of professional identity: (1) connectedness and relationships (2) communication, and (3) competencies. A fourth theme, values, beliefs, and ethics, affected how the health professionals coped with the changes in the first three themes. When empowering parents of newborns in a hospital setting, health professionals experience beneficial as well as threatening shifts in their professional identities. Values, beliefs, and ethics associated with family integrated care helped health professionals to embrace their new roles, but other values, beliefs and ethics could create barriers. Continuous professional identity development in a patient-inclusive team is a topic for future research.
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Affiliation(s)
- Mireille Stelwagen
- Department of Teaching and Pediatrics, OLVG Hospital, Amsterdam, The Netherlands
| | - Alvin Westmaas
- Department of Social Psychology, Faculty of Health, University of Applied Sciences Leiden, Leiden, Netherlands
| | - Anne Van Kempen
- Department of Pediatrics, OLVG Hospital, Amsterdam, The Netherlands
| | - Fedde Scheele
- Department of Gynecology and Teaching, OLVG Hospital, Amsterdam, The Netherlands
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Sarraf-Yazdi S, Pisupati A, Goh CK, Ong YT, Toh YR, Goh SPL, Krishna LKR. A scoping review and theory-informed conceptual model of professional identity formation in medical education. MEDICAL EDUCATION 2024. [PMID: 38597258 DOI: 10.1111/medu.15399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/12/2024] [Accepted: 03/18/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Professional identity formation (PIF) is a central tenet of effective medical education. However, efforts to support, assess and study PIF are hindered by unclear definitions and conceptualisations of what it means to 'think, act, and feel like a physician'. Gaps in understanding PIF, and by extension, its support mechanisms, can predispose individuals towards disengaged or unprofessional conduct and institutions towards short-sighted or reactionary responses to systemic issues. METHODS A Systematic Evidence-Based Approach-guided systematic scoping review of PIF theories was conducted related to medical students, trainees and practising doctors, published between 1 January 2000 and 31 December 2021 in PubMed, Embase, ERIC and Scopus databases. RESULTS A total of 2441 abstracts were reviewed, 607 full-text articles evaluated and 204 articles included. The domains identified were understanding PIF through the lens of pivotal theories and characterising PIF by delineating the underlying factors that influence it and processes that define it. CONCLUSIONS Based on regnant theories and frameworks related to self-concepts of identity and personhood, the relationships between key PIF influences, processes and outcomes were examined. A theory-backed integrated conceptual model was proposed to delineate the interconnected relationships among these, aiming to untangle some of the complexities inherent to PIF, to shed light on existing practices and to identify shortcomings in our understanding so as to develop mechanisms in support of its multifaceted, interlinked components.
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Affiliation(s)
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Chloe Keyi Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - You Ru Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Suzanne Pei Lin Goh
- Duke-NUS Medical School, National University of Singapore, Singapore
- KK Women's and Children Hospital, Singapore
| | - Lalit Kumar Radha Krishna
- Duke-NUS Medical School, National University of Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
- Palliative Care Institute Liverpool, Academic Palliative and End of Life Care Centre, United Kingdom Cancer Research Centre, University of Liverpool, Liverpool, UK
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore
- Palliative Care Centre for Excellence in Research and Education, Singapore
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Schumm M, Teufel D, Brunnhuber M, Wijnen-Meijer M, Berberat PO. Seeing with Different Eyes. The Module Life & Science of the Elite-Master Program Biomedical Neuroscience. MEDICAL SCIENCE EDUCATOR 2024; 34:463-469. [PMID: 38686155 PMCID: PMC11055818 DOI: 10.1007/s40670-024-01992-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 05/02/2024]
Abstract
From its beginnings in 2018, the international elite-master program Biomedical Neuroscience of TUM School of Medicine and Health at Technical University of Munich was guided by two convictions: First, excellent research depends not only on the mediation of scientific knowledge and skills, but also on a multifaceted understanding of science itself. Second, teaching must recognize and support not only student's growing expertise but also their personal and professional development. To this end, the module Life & Science was designed. It gives students the opportunity to explore neuroscience from different angles to deepen the epistemological, sociological, and cultural understanding of their chosen profession.
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Affiliation(s)
- Moritz Schumm
- Technical University of Munich, TUM School of Medicine and Health – University Hospital rechts der Isar, TUM Medical Education Center (TUM MEC), Nigerstraße 3, Munich, Bavaria 81675 Germany
| | - Daniel Teufel
- Technical University of Munich, TUM School of Medicine and Health – University Hospital rechts der Isar, TUM Medical Education Center (TUM MEC), Nigerstraße 3, Munich, Bavaria 81675 Germany
| | - Michael Brunnhuber
- Technical University of Munich, TUM School of Medicine and Health – University Hospital rechts der Isar, TUM Medical Education Center (TUM MEC), Nigerstraße 3, Munich, Bavaria 81675 Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, TUM School of Medicine and Health – University Hospital rechts der Isar, TUM Medical Education Center (TUM MEC), Nigerstraße 3, Munich, Bavaria 81675 Germany
| | - Pascal O. Berberat
- Technical University of Munich, TUM School of Medicine and Health – University Hospital rechts der Isar, TUM Medical Education Center (TUM MEC), Nigerstraße 3, Munich, Bavaria 81675 Germany
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Carvajal B, White H, Brooks J, Thomson AM, Cooke A. Navigating a maze: Midwives' identity response to the enactment of an abortion law in Chile. Midwifery 2024; 131:103938. [PMID: 38309123 DOI: 10.1016/j.midw.2024.103938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/23/2023] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Chilean midwives have been identified as essential for successfully implementing an abortion law, a practice which could potentially be understood as contradicting their central mission. Nevertheless, to date, there has been no investigation into how Chilean midwives have incorporated induced abortion care provision into their professional identity. OBJECTIVE To elucidate how Chilean midwives understand and provide abortion care and how they have (re)defined their professional identity to include induced abortion care. This article reports the findings of the second part of this aim. METHODS This study was underpinned by a constructivist grounded theory methodology informed by a reproductive justice and feminist perspective. Midwives from Chile who have cared for women undergoing abortion were invited to participate in the study. After purposive and theoretical sampling, fifteen midwives were recruited. FINDINGS Midwives' identity is woman-centred, with high value placed on their role protecting life. These two aspects of midwives' identity are in contradiction when providing abortion care. Midwives' identity results from and informs midwives' practice. Midwifery regulation influences both practice and identity. The model 'Navigating a maze' explains the interaction of these three elements. CONCLUSION Midwives' identity response to the enactment of the Chilean abortion law is an example of how professional identity must navigate regulation and practice to make sense of its purpose. In light of this study's findings, the current tension experienced in midwives' identity should be carefully attended to prevent adverse outcomes for midwives and the Chilean population.
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Affiliation(s)
- Bielka Carvajal
- Division of Nursing, Midwifery and Social Work, The University of Manchester, UK; Departamento de Promocion de la Salud de la Mujer y el Recien Nacido, Universidad de Chile, Chile.
| | - Helen White
- Division of Nursing, Midwifery and Social Work, The University of Manchester, UK.
| | - Jane Brooks
- Division of Nursing, Midwifery and Social Work, The University of Manchester, UK.
| | - Ann M Thomson
- Division of Nursing, Midwifery and Social Work, The University of Manchester, UK.
| | - Alison Cooke
- Division of Nursing, Midwifery and Social Work, The University of Manchester, UK; School of Nursing and Midwifery, Keele University, UK; Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK.
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Mattila P, Hyppölä H, Heikkilä T, Heistaro S, Kaila M, Kulmala P, Sumanen M, Mäntyselkä P. Team players and helpers - describing professional identity among finnish physicians in a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:304. [PMID: 38504233 PMCID: PMC10949613 DOI: 10.1186/s12909-024-05268-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Every physician has a unique professional identity. However, little is known about the diversity of identities among physicians. This study aimed to quantitatively assess the professional identity of physicians in Finland using descriptions of professional identity. METHODS This study was part of a larger cross-sectional Finnish Physician 2018 Study. The target population consisted of all Finnish physicians under the age of 70 (N = 24,827) in 2018. The sample was drawn from physicians born on even numbered days (N = 11,336) using the Finnish Medical Association register. A total of 5,187 (46%) physicians responded. Professional identity was examined by 27 given characterisations using a five-point Likert scale. Multivariate logistic regression was used in assessing how place of work, graduation year and gender were associated with identity descriptions. RESULTS The descriptions which most physicians identified with were "member of a working group/team" (82%), "helper" (82%), and "health expert" (79%); the majority reported these as describing them very or quite well. Identity descriptions such as "prescriber of medications" (68% vs. 45%), "prioritiser" (57% vs. 35%) and "someone issuing certificates" (52% vs. 32%) were more popular among junior than senior physicians. The biggest differences between the genders were found in the descriptions "provider of comfort" (62% vs. 40%) and "someone engaged in social work" (45% vs. 25%), with which women identified more frequently than men. CONCLUSIONS Strong identification as a member of a team is an important finding in the increasingly multiprofessional world of health care. Importantly, most physicians shared several core professional identity descriptions (i.e., helper, health expert) that reflect the traditional image of an exemplary doctor.
