1
|
Khan A, Gurbutt R. Registered nurses' perceptions of nursing associates' professional identity. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:713-717. [PMID: 39141339 DOI: 10.12968/bjon.2024.0054] [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: 08/15/2024]
Abstract
The nursing associate (NA) role was introduced in 2017 with a pilot programme of trainees, and in 2019 became regulated by the Nursing and Midwifery Council (NMC). The role bridges the gap between the healthcare assistant (HCA) and registered nurse (RN), allowing RNs to focus on complex care. With over 9000 NAs on the NMC register and more in training, it is important to understand RN perceptions of the NA professional identity. The findings of a qualitative survey of RNs (n=23) identified the following themes: NMC standards and scope of practice; The 'cheap nurse'; Skills development and progression; A supportive bridging role. Although valued, the role was perceived as a threat, ambiguous and inconsistently implemented. The implications are that the role ambiguity and lack of standardisation need addressing and a clear understanding of these must be articulated for the professions and public alike.
Collapse
Affiliation(s)
- Aleeza Khan
- Assistant Teaching Professor, Faculty of Health and Wellbeing, University of Bolton
| | - Russell Gurbutt
- Teaching Professor, Faculty of Health and Wellbeing, University of Bolton
| |
Collapse
|
2
|
He Q, Dizon JIWT, Ganotice FA, Zheng B, Yeung PPN, Shen X, Ho LYW, Wong AKC, Cheng FWT, Chan KMK, Chan L, Chan SSC, Chow AYM, Chu JKP, Chua DM, Dung ECH, Lee WN, Leung FCY, Wang Q, Tsia KK, Vackova D, Jen J, Tipoe GL. Unveiling the impact of interprofessional education on shaping students' interprofessional identity and collaboration perception: a mixed-method study. BMC MEDICAL EDUCATION 2024; 24:855. [PMID: 39118125 PMCID: PMC11312693 DOI: 10.1186/s12909-024-05833-0] [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: 04/29/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Interprofessional education (IPE) has the potential to shape students' collaboration perception and interprofessional identity but remains understudied. This study aims to understand the effects of the IPE program as a contextual trigger to promote collaboration perception change and interprofessional identity formation among healthcare professional students. METHODS Using concurrent triangulation mixed-methods, we examined the relationship between collaboration perception and interprofessional identity change among health profession students (N = 263), and explored their perspectives on how their IPE experiences influenced their perception and identity. Participants completed the Interdisciplinary Education Perception Scale and Extended Professional Identity Scale and responded to open-ended questions before and after the IPE intervention. Pearson's correlation, t-tests, regression (quantitative), and thematic analysis (qualitative) were conducted. RESULTS Teams with initially lower collaboration perception (M = 3.59) and lower interprofessional identity (M = 3.59) showed a significant increase in collaboration perception (M = 3.76, t = 2.63; p = .02) and interprofessional identity (M = 3.97, t = 4.86; p < .001) after participating in IPE. The positive relationship between collaboration perception and interprofessional identity strengthened after participating in IPE, as evident from the correlation (Time 1: r = .69; p < .001; Time 2: r = .79; p < .001). Furthermore, collaboration perception in Time 1 significantly predicted the variance in interprofessional identity at Time 2 (β = 0.347, p < .001). Qualitative findings indicated that 85.2% of students expressed that IPE played a role in promoting their interprofessional identity and collaboration attitudes. CONCLUSIONS Incorporating the IPE program into the curriculum can effectively enhance students' collaboration perception and interprofessional identity, ultimately preparing them for collaborative practice in the healthcare system. By engaging students in interprofessional teamwork, communication, and joint decision-making processes, the IPE program provides a valuable context for students to develop a sense of belonging and commitment to interprofessional collaboration.