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Affiliation(s)
- Pyry Mattila
- Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Yliopistonranta 1 C, Kuopio, FI-70211, Finland.
| | - Harri Hyppölä
- Emergency Department, Mikkeli Central Hospital, Mikkeli, Finland
| | | | | | - Minna Kaila
- Public Health Medicine, University of Helsinki, Helsinki, Finland
| | - Petri Kulmala
- Faculty of Medicine and MRC Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Markku Sumanen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Yliopistonranta 1 C, Kuopio, FI-70211, Finland
- Clinical Research and Trials Centre, Wellbeing Services County of North Savo, Kuopio, Finland
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Tolleson S, Truong M, Rosario N. Navigating power dynamics between pharmacy preceptors and learners. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 13:100408. [PMID: 38317645 PMCID: PMC10838950 DOI: 10.1016/j.rcsop.2024.100408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/18/2023] [Accepted: 01/15/2024] [Indexed: 02/07/2024] Open
Abstract
Pharmacy preceptors are crucial in pharmacy experiential education. They help develop learners during didactic learning, experiential learning, and post-graduate training. Preceptors hold a position of authority over learners as they are responsible for providing feedback and ultimately completing evaluations that determine whether the student passes or does not pass the rotation. Preceptor status, behavior, and communication style may cause students to feel intimidated. Preceptors should be aware of this power differential and keep generational, gender, cultural, and other factors in mind when providing feedback. Preceptors should also receive training and be open to constructive feedback from learners to ensure the experience meets the needs of the learner and allow for adjustments on the experiential rotation. Students should be empowered to provide open and honest feedback to preceptors in a psychologically safe environment without fear of repercussions.
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Affiliation(s)
- Shane Tolleson
- University of Houston College of Pharmacy, Health 2, 4349 Martin Luther King Blvd, Office 3024, Houston, TX 77204-5039, United States of America
| | - Mabel Truong
- University of Houston College of Pharmacy, Health 2, 4349 Martin Luther King Blvd, Office 3022, Houston, TX 77204-5039, United States of America
| | - Natalie Rosario
- University of Houston College of Pharmacy, Health 2, 4349 Martin Luther King Blvd, Office 4026, Houston, TX 77204-5039, United States of America
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Karia CT, Anderson E, Burgess A, Carr S. Peer teacher training develops "lifelong skills". MEDICAL TEACHER 2024; 46:373-379. [PMID: 37783200 DOI: 10.1080/0142159x.2023.2256463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
INTRODUCTION Peer teaching is a valuable approach whereby students engage in reciprocal teaching and learning. However, there is limited literature on preparing students for this role, known as Peer Teacher Training (PTT), and exploring its long-term impact. This study investigates the impact of a previously implemented PTT programme on participants' application to clinical practice and their preparation for a future educator role. METHODS A convergent mixed methods approach was used involving questionnaires and semi-structured interviews after a mean time interval of seventeen months post-course. All participants who had previously undertaken the programme (n = 20), were invited to join. RESULTS Fifteen respondents completed the questionnaire, with twelve participating in one-to-one interviews. Participants demonstrated sustained improvements in perceived understanding and application of educational principles with greater confidence to teach upon entering the workforce. Interviews highlighted enhanced preparation for future educator roles, reflective teaching practices, influence over career choices and a wider benefit of the PTT to patients, peers, and students. DISCUSSION This study demonstrates the long-term benefits of a PTT through sustained improvements in participants' confidence and perceived competence in teaching skills. Future work should focus on integrating PTT into the medical curricula and expansion to include other healthcare professional students.
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Affiliation(s)
| | - Elizabeth Anderson
- Interprofessional Education and Patient Safety, Leicester Medical School, Leicester, UK
| | - Annette Burgess
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Australia
| | - Sue Carr
- Medical Education and current Deputy Medical, General Medical Council (GMC), Leicester, UK
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Drossard S, Härtl A. Development and implementation of digital peer mentoring in small groups for first-year medical students. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc11. [PMID: 38504864 PMCID: PMC10946215 DOI: 10.3205/zma001666] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 08/10/2023] [Accepted: 11/14/2023] [Indexed: 03/21/2024]
Abstract
Introduction Mentoring has become an important educational strategy in medical training. Peer mentoring (PM) can enhance student experience and support transition to higher education. This article documents the implementation of an online peer mentoring program for first year medical students at a newly founded medical school in Germany during the COVID-19 pandemic and its development into in-person PM. Project description We developed the program in close collaboration between students and teachers. Students were invited to apply as peer mentors via email; they received instructions and reflected on their role and experiences in meetings before, during and after the semester. One or more peer mentors were assigned randomly to a student group. We evaluated the program with an online survey inspired by the "Modified Mentorship Effectiveness Scale". After successful piloting PM was implemented into the core curriculum. Results In 2020 we assigned 17 peer mentors to 14 groups of 6-7 students. Groups met 3 or more times via Zoom®. Overall satisfaction was high. Both student groups reported benefits for their personal and professional identity formation. Atmosphere in online meetings was excellent. Most important topics were exams/learning strategies. In 2021 meetings were held in person. Overall satisfaction, perceived benefits and learning atmosphere were again rated very positively. Most students preferred many-to-many PM and random matching. Conclusion The implementation of PM was successful and beneficial for the participating students. PM can help first-year medical students reduce anxiety, improve self-organization and orientation at university. It fosters identity formation and has positive effects on peer mentees as well as on peer mentors.
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Affiliation(s)
- Sabine Drossard
- University Hospital Augsburg, Department of Pediatric Surgery, Augsburg, Germany
- University Hospital Würzburg, Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, Würzburg, Germany
| | - Anja Härtl
- University of Augsburg, Medical Faculty, Medical Didactics and Educational Research, DEMEDA, Augsburg, Germany
- University Hospital Augsburg, Department of Hygiene and Environmental Medicine, Augsburg, Germany
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Lee ICJ, Wong P. A mixed methods, longitudinal study: characterizing the differences in engagement and perceived learning of medical students in online and in-person team-based learning classes. MEDEDPUBLISH 2024; 13:33. [PMID: 39139988 PMCID: PMC11320038 DOI: 10.12688/mep.19535.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2024] [Indexed: 08/15/2024] Open
Abstract
Background The rapid transition to online delivery of medical curriculum has facilitated the continuation of medical education during the COVID-19 pandemic. Whilst active learning approaches, including Team-Based Learning (TBL), are generally more supportive of the learner's needs during such transition, it remains elusive how different learning environments affect a learner's motivation, engagement, and perceived learning over a prolonged period. We leveraged on Self-Determination Theory (SDT) and key learners' characteristics to explore the levels of student's engagement and perceived learning in two TBL learning environments, online and in-person, over an extended period. We hypothesize that students' self-reported perceptions of engagement and learning will be lower in online compared to in-person TBL classes. Methods This is a mixed methods study with 49 preclinical graduate medical students completing the same questionnaire twice for each learning environment, online TBL and in-person TBL, over an eight-month period. Quantitative data were collected on learners' characteristics, basic psychological needs satisfaction, motivation, student's engagement and perceived learning. The final questionnaire also explored participants' perception on which learning environment better supported their learning. Results We found that autonomy support, perceived competence and needs satisfaction, and perceived learning were higher in-person than online. Additionally, most learners felt that in-person TBL was better for learning, as the concepts of learning space and the community of practice were mediated by being in-person. Conclusions TBL, being an active instructional method, can maintain students' engagement because it supports many aspects of SDT constructs and perceived learning. However, online TBL is unable to fully support the students' needs and perceived learning. Hence, we strongly advocate for any in-person opportunities to be included in a course, as in-person classes best supports students' engagement and perceived learning.
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Affiliation(s)
| | - Peiyan Wong
- MD Programme, Duke-NUS Medical School, Singapore, 169857, Singapore
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
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Bashir A, McTaggart IJ, Tufail S, Mustafa N, Rauf A. Negative faculty role modelling - is it a reflection of deteriorating societal values? MEDICAL TEACHER 2024:1-7. [PMID: 38306677 DOI: 10.1080/0142159x.2024.2306844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/15/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Negative faculty role modelling is an area of growing concern especially due to its implications on medical professionalism. The study aims to explore the impacts of negative role modelling on professionalism of medical students in the context of Pakistan. METHODS This qualitative study is part of a larger study exploring impacts of role modelling on professionalism of students. It is based on Constructivist Grounded Theory involving six semi-structured interviews with clinical faculty and three focus group discussions with 22 students. Initial, focused, selective coding and thematic analysis was used to find the core category. RESULTS Three overarching categories were developed: traits observed with negative role models; impact of negative role modelling; factors promoting negative role modelling. Subcategories of impacts included negative impact on professionalism, emotional impact, and its paradoxical positive impact. Negative role modelling, a manifestation of declining professionalism, was attributed to deteriorating societal values; further compounded by the lack of required mechanisms by institutions and the regulatory authority at their respective levels. CONCLUSIONS In the absence of a strong moral platform at societal level, the burden of responsibility rests with the faculty and more importantly with institutions and regulatory bodies to discourage negative role modelling and educate students to recognize, reflect on and avoid negative behaviours and adopt strong professional values.
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Affiliation(s)
- Adeela Bashir
- Department of Health Professions Education, National University of Medical Sciences, Rawalpindi, Pakistan
| | | | - Shazia Tufail
- Department of Obstetrics & Gynaecology, CMH Lahore Medical College, National University of Medical Sciences, Lahore, Pakistan
| | - Nilofar Mustafa
- Department of Obstetrics & Gynaecology, CMH Lahore Medical College, National University of Medical Sciences, Lahore, Pakistan
| | - Ayesha Rauf
- Department of Health Professions Education, National University of Medical Sciences, Rawalpindi, Pakistan
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Schultz K, Cofie N, Braund H, Joneja M, Watson S, Drover J, MacMillan-Jones L, Dalgarno N. The hidden curriculum across medical disciplines: an examination of scope, impact, and context. CANADIAN MEDICAL EDUCATION JOURNAL 2024; 15:15-25. [PMID: 38528901 PMCID: PMC10961118 DOI: 10.36834/cmej.75207] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Background While research suggests that manifestations of the hidden curriculum (HC) phenomenon have the potential to reinforce or undermine the values of an institution, very few studies have comprehensively measured its scope, impact, and the varied clinical teaching and learning contexts within which they occur. We explored the HC and examined the validity of newly developed constructs and determined the influence of context on the HC. Methods We surveyed medical students (n =182), residents (n =148), and faculty (n = 140) from all disciplines at our institution between 2019 and 2020. Based on prior research and expertise, we measured participants' experience with the HC including perceptions of respect and disrespect for different medical disciplines, settings in which the HC is experienced, impact of the HC, personal actions, efficacy, and their institutional perceptions. We examined the factor structure, reliability, and validity of the HC constructs using exploratory factor analysis Cronbach's alpha, regression analysis and Pearson's correlations. Results Expert judges (physician faculty and medical learners) confirmed the content validity of the items used and the analysis revealed new HC constructs reflecting negative expressions, positive impacts and expressions, negative impacts, personal actions, and positive institutional perceptions of the HC. Evidence for criterion validity was found for the negative impacts and the personal actions constructs and were significantly associated with the stage of respondents' career and gender. Support for convergent validity was obtained for HC constructs that were significantly correlated with certain contexts within which the HC occurs. Conclusion More unique dimensions and contexts of the HC exist than have been previously documented. The findings demonstrate that specific clinical contexts can be targeted to improve negative expressions and impacts of the HC.
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Affiliation(s)
- Karen Schultz
- Department of Family Medicine, Queens University, Ontario, Canada
| | - Nicholas Cofie
- Office of Professional Development and Educational Scholarship, Faculty of Health Sciences, Queens University, Ontario, Canada
| | - Heather Braund
- Office of Professional Development and Educational Scholarship, Faculty of Health Sciences, Queens University, Ontario, Canada
| | - Mala Joneja
- Division of Rheumatology, School of Medicine, Faculty of Health Sciences, Queen’s University, Ontario, Canada
| | - Shayna Watson
- Department of Family Medicine, Queens University, Ontario, Canada
| | - John Drover
- Departments of Critical Care Medicine and Surgery, School of Medicine, Faculty of Health Sciences, Queen’s University, Ontario, Canada
| | | | - Nancy Dalgarno
- Department of Family Medicine, Queens University, Ontario, Canada
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Diaz R, Balgord S, Klekowski N, Farthing AS, Escolero SG, DeCloux K, Burkhardt JC, Haggins AN, Hopson LR. Understanding clerkship experiences in emergency medicine and their potential influence on specialty selection: A qualitative study. AEM EDUCATION AND TRAINING 2024; 8:e10932. [PMID: 38343629 PMCID: PMC10858322 DOI: 10.1002/aet2.10932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 02/16/2024]
Abstract
Objectives The specialty of emergency medicine (EM) is experiencing a significant decrease in student interest. In addition, women are historically underrepresented within the specialty at all levels of training and practice. We sought to understand how clinical experiences and perceptions of EM influence specialty selection by medical students, particularly women. Methods Using a constructivist grounded theory approach, we analyzed semistructured interviews with senior medical students who considered EM as a specialty. We used purposive sampling to recruit from diverse learning environments and represent a variety of experiences. Participants reflected on their specialty selection process and experiences in EM including their perceived acceptance in the work environment. Results Twenty-five medical students from 11 geographically diverse schools participated. A total of 68% (17/25) identified as women. The majority (21/25, 84%) planned on applying to EM residency. We identified four major themes: (1) distressing interpersonal interactions with patients and the ED care team negatively affect students; (2) EM culture includes behaviors that are perceived as exclusionary; (3) beliefs about the attributes of an ideal EM physician and the specialty itself have a gendered nature; and (4) ease of access to mentors, representation, and early exposure to EM environment increased interest in specialty. Conclusions Our participants express that EM causes challenges for students to accept the norms of behavior in the field, which is an essential element in joining a group and professional identity formation. In addition, we raise concern that gendered perceptions and language may send exclusionary environmental cues that may negatively impact recruitment of a diverse physician workforce.
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Affiliation(s)
- Rosemarie Diaz
- Department of Emergency MedicineUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Sarah Balgord
- Department of Emergency MedicineMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Nicole Klekowski
- Department of Emergency MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | | | | | - Korynne DeCloux
- Department of Internal MedicineYale UniversityNew HavenConnecticutUSA
| | - John C. Burkhardt
- Departments of Emergency Medicine and Learning Health SciencesUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Adrianne N. Haggins
- Department of Emergency MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Laura R. Hopson
- Department of Emergency MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
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Haramati A, Bonaminio G, Osheroff N. Professional Identity Formation of Medical Science Educators: An Imperative for Academic Medicine. MEDICAL SCIENCE EDUCATOR 2024; 34:209-214. [PMID: 38510409 PMCID: PMC10948639 DOI: 10.1007/s40670-023-01922-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 03/22/2024]
Abstract
Medical schools increasingly seek the expertise of talented medical science faculty to engage in the educational mission of the school; yet, the professional identity of these individuals is in flux. As courses and departments have become more integrated and less discipline-based, faculty with doctorates in biomedical science disciplines who primarily teach may suffer a loss of connection to their discipline, either in the courses they are teaching or in their home departments. Recent reports suggest that most medical science educators transitioned from the laboratory to the classroom by happenstance-not the most ideal way to build this key segment of the faculty. This article addresses the importance of foundational sciences in medical training, highlights the unique contributions of science educators in medical schools, and makes a case for why the professional identity of medical science educators should be studied. An imperative for academic medicine is to understand the factors that underpin the professional identity formation of medical science educators and to invest in training and nurturing this group of faculty members that are vital to educating the next generation of health professionals.
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Affiliation(s)
- Aviad Haramati
- Department of Biochemistry, Molecular & Cellular Biology, Georgetown University School of Medicine, Washington, DC 20057 USA
- Center for Innovation and Leadership in Education (CENTILE), Georgetown University School of Medicine, Washington, DC 20057 USA
| | - Giulia Bonaminio
- Department of Family Medicine and Community Health, The University of Kansas School of Medicine, Kansas City, KS USA
| | - Neil Osheroff
- Departments of Biochemistry and Medicine, Vanderbilt University School of Medicine, Nashville, TN USA
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Talib MA, Greene RE, Winkel AF. A narrative analysis of clerkship reflections: Medical student identity development in a changing world. CLINICAL TEACHER 2024; 21:e13652. [PMID: 37694819 DOI: 10.1111/tct.13652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 07/27/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Medical students' written reflections on their clinical experiences can be a useful tool for processing complex aspects of development as physicians. To create educational programs that scaffold adaptive professional identity development, it is essential to understand how medical students develop as professionals and process the dynamic sociocultural experiences of the current moment. OBJECTIVE To explore the developing professional consciousness of medical students through clerkship reflections. DESIGN Narrative analysis of written reflections are produced by clerkship students, who were asked to tell a story that resonated with the physician's relationship with patient, self and colleagues. Two independent readers applied inductive labels to generate a homogenous codebook, which was used to generate themes that were then used to construct a conceptual model. KEY RESULTS Four themes were identified in the data that describe relationships between medical students' developing professional identities and the norms of their future professional and personal communities. These included: medical students as outsiders, conflict between the student identifying with the patient versus the healthcare team, medical students' own value judgements and, finally, the changing societal mores as they relate to social and racial injustice. The conceptual model for this experience depicts the medical student as pulled between patients and the social context on one side and the professional context of the medical centre on the other. Students long to move towards identification with the healthcare team, but reject the extremes of medical culture that they view on conflict with social and racial justice. CONCLUSIONS Medical students in clinical training identify strongly with both patients and the medical team. Rather than viewing professional identity development as a longitudinal journey from one extreme to another, students have the power to call attention to entrenched problems within medical culture and increase empathy for patients by retaining their strong identification with the important issues of this time.