Collapse
Affiliation(s)
- Qing He
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - John Ian Wilzon T Dizon
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Fraide A Ganotice
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Binbin Zheng
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Pauline Pui Ning Yeung
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Xiaoai Shen
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Lily Yuen Wah Ho
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Arkers Kwan Ching Wong
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Franco Wing Tak Cheng
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Karen Man Kei Chan
- Swallowing Research Laboratory, Faculty of Education, The University of Hong Kong, Hong Kong SAR, China
| | - Linda Chan
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Sarah So Ching Chan
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Amy Yin Man Chow
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Jody Kwok Pui Chu
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Denise Mae Chua
- Swallowing Research Laboratory, Faculty of Education, The University of Hong Kong, Hong Kong SAR, China
| | - Edwin Chung-Hin Dung
- Department of Electrical and Electronic Engineering, Faculty of Engineering, The University of Hong Kong, Hong Kong SAR, China
| | - Wei-Ning Lee
- Department of Electrical and Electronic Engineering, Faculty of Engineering, The University of Hong Kong, Hong Kong SAR, China
| | - Feona Chung Yin Leung
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Qun Wang
- Department of Mechanical Engineering, Faculty of Engineering, The University of Hong Kong, Hong Kong SAR, China
| | - Kevin K Tsia
- Department of Electrical and Electronic Engineering, Faculty of Engineering, The University of Hong Kong, Hong Kong SAR, China
| | - Dana Vackova
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Julienne Jen
- Department of Professional Legal Education, Faculty of Law, The University of Hong Kong, Hong Kong SAR, China
| | - George L Tipoe
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
3
|
Beattie J, Binder M, Beks H, Fuller L. Influence of a rural Longitudinal Integrated Clerkship on medical graduates' geographic and specialty decisions: a constructivist grounded theory study. BMC MEDICAL EDUCATION 2024; 24:795. [PMID: 39049054 PMCID: PMC11267796 DOI: 10.1186/s12909-024-05793-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Like many countries, Australia is suffering from a longstanding and persistent medical workforce maldistribution with fewer doctors per capita in rural locations and a trend towards sub-specialisation. Longitudinal Integrated Clerkships (LIC), a medical education model, are more likely than other clerkship models to produce graduates who work rurally, in communities of increasing remoteness and in primary care. While this quantitative data is essential, there has been a dearth of program-specific evidence explaining this phenomenon. METHODS To address this knowledge gap, a constructivist qualitative grounded theory approach was employed to identify how the Deakin University comprehensive rural LIC influences graduates' (2011-2020) career decisions in terms of both medical specialty and geographic practice location. RESULTS Thirty-nine graduates participated in qualitative interviews. The Rural LIC Career Decision Making Framework was developed, postulating that an alignment of personal and program factors under the central concept of 'choosing to participate' can influence graduates' geographic and specialist career decisions, both individually and symbiotically. Once embedded in the clerkship, participation was augmented by the concepts of learning design affordance and learning in place, providing the participants with longitudinal opportunities to experience and compare medical disciplines in an integrated manner. CONCLUSIONS The developed framework presents contextual elements of the program that were deemed influential on graduates' subsequent career decisions. The alignment of these elements with the program's mission statement has the capacity to enhance the program's rural workforce goals. Regardless of graduates' willingness to participate in the program, a transformation occurred. Transformation occurs through reflection, either challenging or confirming the graduate's pre-conceived ideas about career decisions and in turn influencing professional identity formation.
Collapse
Affiliation(s)
- Jessica Beattie
- School of Medicine, Deakin University, Rural Community Clinical School, PO Box 713, Colac, Vic, 3250, Australia.
| | - Marley Binder
- School of Medicine, Department of Rural Health, Deakin University Princess Hwy, Warrnambool, 3280, Australia
| | - Hannah Beks
- School of Medicine, Department of Rural Health, Deakin University Princess Hwy, Warrnambool, 3280, Australia
| | - Lara Fuller
- School of Medicine, Deakin University, Rural Community Clinical School, PO Box 713, Colac, Vic, 3250, Australia
| |
Collapse
|
4
|
Teo MYK, Ibrahim H, Lin CKR, Hamid NABA, Govindasamy R, Somasundaram N, Lim C, Goh JL, Zhou Y, Tay KT, Ong RRS, Tan V, Toh Y, Pisupati A, Raveendran V, Chua KZY, Quah ELY, Sivakumar J, Senthilkumar SD, Suresh K, Loo WTW, Wong RSM, Pei Y, Sng JH, Quek SQM, Owyong JLJ, Yeoh TT, Ong EK, Phua GLG, Mason S, Hill R, Chowdhury AR, Ong SYK, Krishna LKR. Mentoring as a complex adaptive system - a systematic scoping review of prevailing mentoring theories in medical education. BMC MEDICAL EDUCATION 2024; 24:726. [PMID: 38970020 PMCID: PMC11225364 DOI: 10.1186/s12909-024-05707-5] [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: 02/22/2024] [Accepted: 06/25/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring's personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS). METHODS A systematic scoping review using Krishna's Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion. RESULTS Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring's CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes. CONCLUSION Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.