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Affiliation(s)
- Mahino A Talib
- New York University School of Medicine, New York City, New York, USA
| | - Richard E Greene
- New York University School of Medicine, New York City, New York, USA
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Consorti F, Borcea MC, Melcarne R, Giacomelli L. Peer assisted learning: a meta-ethnographic synthesis of qualitative studies and recommendations for cardiovascular training, practice, and research. Minerva Cardiol Angiol 2024; 72:11-23. [PMID: 37158626 DOI: 10.23736/s2724-5683.23.06265-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Peer assisted learning (PAL) is a common method to complement more traditional teaching. Several systematic reviews and meta-analyses described the most used ways of implementation and showed that it is effective in fostering learning. A synthesis of qualitative data is missing, to highlight the perceived value by the students and to drive a successful implementation. EVIDENCE ACQUISITION The search was performed in Pubmed, Scopus and ERIC databases, with a combination of the search strings. The quality of the retrieved articles was assessed through the Critical Appraisal Skills Checklist. The analysis was performed according to the meta-ethnographic method. Fifteen articles were considered for the analysis, saturation was reached after 12 articles. EVIDENCE SYNTHESIS Three main themes emerged from the analysis: PAL is effective when implemented in a safe environment, PAL is a driver of development of students' abilities and identity, and the "dark side" of PAL. Nine sub-themes emerged as components of the themes. The final line of argument highlighted the ambivalence of PAL, as an expression of the ambivalence of the still developing professional identity of students. CONCLUSIONS This meta-ethnographic synthesis summarizes the elements of success and the threats of PAL, a method that is particularly suitable for the cardiovascular domain. It must be implemented according to some precautions, such as organization and protected time, tutor selection, training and support, a clear integration and endorsement in the framework of the medical curriculum.
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Affiliation(s)
| | - M Carola Borcea
- Department of General and Specialist Surgery, Sapienza University, Rome, Italy
| | - Rossella Melcarne
- Department of General and Specialist Surgery, Sapienza University, Rome, Italy
| | - Laura Giacomelli
- Department of General and Specialist Surgery, Sapienza University, Rome, Italy
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Öhman E, Pal ET, Hult H, Nilsson GH, Salminen H. Medical students' perception of learning from patient encounters in primary health care; a qualitative interview study. BMC MEDICAL EDUCATION 2023; 23:935. [PMID: 38066519 PMCID: PMC10709937 DOI: 10.1186/s12909-023-04923-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Clinical practice gives medical students opportunities to develop clinical skills and to gain insight into their future profession as a physician. Students in the medical programme at Karolinska Institutet in Sweden had clinical practice in primary health care in nine of their 11 semesters. The aim of this study was to explore medical students' perceptions of learning from patient encounters in a primary health care context. METHODS The study was a qualitative inductive interview study. The 21 participating medical students were from their 3rd, 4th and 5th (final year) year of the study programme. A semi-structured interview guide was used. The data analysis was performed with qualitative content analysis. RESULTS The overarching theme of the study was: The individual patient encounters are the key to learning in primary health care. The patient encounters presented both useful opportunities and challenges that could contribute to the students' professional development. The following four categories were found: 1. Patient encounters in are instructive, rewarding and challenging. Practising in primary health care provided experience in meeting and communicating with a wide variety of patients. Students described it being challenging to trust in their own clinical competence and feeling a responsibility towards the patients. 2. Encounters with patients in primary health care provide opportunities for gradual professional development. Students had the opportunity of increasing independence based on their level of clinical competence. They experienced a progression in their professional development after each period in primary health care. 3. A committed supervisor plays a significant role in learning. Committed supervisors who set aside time for supervision, offered support, and encouraged the student, played an important role in the student's learning. 4. Learning in primary health care and learning in hospitals complement one another. It could be difficult for the students to sort out exactly where they learnt different things as they perceived that learning in primary health care and in hospitals complemented one another. CONCLUSIONS The students' encounters with authentic patients in primary health care gave them recurring opportunities to develop communication skills and to be trusted to work on their own under supervision, giving them guidance on their way to becoming future physicians.
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Affiliation(s)
- Eva Öhman
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, SE-141 83, Sweden.
- Academic Primary Healthcare Centre Stockholm, Stockholm, Sweden.
| | - Eva Toth Pal
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, SE-141 83, Sweden
- Academic Primary Healthcare Centre Stockholm, Stockholm, Sweden
| | - Håkan Hult
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar H Nilsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, SE-141 83, Sweden
- Academic Primary Healthcare Centre Stockholm, Stockholm, Sweden
| | - Helena Salminen
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, SE-141 83, Sweden
- Academic Primary Healthcare Centre Stockholm, Stockholm, Sweden
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Hayashi M, Breugelmans R, Nishiya K. Identity conflicts of student affairs officers in a medical university. MEDICAL EDUCATION ONLINE 2023; 28:2182216. [PMID: 36840965 PMCID: PMC9970241 DOI: 10.1080/10872981.2023.2182216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/24/2022] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Collaboration between student affairs officers and the faculty is important in dealing with the recent rapid changes in medical education, and mutual understanding is essential to ensure that participants become a cohesive social group. This study explores the identity conflicts of student affairs officers in medical universities using the figured worlds theory. METHODS An exploratory qualitative case study was conducted with 24 student affairs officers at a private medical university in Japan. Data were collected through face-to-face, semi-structured interviews and analysed using thematic analysis from the perspective of a social constructivism paradigm. RESULTS Qualitative analysis revealed the following three themes regarding the identity conflicts of student affairs officers: differences in the perception of medical students, difficulties in building trusting relationships with the faculty, and resistance to the medical university's traditional atmosphere. Student affairs officers tended to provide support from a student-centred perspective when interacting with medical students, while the faculty employed a teacher-centred perspective. DISCUSSION To promote understanding between professions, it is necessary to set aside certain professional views and welcome dialogue with other professionals with different values, while also understanding the multi-layered context of medical education, so that conflicts can be handled optimally and relationships can be professionalised for social cohesion.
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Affiliation(s)
- Mikio Hayashi
- Center for Health Professions Education, Kansai Medical University, Osaka, Japan
- Master of Medical Sciences in Medical Education, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Katsumi Nishiya
- Center for Health Professions Education, Kansai Medical University, Osaka, Japan
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McLean M, Khaira A, Alexander C. Symbols and rituals are alive and well in clinical practice in Australia: Perspectives from a longitudinal qualitative professional identity study. MEDICAL TEACHER 2023; 45:1425-1430. [PMID: 37339497 DOI: 10.1080/0142159x.2023.2225722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
PURPOSE Many factors impact an individual's professional identity on their journey to becoming a doctor, including their experiences, the learning environment, role models, and symbols and rituals. Rituals and symbols associated with the medical profession have historically included wearing a white coat (now rare) and the stethoscope. This study explored two medical students' perspectives of symbolic identifiers in a six-year longitudinal study in Australia (2012-2017). METHODOLOGY A 2012 qualitative cross-sectional qualitative professional identity study in an Australian five-year undergraduate medical programme was extended to a longitudinal study with annual interviews. A conversation about the symbolism of the stethoscope and other identifiers began in Year 1 and concluded when the students were junior doctors. FINDINGS Symbols and rituals remain part of the 'becoming' and 'being' a doctor. In the context of Australian hospitals, the stethoscope appears to no longer be exclusively associated with the medical profession, with 'professional attire' distinguishing medical students and doctors from other team members (uniform). The study identified lanyard colour and design as a symbol and language as a ritual. CONCLUSIONS Although symbols and rituals may change over time and across cultural contexts, some forms of treasured material possessions and rituals will persist in medical practice.[Box: see text].
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Affiliation(s)
- Michelle McLean
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Arjun Khaira
- Mental Health, Mayo Private Hospital, Taree, New South Wales, Australia
| | - Charlotte Alexander
- Emergency Department, Gold Coast University Hospital, Gold Coast, Queensland, Australia
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Astle KN, Hart LA, Holloway J, Medlin CG, Mills AR, Nardolillo JA, Phan T, Wilby KJ. Born This Way: Integrating LGBTQIA+ Identities as Pharmacy Practitioners. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100122. [PMID: 38097310 DOI: 10.1016/j.ajpe.2023.100122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 02/20/2023] [Accepted: 04/11/2023] [Indexed: 12/18/2023]
Abstract
Progression through the profession of pharmacy is filled with many milestones that can contribute to feelings of stress, rejection, and isolation. For Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual+(LGBTQIA+) students and practitioners, these feelings can be compounded by similar issues experienced by their sexual orientation or gender identity. Historically, LGBTQIA+ students, new practitioners, and seasoned professionals alike have lacked visible role models for how to intersect personal and professional identity in the pharmacy profession. In this paper, the authors describe experiences of intersecting personal queer identities with professional pharmacy identities; exploring barriers to integration and developing solutions to overcome these barriers. The authors also share how the formation of a collective of LGBTQIA+ practitioners and educators has led to a unified voice to advocate for the advancement of LGBTQIA+ healthcare in pharmacy education and practice. This manuscript will provide readers with a guide to navigate and address issues with the integration of personal and professional identity to lead to practice that validates personal identity as important, valuable, and affirmed.
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Affiliation(s)
| | - Laura A Hart
- University of California, San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA
| | | | | | - Alex R Mills
- Department of Pharmacy Practice, University of Mississippi School of Pharmacy, University Ave, MS, USA
| | | | - Tam Phan
- University of Southern Calfornia, Los Angeles, CA, USA
| | - Kyle John Wilby
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS, Canada; Editorial Board, American Journal of Pharmaceutical Education, USA
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Lönn A, Weurlander M, Seeberger A, Hult H, Thornberg R, Wernerson A. The impact of emotionally challenging situations on medical students' professional identity formation. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023; 28:1557-1578. [PMID: 37184676 PMCID: PMC10184105 DOI: 10.1007/s10459-023-10229-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 04/09/2023] [Indexed: 05/16/2023]
Abstract
In their interactions with patients and health care professionals during work-based learning, medical students are known to experience emotionally challenging situations that can evoke negative feelings. Students have to manage these emotions. Students learn and develop their professional identity formation through interactions with patients and members of the healthcare teams. Earlier studies have highlighted the issues involved with processing emotionally challenging situations, although studies concerning learning and professional identity formation in response to these experiences are rare. In this study, we explored medical students' experiences of emotionally challenging situations in work-based learning, and the impact these experiences had on forming medical students' professional identities. We conducted an analysis of narrative data (n = 85), using a constructivist grounded theory approach. The narratives were made up of medical students' reflective essays at the end of their education (tenth term). The analysis showed that students' main concern when facing emotionally challenging situations during their work-based education was the struggle to achieve and maintain a professional approach. They reported different strategies for managing their feelings and how these strategies led to diverse consequences. In the process, students also described arriving at insights into their own personal needs and shortcomings. We consider this development of self-awareness and resulting self-knowledge to be an important part of the continuously ongoing socialization process of forming a professional identity. Thus, experiencing emotionally challenging situations can be considered a unique and invaluable opportunity, as well as a catalyst for students' development. We believe that highlighting the impact of emotions in medical education can constitute an important contribution to knowledge about the process of professional identity formation. This knowledge can enable faculty to provide students with more effective and sufficient support, facilitating their journey in becoming physicians.
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Affiliation(s)
- Annalena Lönn
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden.
| | - Maria Weurlander
- Department of Education, Stockholm University, Stockholm, Sweden
| | - Astrid Seeberger
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden
| | - Håkan Hult
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden
| | - Robert Thornberg
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Annika Wernerson
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden
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Moll-Jongerius A, Langeveld K, Helmich E, Masud T, Kramer AWM, Achterberg WP. Becoming a physician for older patients: exploring the professional identity formation of medical students during a nursing home clerkship. A qualitative study. BMC MEDICAL EDUCATION 2023; 23:845. [PMID: 37936183 PMCID: PMC10631180 DOI: 10.1186/s12909-023-04835-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 11/01/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND To prepare medical students for the growing population of older patients, an appropriate professional identity formation is desirable. The community of practice of medical school is primarily hospital-based and disease-oriented which will lead to the development of a physician who is mainly focused on cure. This focus alone however is not always appropriate for older persons' health care. The aim of this study is to explore the influence of participating in a nursing home community of practice on the professional identity formation of medical students. METHODS A qualitative study based on a constructivist research paradigm was conducted, using individual semi-structured, in-depth interviews and a visual narrative method (drawing) as a prompt. Thematic analysis was applied to structure and interpret the data. The study population consisted of fifth-year medical students participating in a six-week nursing home clerkship. Thirteen participants were purposefully sampled. The clerkship took place in nursing homes in the South-West of the Netherlands. RESULTS The medical students described the nursing home as the living environment of the patients. Actively participating in the patients' care and experiencing the daily life of the patients was meaningful for the physician the students want to become in five ways: (1) a physician with a complete picture; (2) a physician who is close; (3) a physician who is in dialogue; (4) a physician who is able to let go and (5) a physican who collaborates. CONCLUSIONS Caring for older patients in the nursing home influences the professional identity formation of medical students. Patient-centeredness, personal, holistic and tailored care, approachability and collaboration are important characteristics in becoming a physician for older persons' health care. The context of this care provides relevant learning experiences for this development and the becoming of a physician in general.
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Affiliation(s)
- Annemarie Moll-Jongerius
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Leiden, 2333 ZD, The Netherlands.
| | - Kirsten Langeveld
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Leiden, 2333 ZD, The Netherlands
| | - Esther Helmich
- Amsta Health Care Organization, Amsterdam, The Netherlands
| | - Tahir Masud
- Department of Health Care for Older People (HCOP), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Anneke W M Kramer
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Leiden, 2333 ZD, The Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Leiden, 2333 ZD, The Netherlands
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Ollen-Bittle N, Sivajohan A, Jesin J, Gasim M, Watling C. Examining the Effect of Virtual Learning on Canadian Pre-Clerkship Medical Student Well-Being During the COVID-19 Pandemic. PERSPECTIVES ON MEDICAL EDUCATION 2023; 12:488-496. [PMID: 37929202 PMCID: PMC10624142 DOI: 10.5334/pme.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023]
Abstract
Introduction The restrictions of the COVID-19 pandemic resulted in the broad and abrupt incorporation of virtual/online learning into medical school curricula. While current literature explores the effectiveness and economic advantages of virtual curricula, robust literature surrounding the effect of virtual learning on medical student well-being is needed. This study aims to explore the effects of a predominantly virtual curriculum on pre-clerkship medical student well-being. Methods This study followed a constructivist grounded theory approach. During the 2020-2021 and 2021-2022 academic years, students in pre-clerkship medical studies at Western University in Canada were interviewed by medical student researchers over Zoom. Data was analyzed iteratively using constant comparison. Results We found that students experiencing virtual learning faced two key challenges: 1) virtual learning may be associated with an increased sense of social isolation, negatively affecting wellbeing, 2) virtual learning may impede or delay the development of trainees' professional identity. With time, however, we found that many students were able to adapt by using protective coping strategies that enabled them to appreciate positive elements of online learning, such as its flexibility. Discussion When incorporating virtual learning into medical education, curriculum developers should prioritize optimizing existing and creating new ways for students to interact with both peers and faculty to strengthen medical student identity and combat feelings of social isolation.
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Affiliation(s)
- Nikita Ollen-Bittle
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, CA
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, CA
| | - Asaanth Sivajohan
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, CA
| | - Joshua Jesin
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, CA
| | - Majid Gasim
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, CA
| | - Christopher Watling
- Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, CA
- Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, CA
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Brooks JV, Dickinson BL, Quesnelle KM, Bonaminio GA, Chalk-Wilayto J, Dahlman KB, Fulton TB, Hyland KM, Kruidering M, Osheroff N, Tuan RL, Ho MJ. Professional Identity Formation of Basic Science Medical Educators: A Qualitative Study of Identity Supports and Threats. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:S14-S23. [PMID: 37556802 PMCID: PMC10657385 DOI: 10.1097/acm.0000000000005354] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
PURPOSE Basic science medical educators (BSME) play a vital role in the training of medical students, yet little is known about the factors that shape their professional identities. This multi-institutional qualitative study investigated factors that support and threaten the professional identity formation (PIF) of these medical educators. METHOD A qualitative descriptive study was conducted with a purposive sample of 58 BSME from 7 allopathic medical schools in the U.S. In-depth semi-structured interviews of individual BSME were conducted between December 2020 and February 2021 to explore the facilitators and barriers shaping the PIF of BSME. Thematic analysis was conducted. RESULTS Factors shaping PIF were grouped into 3 broad domains: personal, social, and structural. Interrelated themes described a combination of factors that pushed BSME into teaching (early or positive teaching experiences) and kept them there (satisfaction and rewards of teaching, communities of like-minded people), as well as factors that challenged their PIF (misunderstanding from medical students, clinical, and research faculty, lack of formal training programs, and lack of tenure-track educator positions). The structural environment was reported to be crucial for PIF and determined whether BSME felt that they belonged and were valued. CONCLUSIONS This study shows that although most BSME derive a sense of fulfillment and meaning from their role as medical educators, they face considerable obstacles during their PIF. Structural change and support are needed to increase recognition, value, promotion, and belonging for BSME to improve the satisfaction and retention of this important group of faculty.