Collapse
Affiliation(s)
- Mac Yu Kai Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Halah Ibrahim
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Casper Keegan Ronggui Lin
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore
| | - Nur Amira Binte Abdul Hamid
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ranitha Govindasamy
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore
| | - Nagavalli Somasundaram
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Crystal Lim
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Medical Social Services, Singapore General Hospital, Block 3, Singapore, 169854, Singapore
| | - Jia Ling Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Yi Zhou
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Kuang Teck Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ryan Rui Song Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Vanessa Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Youru Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Vijayprasanth Raveendran
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Keith Zi Yuan Chua
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Elaine Li Ying Quah
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jeevasuba Sivakumar
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Samyuktha Dhanalakshmi Senthilkumar
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Keerthana Suresh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Wesley Teck Wee Loo
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ruth Si Man Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Yiying Pei
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Julia Huina Sng
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Simone Qian Min Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jasmine Lerk Juan Owyong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ting Ting Yeoh
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Assisi Hospice, 832 Thomson Road, Singapore, 574627, Singapore
| | - Gillian Li Gek Phua
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK
| | - Ruaraidh Hill
- Health Data Science, University of Liverpool, Whelan Building The Quadrangle, Liverpool, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Anupama Roy Chowdhury
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Department of Geriatric Medicine, Singapore General Hospital, Academia, Level 3, College Road, Singapore, 169608, Singapore
| | - Simon Yew Kuang Ong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore.
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK.
- Health Data Science, University of Liverpool, Whelan Building The Quadrangle, Liverpool, Brownlow Hill, Liverpool, L69 3GB, UK.
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
| |
Collapse
|
5
|
Luo W, Fan W, Xia Y, Dou Y, Du J. Professional psychological qualities of Chinese medical students: theoretical models, questionnaire development, and relationship with mental health. Front Psychol 2024; 15:1411085. [PMID: 39035093 PMCID: PMC11258856 DOI: 10.3389/fpsyg.2024.1411085] [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: 04/02/2024] [Accepted: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Professional psychological qualities are crucial for individuals' career development and overall well-being, especially in clinical medical professions. Medical students often face significant work, academic, and doctor-patient communication pressures, which can challenge their mental and emotional health. Measuring and understanding the relationship between medical students' professional psychological qualities and their mental health is of significant practical importance. Methods This study developed a comprehensive professional psychological qualities scale through a series of qualitative and quantitative studies, consisting of three main components and thirteen secondary dimensions. The scale's reliability was assessed using Cronbach's α coefficients. In Study 2, the scale was administered to 972 medical students to explore their anxiety and depression levels. A simple mediation analysis was conducted to investigate the relationship between professional psychological qualities, anxiety, and depression. Results The professional psychological qualities scale demonstrated satisfactory reliability, with a total scale α coefficient of 0.947 and subscale α coefficients ranging from 0.895 to 0.933. The mediation analysis revealed that medical students' professional psychological qualities directly negatively impact depression levels and indirectly positively influence them via their effects on anxiety levels, exhibiting an overall masking effect unrelated to depression levels. Discussion This study addresses the gap in research on the professional psychological qualities of medical students by providing a reliable measurement tool. The findings shed light on the complex mechanisms through which these qualities impact the mental health process. The scale can be used by other researchers to assess medical students' professional psychological qualities and further investigate their relationship with mental health outcomes.
Collapse
Affiliation(s)
- Wenping Luo
- School of Clinical Medicine/Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wenshu Fan
- Mental Health Education Center for College Students, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yanglin Xia
- College of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yanchun Dou
- Mianyang Maternal and Child Health Hospital, Mianyang, China
| | - Juan Du
- Mental Health Education Center for College Students, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| |
Collapse
|
6
|
Zinn D, Lusky-Weisrose E, Shaibe J, Sigad LI, Tener D. "Today, I Say It's Mine!": Professional Identity Construction among Jewish and Arab School Counselors Coping with CSA Disclosure in Israel. Behav Sci (Basel) 2024; 14:424. [PMID: 38785915 PMCID: PMC11117735 DOI: 10.3390/bs14050424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
School counselors play a crucial role in preventing, disclosing, and intervening in child sexual abuse cases (CSA) and in maintaining safe and protected school environments. However, research on their experiences coping with CSA remains limited. The purpose of the present study was to describe and analyze the coping experiences of Israeli Jewish and Arab school counselors with CSA disclosure, particularly the consequences for their processes of professional identity construction (the ongoing process through which they develop and refine their sense of self in their profession). Semi-structured interviews were conducted with 21 Israeli Jewish and Arab school counselors working in elementary schools (grades 1-6) with significant experience in coping with CSA. Two themes surfaced, reflecting the counselors' professional identity construction: (1) Counselors' professional identity transformation following encounters with CSA among their students; (2) Integrating professional knowledge, attitudes, and engagement behaviors into professional identity. The findings describe a trajectory of transformation and professional development among the counselors, beginning with defining and refining their professional roles and followed by the integration of professional knowledge, attitudes, and behaviors into their professional routines. Arab counselors also highlighted specific sociocultural challenges within this process, relating to the gap between cultural values and role expectations. Implications for future research, policy, and practice are discussed.