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Affiliation(s)
- Joanna Veazey Brooks
- J.V. Brooks is associate professor, Department of Population Health & Division of Palliative Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Bonny L Dickinson
- B.L. Dickinson is senior associate dean for faculty affairs, director of medical education research, and professor, Department of Biomedical Sciences, Mercer University School of Medicine, Macon, Georgia
| | - Kelly M Quesnelle
- K.M. Quesnelle is clinical professor and chair, Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina
| | - Giulia A Bonaminio
- G.A. Bonaminio is professor, Department of Family Medicine and Community Health, University of Kansas School of Medicine, Kansas City, Kansas
| | - Janine Chalk-Wilayto
- J. Chalk-Wilayto is associate professor of anatomy, Department of Biomedical Sciences, Mercer University School of Medicine, Macon, Georgia
| | - Kimberly Brown Dahlman
- K.B. Dahlman is associate professor of medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Tracy B Fulton
- T.B. Fulton is professor, Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, California
| | - Katherine M Hyland
- K.M. Hyland is professor, Department of Biochemistry and Biophysics, Institute for Human Genetics, University of California, San Francisco, San Francisco, California
| | - Marieke Kruidering
- M. Kruidering is professor, Department of Cellular and Molecular Pharmacology, University of California San Francisco, San Francisco, California
| | - Neil Osheroff
- N. Osheroff is professor, Departments of Biochemistry and Medicine, Vanderbilt University School of Medicine, and has an appointment at VA Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Rupa Lalchandani Tuan
- R.L. Tuan is associate professor, Department of Cellular and Molecular Pharmacology, University of California San Francisco, San Francisco, California
| | - Ming-Jung Ho
- M.-J. Ho is professor of family medicine and associate director, Center for Innovation and Leadership in Education, Georgetown University Medical Center, and director of education research, MedStar Health, Washington, DC
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Walinga CW, Barnhoorn PC, Essers GTJM, Schaepkens SPC, Kramer AWM. 'You are not alone.' An exploratory study on open-topic, guided collaborative reflection sessions during the General Practice placement. BMC MEDICAL EDUCATION 2023; 23:769. [PMID: 37845655 PMCID: PMC10577966 DOI: 10.1186/s12909-023-04756-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND To support professional development of medical students faced with challenges of the clinical phase, collaborative reflection sessions (CRSs) are used to share and reflect on workplace experiences. Facilitation of CRSs seems essential to optimise learning and to provide important skills for lifelong learning as a professional. However, little is known about which workplace experiences students share in CRSs without advance guidance on specific topics, and how reflecting on these experiences contributes to students' professional development. Therefore, we explored which workplace experiences students shared, what they learned from reflection on these experiences, and how they perceived the value of CRSs. METHODS We conducted an exploratory study among medical students (N = 99) during their General Practice placement. Students were invited to openly share workplace experiences, without pre-imposed instruction. A thematic analysis was performed on shared experiences and student learning gains. Students' perceptions of CRSs were analysed using descriptive statistics. RESULTS All 99 students volunteered to fill out the questionnaire. We found four themes relating to students' shared experiences: interactions with patients, complex patient care, diagnostic or therapeutic considerations, and dealing with collegial issues. Regarding students' learning gains, we found 6 themes: learning from others or learning from sharing with others, learning about learning, communication skills, self-regulation, determination of position within the healthcare team, and importance of good documentation. Students indicated that they learned from reflection on their own and peer's workplace experiences. Students valued the CRSs as a safe environment in which to share workplace experiences and helpful for their professional development. CONCLUSIONS In the challenging General Practice placement, open-topic, guided CRSs provide a helpful and valued learning environment relevant to professional development and offer opportunities for vicarious learning among peers. CRSs may also be a valuable tool to incorporate into other placements.
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Affiliation(s)
- Chris W Walinga
- Department of Public Health and Primary Care, Leiden University Medical Centre, PO Box 9600, Leiden, 2300 RC, The Netherlands.
| | - Pieter C Barnhoorn
- Department of Public Health and Primary Care, Leiden University Medical Centre, PO Box 9600, Leiden, 2300 RC, The Netherlands
| | | | - Sven P C Schaepkens
- Department of General Practice, Erasmus University Medical Centre, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| | - Anneke W M Kramer
- Department of Public Health and Primary Care, Leiden University Medical Centre, PO Box 9600, Leiden, 2300 RC, The Netherlands
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Silveira GL, Monson V, Poço PCE, Haydar A, Brenelli SL, Succi FMP, de Menezes Succi G, de Arruda Martins M, Tempski PZ. Assessment of professional identity formation: a transcultural validation of the professional identity essay for brazilian portuguese. BMC MEDICAL EDUCATION 2023; 23:738. [PMID: 37803330 PMCID: PMC10559411 DOI: 10.1186/s12909-023-04627-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/29/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION Professional identity formation (PIF) is recognized worldwide as an outcome of medical education grounded in the psychology of adult development and the literature on medical professionalism. However, instruments to assess and support PIF are scarce. The Professional Identity Essay (PIE) is an open-ended question assessment of PIF that elicits short narrative responses from learners and that can be analyzed to provide formative feedback and an overall stage of development. In this study, our aim was to translate and adapt the PIE to Brazilian Portuguese. METHODS We followed a systematic procedure for the translation and cross-cultural adaptation of the instrument. A pilot study was conducted with medical students from the University of São Paulo. After providing individual formative feedback, we administered an online questionnaire to the Brazilian students to better understand the consequences of using the PIE. Content analyses of qualitative data were performed, we employ manifest content analysis, and the categories of analysis emerged from the participants' speeches. RESULTS Students found the instrument's questions easy to interpret and self-reflective. It also gave students the opportunity to consider their PIF. The PIE was perceived as reliable and brought more awareness of the students' own processes in addition to a sense of capability to foster their own development. In the same way, the students emphasized the importance of being helped in this process. CONCLUSION We found sufficient evidence of the validity of the PIE in terms of content, face validity, and consequences of use. The PIE enhances self-assurance in PIF through formative assessment and is sensitive to different cultures, making it a potential tool for educators.
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Affiliation(s)
- Gabrielle Leite Silveira
- São Leopoldo Mandic School of Medicine, Campinas - SP, Brazil.
- Center of Development of Medical Education, School of Medicine of University of São Paulo, Av. Dr. Arnaldo, 455, room 2349, São Paulo, SP, 01246-903, Brazil.
| | - Verna Monson
- Kern Institute for the Transformation of Medical Education, Medial College of Wisconsin, Milwaukee, USA
| | - Paula Cristina Eiras Poço
- São Leopoldo Mandic School of Medicine, Campinas - SP, Brazil
- Center of Development of Medical Education, School of Medicine of University of São Paulo, Av. Dr. Arnaldo, 455, room 2349, São Paulo, SP, 01246-903, Brazil
| | - Ahmed Haydar
- Center of Development of Medical Education, School of Medicine of University of São Paulo, Av. Dr. Arnaldo, 455, room 2349, São Paulo, SP, 01246-903, Brazil
| | - Sigisfredo Luis Brenelli
- São Leopoldo Mandic School of Medicine, Campinas - SP, Brazil
- Center of Development of Medical Education, School of Medicine of University of São Paulo, Av. Dr. Arnaldo, 455, room 2349, São Paulo, SP, 01246-903, Brazil
| | | | | | - Milton de Arruda Martins
- Center of Development of Medical Education, School of Medicine of University of São Paulo, Av. Dr. Arnaldo, 455, room 2349, São Paulo, SP, 01246-903, Brazil
| | - Patrícia Zen Tempski
- Center of Development of Medical Education, School of Medicine of University of São Paulo, Av. Dr. Arnaldo, 455, room 2349, São Paulo, SP, 01246-903, Brazil
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O'Sullivan TA, Allen RA, Bacci JL, O'Sullivan AC. A Qualitative Study of Experiences Contributing to Professional Identity Formation in Recent Pharmacy Graduates. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100070. [PMID: 37852681 DOI: 10.1016/j.ajpe.2023.100070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/22/2022] [Accepted: 02/15/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE A professional identity has been described as "an individual thinking, acting, and feeling" like a person within the profession. The objective of this study was to learn about professional identity formation (PIF) in recent graduates of a pharmacy program. METHODS In-depth interviews were conducted with students graduating from a doctor of pharmacy degree program. Investigators performed a thematic content analysis of interview transcripts. RESULTS Participants were from community pharmacy practice (4), residencies (4), industry (1), and ambulatory care (1). At the time of the interview, participants were a range of 5-13 months out from graduation. Analysis of the data revealed 4 thematic findings. First, thinking and acting like a pharmacist occurred frequently while in school but feeling like a pharmacist occurred mostly after graduation. Second, feeling like a pharmacist meant participants felt confident in their knowledge base and ability to independently make decisions. Third, real-world practice is critical to PIF, particularly through interactions with patients. Finally, feedback, mentoring, and reflection support PIF and can aid in reconciling the tensions between concepts taught in school and experiences in practice. CONCLUSIONS In this qualitative analysis of data about PIF obtained from recent graduates from a pharmacy school, we found that thinking and acting like a pharmacist preceded feeling like a pharmacist; feeling like a pharmacist involved confidence in the ability to work autonomously; feedback, mentoring, and reflection on experiences supported PIF; and real-world experiences were critical to PIF.
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Affiliation(s)
| | - Rachel A Allen
- University of Washington School of Pharmacy, Seattle, WA, USA
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McMains KC, Durning SJ, Norton C, Meyer HS. The Making of an Educator: Professional Identity Formation Among Graduate Medical Education Faculty Through Situated Learning Theory. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 43:254-260. [PMID: 37201556 DOI: 10.1097/ceh.0000000000000491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Professional identity formation (PIF) is a foundational element to professional medical education and training. Given the impact of faculty role models and mentors to student and trainee learning, mapping the landscape of PIF among faculty takes on increased importance. We conducted a scoping review of PIF through the lens of situated learning theory. Our scoping review question was: How is situated learning theory used to understand the process of PIF among graduate medical educators? METHODS The scoping review methodology described by Levac et al served as the architecture for this review. Medline, Embase, PubMed, ERIC, CINAHL, PsycINFO, and Web of Science Core Collection were searched (from inception) using a combination of terms that describe PIF among graduate medical educators. RESULTS Of the 1434 unique abstracts screened, 129 articles underwent full-text review, with 14 meeting criteria for inclusion and full coding. Significant results organized into three main themes: importance of using common definitions; evolution of theory over time with untapped explanatory power; identity as a dynamic construct. DISCUSSION The current body of knowledge leaves many gaps. These include lack of common definitions, need to apply ongoing theoretical insights to research, and exploration of professional identity as an evolving construct. As we come to understand PIF among medical faculty more fully, twin benefits accrue: (1) Community of practices can be designed deliberately to encourage full participation of all graduate medical education faculty who desire it, and (2) Faculty can more effectively lead trainees in negotiating the ongoing process of PIF across the landscape of professional identities.
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Affiliation(s)
- Kevin C McMains
- Dr. McMains : Professor, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD. Dr. Durning : Director, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD, and Professor, Department of Medicine. Norton : Instruction Librarian, Division of Library Services, National Institutes of Health Library, Bethesda, MD. Dr. Meyer : Assistant Professor, Department of Medicine, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD
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Bacci JL, Mangrum JS, Jefferson CG, Soverns T, Gin G, Wakuzawa K, Goo S, Odegard P. Impact of Pre-Advanced Pharmacy Practice Experience (APPE) Curriculum on Student Pharmacists' Professional Identity Formation. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100121. [PMID: 37852689 DOI: 10.1016/j.ajpe.2023.100121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 03/14/2023] [Accepted: 04/10/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To (1) evaluate changes in student pharmacists' professional identity during a curriculum prior to advanced pharmacy practice experiences (APPEs) and (2) describe the components of a pre-APPE curriculum that positively and negatively influenced students' professional identity formation (PIF). METHODS The University of Washington School of Pharmacy launched a new curriculum in 2019 featuring components intentionally designed to support students' PIF. The Macleod-Clark Professional Identity Scale (MCPIS) was administered to the class of 2023 before starting pharmacy school (pre) and upon completion of the pre-APPE curriculum (post). The postsurvey also contained 2 open-response questions asking students to identify the most positive and negative influences on their PIF. Mean pre- and post-responses were calculated for all MCPIS items and each MCPIS item and compared using paired t tests. Responses to the open-ended questions were sorted into categories using inductive thematic analysis and frequencies were calculated. RESULTS A total of 99 students (96%) completed both surveys. Mean MCPIS pre-scores and post-scores were both 3.3, indicating no statistically significant change in professional identity. The most frequently reported positive influences on PIF were didactic coursework (40%), experiential learning (30%), and student organizations (27%). The most frequently reported negative influences were didactic coursework (27%), none (25%), and perceptions of the pharmacy profession (22%). CONCLUSION Students' overall professional identity, as measured by the MCPIS, did not change during the pre-APPE curriculum. Didactic coursework had the most common positive and negative influence on professional identity prior to APPEs.
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Affiliation(s)
| | | | | | - Tim Soverns
- University of Washington School of Pharmacy, Seattle, WA, USA
| | - Gregory Gin
- The Queen's Medical Center, Honolulu, HI, USA
| | | | - Sydney Goo
- Providence Regional Medical Center, Everett, WA, USA
| | - Peggy Odegard
- University of Washington School of Pharmacy, Seattle, WA, USA
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Hauer KE, Chang A, van Schaik SM, Lucey C, Cowell T, Teherani A. "It's All About the Trust And Building A Foundation:" Evaluation of a Longitudinal Medical Student Coaching Program. TEACHING AND LEARNING IN MEDICINE 2023; 35:550-564. [PMID: 35996842 DOI: 10.1080/10401334.2022.2111570] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
Coaching is increasingly implemented in medical education to support learners' growth, learning, and wellbeing. Data demonstrating the impact of longitudinal coaching programs are needed. We developed and evaluated a comprehensive longitudinal medical student coaching program designed to achieve three aims for students: fostering personal and professional development, advancing physician skills with a growth mindset, and promoting student wellbeing and belonging within an inclusive learning community. We also sought to advance coaches' development as faculty through satisfying education roles with structured training. Students meet with coaches weekly for the first 17 months of medical school for patient care and health systems skills learning, and at least twice yearly throughout the remainder of medical school for individual progress and planning meetings and small-group discussions about professional identity. Using the developmental evaluation framework, we iteratively evaluated the program over the first five years of implementation with multiple quantitative and qualitative measures of students' and coaches' experiences related to the three aims. The University of California, San Francisco, School of Medicine, developed a longitudinal coaching program in 2016 for medical students alongside reform of the four-year curriculum. The coaching program addressed unmet student needs for a longitudinal, non-evaluative relationship with a coach to support their development, shape their approach to learning, and promote belonging and community. In surveys and focus groups, students reported high satisfaction with coaching in measures of the three program aims. They appreciated coaches' availability and guidance for the range of academic, personal, career, and other questions they had throughout medical school. Students endorsed the value of a longitudinal relationship and coaches' ability to meet their changing needs over time. Students rated coaches' teaching of foundational clinical skills highly. Students observed coaches learning some clinical skills with them - skills outside a coach's daily practice. Students also raised some concerns about variability among coaches. Attention to wellbeing and belonging to a learning community were program highlights for students. Coaches benefited from relationships with students and other coaches and welcomed the professional development to equip them to support all student needs. Students perceive that a comprehensive medical student coaching program can achieve aims to promote their development and provide support. Within a non-evaluative longitudinal coach relationship, students build skills in driving their own learning and improvement. Coaches experience a satisfying yet challenging role. Ongoing faculty development within a coach community and funding for the role seem essential for coaches to fulfill their responsibilities.
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Affiliation(s)
- Karen E Hauer
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Anna Chang
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Sandrijn M van Schaik
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Catherine Lucey
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Tami Cowell
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Arianne Teherani
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
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Stout J, Stahl A, Fortenberry JD. Developing medical professionalism in care of gender nonconforming patients: Reflections of second-year medical students after a curricular experience with gender nonconforming people and allies. MEDICAL TEACHER 2023; 45:984-990. [PMID: 37068168 DOI: 10.1080/0142159x.2023.2197136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Negative healthcare experiences persist for gender nonconforming individuals. Clinician-related factors, including lack of comfort with gender nonconforming persons and unexamined personal biases, present barriers to equitable and affirming healthcare. We explored the effects of contact with gender nonconforming individuals in preclinical medical education through a structured curricular intervention designed to build medical and humanistic knowledge and stimulate the development of medical professionalism surrounding the care of gender nonconforming individuals. METHODS A curricular module (didactic prework, time-synchronous online panel discussion, and post-event written reflection) was implemented in a second-year preclinical course in a large multi-campus Midwestern medical school. The module was based on pedagogical foundations of contact theory and reflective writing. Post-event written reflections were investigated using thematic analysis. RESULTS Analysis of 355 written reflections revealed three major themes (moments of insight, topics of confusion, connections to professional identity formation) and eight sub-themes. The findings demonstrated emerging gender professionalism and the importance of contact in professional development. DISCUSSION Contact with gender nonconforming people and the use of written reflections can encourage self-examination and foster professional identity formation among preclinical medical students. Modeling gender-affirming approaches may help counteract negative cultural messages about gender nonconforming people, aiding development of inclusive future physicians.
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Affiliation(s)
- Julianne Stout
- Veterinary Administration Department, Purdue University, West Lafayette, IN, USA
| | - Aletha Stahl
- Center for Intercultural Learning, Mentorship, Assessment and Research Purdue University, West Lafayette, IN, USA
| | - J Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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Noyen M, Sanghera R, Kung JY, Schindel TJ. Pharmacy Students' Perceptions of the Pharmacist Role: An Arts-Informed Approach to Professional Identity Formation. PHARMACY 2023; 11:136. [PMID: 37736908 PMCID: PMC10514856 DOI: 10.3390/pharmacy11050136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/07/2023] [Accepted: 08/24/2023] [Indexed: 09/23/2023] Open
Abstract
Elements of professional identity are closely intertwined with professional roles, and individuals perceive themselves in relation to their roles. How pharmacists perceive their professional identity influences how they enact their roles in practice. For pharmacy students, understanding the pharmacist role and envisioning themselves in that role supports the formation of their professional identity. This study explores students' perceptions of the pharmacist role. First-year pharmacy students enrolled in the Doctor of Pharmacy program at the University of Alberta were invited to participate in this study. Using an adapted version of the draw-and-write technique, participants were asked to express their understanding of the pharmacist role visually. An analysis of the results was guided by established discourses related to pharmacist identity derived from pharmacy education literature. In total, 100 pharmacy students participated in this study. The findings indicate that pharmacy students have a comprehensive understanding of the pharmacist role, especially the dispenser and health care provider aspects of a pharmacist's professional identity. Additionally, students acknowledged the involvement of pharmacists in health care teams, in public health, and primary health care services. A discourse related to professional identity, the multi-faceted professional, emerged to describe the coexistence of multiple roles in modern pharmacy practice. An arts-based activity successfully facilitated the exploration of pharmacy students' perceptions of the professional role of pharmacists. This approach has potential in supporting instruction regarding professional identity formation within the curriculum.