Collapse
Affiliation(s)
- Dafna Zinn
- Department of Inclusive Education, Faculty of Graduate Studies, Oranim Academic College of Education, Tivon 3600600, Israel; (D.Z.); (J.S.); (L.I.S.)
| | - Efrat Lusky-Weisrose
- The Paul Baerwald School of Social Work and Social Welfare, Mount Scopus Campus, Hebrew University of Jerusalem, Jerusalem 9190500, Israel;
| | - Jordan Shaibe
- Department of Inclusive Education, Faculty of Graduate Studies, Oranim Academic College of Education, Tivon 3600600, Israel; (D.Z.); (J.S.); (L.I.S.)
- The Paul Baerwald School of Social Work and Social Welfare, Mount Scopus Campus, Hebrew University of Jerusalem, Jerusalem 9190500, Israel;
| | - Laura I. Sigad
- Department of Inclusive Education, Faculty of Graduate Studies, Oranim Academic College of Education, Tivon 3600600, Israel; (D.Z.); (J.S.); (L.I.S.)
| | - Dafna Tener
- The Paul Baerwald School of Social Work and Social Welfare, Mount Scopus Campus, Hebrew University of Jerusalem, Jerusalem 9190500, Israel;
| |
Collapse
|
7
|
Phua GLG, Owyong JLJ, Leong ITY, Goh S, Somasundaram N, Poon EYL, Chowdhury AR, Ong SYK, Lim C, Murugam V, Ong EK, Mason S, Hill R, Krishna LKR. A systematic scoping review of group reflection in medical education. BMC MEDICAL EDUCATION 2024; 24:398. [PMID: 38600515 PMCID: PMC11007913 DOI: 10.1186/s12909-024-05203-w] [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: 01/20/2023] [Accepted: 02/20/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Reviewing experiences and recognizing the impact of personal and professional views and emotions upon conduct shapes a physician's professional and personal development, molding their professional identity formation (PIF). Poor appreciation on the role of reflection, shortages in trained tutors and inadequate 'protected time' for reflections in packed medical curricula has hindered its integration into medical education. Group reflection could be a viable alternative to individual reflections; however, this nascent practice requires further study. METHODS A Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) was adopted to guide and structure a review of group reflections in medical education. Independent searches of articles published between 1st January 2000 and 30th June 2022 in bibliographic and grey literature databases were carried out. Included articles were analysed separately using thematic and content analysis, and combined into categories and themes. The themes/categories created were compared with the tabulated summaries of included articles to create domains that framed the synthesis of the discussion. RESULTS 1141 abstracts were reviewed, 193 full-text articles were appraised and 66 articles were included and the domains identified were theories; indications; types; structure; and benefits and challenges of group reflections. CONCLUSIONS Scaffolded by current approaches to individual reflections and theories and inculcated with nuanced adaptations from other medical practices, this SSR in SEBA suggests that structured group reflections may fill current gaps in training. However, design and assessment of the evidence-based structuring of group reflections proposed here must be the focus of future study.
Collapse
Affiliation(s)
- Gillian Li Gek Phua
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Jasmine Lerk Juan Owyong
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, 463 Clementi Road, Singapore, Singapore
| | - Ian Tze Yong Leong
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Suzanne Goh
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- KK Women's and Children Hospital, 100 Bukit Timah Rd, Singapore, 169854, Singapore
| | - Nagavalli Somasundaram
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Eileen Yi Ling Poon
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Simon Yew Kuang Ong
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Crystal Lim
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Medical Social Services, Singapore General Hospital, 16 College Road, Block 3 Level 1, Singapore, 169854, Singapore
| | - Vengadasalam Murugam
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Assisi Hospice, 832 Thomson Rd, Singapore, Singapore
- Office of Medical Humanities, SingHealth Medicine Academic Clinical Programme, 31 Third Hospital Ave, Singapore, 168753, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK
| | - Ruaridh Hill
- Health Data Science, University of Liverpool, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, UK
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Singapore, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore.