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Affiliation(s)
- Meghan Noyen
- College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 2H7, Canada
| | - Ravina Sanghera
- College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 2H7, Canada
- Office of the Dean of Students, University of Alberta, Edmonton, AB T6G 2H7, Canada
| | - Janice Y. Kung
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB T6G 2R7, Canada
| | - Theresa J. Schindel
- College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 2H7, Canada
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Zhan HQ, Zhang XX, Qin R, Fei J, Dong GY, Hao JH. Application of integrated problem-based learning combined with lecture-based classroom teaching in undergraduate medical education: An effective teaching model in a Medical School in China. Medicine (Baltimore) 2023; 102:e34792. [PMID: 37653783 PMCID: PMC10470717 DOI: 10.1097/md.0000000000034792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/03/2023] [Accepted: 07/26/2023] [Indexed: 09/02/2023] Open
Abstract
The problem-based learning (PBL) is increasingly used in undergraduate education. However, the application of integrated PBL to medical undergraduate education has not been well assessed. An observational study was designed to compare integrated PBL combined with lecture-based classroom (LBC) with traditional LBC teaching in 2 semesters of a Medical School in China. This study was conducted from March 2021 to July 2022. A total of 118 undergraduates majoring in clinical medicine were randomly allocated in 2 groups, 1 group receiving the integrated PBL + LBC teaching (experimental group, n = 60) and another group receiving LBC teaching (control group, n = 58). The experimental group attended the integrated PBL courses for the basic and clinical medicine conducted in the 6th and 8th semesters, respectively, as well as taking the LBC courses. The experimental group was required to preview the course materials before class, make presentations in class and take online feedback questionnaires after class, while the control group was required to preview the textbooks and listen to the traditional LBC courses. The students' scores of these 2 groups were compared, and feedback questionnaires were performed to evaluate the effectiveness of the experimental group over the control group. Results showed that the experimental group scored significantly higher than the control group in Clinical Skills (95% confidence interval [CI] 4.19-5.89), Internal Medicine I (95% CI: 1.85-9.93), Internal Medicine II (95% CI: 8.07-15.90), Introduction to Surgery (95% CI: 5.08-10.25), Surgery (General Surgery) (95% CI: 7.82-12.72), Surgery (Specialty) (95% CI: 6.47-9.97), and Clinical Medical Level Test (95% CI: 1.60-5.15) (all P < .01). In the feedback questionnaires of integrated PBL, up to 80% and 90% of students were satisfied with the teaching methods and lecturers, respectively. More than 80% of students agreed that the integrated PBL improved their abilities to learn independently, understand knowledge, and to raise, analyze and solve problems. In terms of stress in and out of class, a small number of students, <36.7%, felt stressed. The integrated PBL combined with LBC is an effective teaching approach, which may provide new ideas for teaching research and reform on undergraduate medical education in clinical medicine specialty and other medical majors.
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Affiliation(s)
- He-Qin Zhan
- Department of Pathology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, P.R. China
- Department of Pathology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Xiao-Xun Zhang
- Department of Pathology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Rong Qin
- Department of Pathology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Jun Fei
- Department of Respiratory Internal Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Gui-Yin Dong
- Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Jia-Hu Hao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
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McMains KC, Konopasky A, Durning SJ, Meyer HS. Do All Roads Lead to Full Participation? Examining Trajectories of Clinical Educators in Graduate Medical Education through Situated Learning Theory. TEACHING AND LEARNING IN MEDICINE 2023:1-11. [PMID: 37547996 DOI: 10.1080/10401334.2023.2230188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 05/23/2023] [Accepted: 06/22/2023] [Indexed: 08/08/2023]
Abstract
Phenomenon: As new faculty members begin their careers in Graduate Medical Education, each begins a journey of Professional Identity Formation from the periphery of their educational communities. The trajectories traveled vary widely, and full participation in a given educational community is not assured. While some medical school and post-graduate training programs may nurture Professional Identity Formation, there is scant support for faculty. To date, the trajectories that Graduate Medical Education faculty travel, what may derail inbound trajectories, and what tools Graduate Medical Education faculty use to navigate these trajectories have not been explicitly described. We explore these three questions here. Approach: Communities of Practice, a component of Situated Learning Theory, serves as a helpful framework to explore trajectories of educator identity development among Graduate Medical Educators. We used a inductive and deductive approach to Thematic Analysis, with Situated Learning Theory as our interpretive frame. Semi-structured interviews of faculty members of GME programs matriculating into a Health Professions Education Program were conducted, focusing on participants' lived experiences in medical education and how these experiences shaped their Professional Identity Formation. Findings: Participants noted peripheral, inbound, boundary, and outbound trajectories, but not an insider trajectory. Trajectory derailment was attributed to competing demands, imposter syndrome and gendered marginality. Modes of belonging were critical tools participants used to shape PIF, not only engagement with educator roles but disengagement with other roles; imagination of future roles with the support of mentors; and fluid alignment with multiple mutually reinforcing identities. Participants identified boundary objects like resumes and formal roles that helped them negotiate across Community of Practice boundaries. Insights: Despite a desire for full participation, some clinical educators remain marginal, struggling along a peripheral trajectory. Further research exploring this struggle and potential interventions to strengthen modes of belonging and boundary objects is critical to create equitable access to the inbound trajectory for all of our colleagues, leaving the choice of trajectories up to them.
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Affiliation(s)
- Kevin C McMains
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Abigail Konopasky
- Department of Medical Education, Dartmouth School of Medicine, Hannover, New Hampshire, USA
| | - Steven J Durning
- Department of Medical Education, Dartmouth School of Medicine, Hannover, New Hampshire, USA
| | - Holly S Meyer
- Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Consorti F, Consorti G. Elements and Determinants of Professional Identity During the Pandemic: A Hermeneutic Qualitative Study. TEACHING AND LEARNING IN MEDICINE 2023; 35:422-435. [PMID: 35711162 DOI: 10.1080/10401334.2022.2080068] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
Phenomenon: The construct of professionalism in undergraduate medical education is a core outcome that is included in the wider concept of professional identity formation. The former is grounded in the more general concept of identity, intended as an internalized set of role expectations. Some have proposed frameworks based on psychological or sociological approaches, but empirical research is still scarce and often limited to the exploration of the role of specific learning activities. The pandemic imposed adaptations that produced an artificial setting for a social experiment, suitable to observe how the deprivation of the social component of a student's life, such as in presence teaching and practical training, unveiled the elements and determinants of the developing identity of medical students. Approach: This research was the extension of a previous phenomenological study about medical students' lived experience of distance learning during the lockdown phase in Italy. We adopted a hermeneutic approach to furtherly deepen the analysis of the phenomenon at stake, in dialogue with the relevant literature. Eight 6th year medical students underwent an in-depth interview, themes were inductively generated and used to identify elements and determinants of the developing identities. Findings: Four themes developed, synthetized in the overarching theme "From crawling to standing on your feet and walking toward an uncertain future". The themes were: "social places and practices that make me feel like a student and a medical student", "toward self-regulation", "an emotional journey", "threats to the identity". The elements of the perceived identity as a medical student were autonomy and learning self-regulation, professional knowledge, competence, and sense of belonging to a community. The determinant factors which influenced the identity as a medical student were living environment, learning spaces and architectures, the social networks, the attendance of the healthcare facilities, the relationship with teachers, the social acknowledgement as a medical student, and as a doctor. Insights: It was possible to identify the generation of both constitutive elements of identity and determinants influencing identity development and this distinction is an added value of the research. According Gilles Deleuze's concept of "empty square" (the sudden lack of an object one used to have at hand: sociality in this case), this research highlighted the ambivalent nature of identity. Individualization and socialization are the "uneven sides" of that same paradoxical object which is identity.
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Affiliation(s)
- Fabrizio Consorti
- Department of Surgical Sciences, University Sapienza of Rome, Rome, Italy
| | - Giacomo Consorti
- Clinical-Based Human Research Department, Centre for Osteopathic Medicine Collaboration, Pescara, Italy, Educational Department of Osteopathy, Istituto Superiore Osteopatia, Milan, Italy
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Sullivan C, Quaintance J, Myers T, Rogers B, Gaddis M, Pirani N. A Framework to Support Medical Students' Professional Development During Large-Scale Societal Events. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:422-427. [PMID: 37237084 PMCID: PMC10218768 DOI: 10.1007/s40596-023-01795-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Affiliation(s)
- Christine Sullivan
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
| | | | - Trenton Myers
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Brenda Rogers
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Monica Gaddis
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Nurbanu Pirani
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
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