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK.
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, Singapore, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore.
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Mouchabac S, Adrien V, Diot T, Renaud MC, Carrié A, Bourla A, Ferreri F. Insights into medical students' perceptions of work culture during the COVID-19 pandemic: a mixed method study. BMC MEDICAL EDUCATION 2024; 24:21. [PMID: 38172850 PMCID: PMC10765811 DOI: 10.1186/s12909-023-04936-4] [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: 05/02/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The COVID-19 pandemic brought about profound social changes that affected students worldwide. These changes had both psychological and economic consequences, and also led to the adoption of new teaching methods. It can also have an impact on work culture, which is the collective set of values, norms, and practices within a specific profession, shaping how individuals in that field behave, communicate, and identify with their work. The aim of the study was to examine medical students' perception of professional culture during the COVID-19 crisis when they voluntarily participated in the healthcare network established, outside of university placements, for the management of COVID patients. METHODS A questionnaire study based on the vignette methodology was conducted among third-year medical students. Drawing from three scenarios in which students were variably engaged in crisis management, it included questions about their perceptions of the medical profession, their motivation, and their sense of belonging to the profession. RESULTS 352 students responded to the survey. The pandemic had both a positive and a negative impact on students' perceptions of the medical profession. Cluster analysis using a k-means algorithm and principal component analysis revealed three clusters of students with different perceptions of the medical profession. The first cluster, which represented the majority of students, corresponded to a relatively positive perception of the profession that was reinforced during the pandemic. In the second cluster, students' perceptions were reinforced still further, and particular importance was attached to field experience. Students in the third cluster had the most negative perceptions, having been shaken the most by the pandemic, and they attached little importance to field experience. CONCLUSIONS The analysis highlighted the importance of students being able to adapt and draw on a range of resources during the COVID-19 pandemic. This underscores the need for work cultures that support adaptability and coping. Further research is needed to understand its long-term effects on students' perceptions of the medical profession and to identify interventions that could support students in the aftermath of this difficult period.
Collapse
Affiliation(s)
- Stephane Mouchabac
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France.
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France.
| | - Vladimir Adrien
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France
| | - Thomas Diot
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
| | | | - Alain Carrié
- Faculty of Medicine, Sorbonne University, Paris, France
| | - Alexis Bourla
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France
| | - Florian Ferreri
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France
| |
Collapse
|
10
|
Wilson L, Kelley C, Cheever CR, Harlow E, Buhr G. The Impact of Scholarly Concentration Programs on Graduates' Career Choices and Interest in the Care of Older Patients. Cureus 2024; 16:e51697. [PMID: 38313885 PMCID: PMC10838523 DOI: 10.7759/cureus.51697] [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] [Accepted: 01/05/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND More geriatricians are needed to care for the aging population. Geriatric scholarly concentration programs (GSCPs) may promote medical students' interest in this underserved field or careers working with older adults. Additionally, graduates of GSCPs may be more comfortable and competent in providing care for older adults. Surveys were administered to graduates of GSCPs to determine the role of these programs in shaping medical students' careers and views about caring for older adults. Methods: The purpose of this study is to understand the impact of GSCPs on medical graduates' career choices and self-perceived skill and comfort in caring for older adults. A Qualtrics survey (Qualtrics International Inc., Seattle, Washington, United States) was developed and distributed to 83 graduates of four GSCPs in the United States. Data were analyzed using a significance level of p>0.05 for all tests. Descriptive statistics were calculated to summarize the data. Wilcoxon signed-rank tests were used to test for significant differences in interest in pursuing a career in geriatrics or working with older adults. Qualitative responses were coded and analyzed for themes. Results: A total of 34 out of 83 surveyed graduates of GSCPs indicated a higher interest in geriatrics as a career as well as increased comfort and self-perceived skill in caring for older adults after completing the GSCP. The components of the GSCP that most strongly improved the participants' ability to care for older adults included the curriculum (n=31, 91%) and mentoring (n=28, 82%). An overwhelming majority of survey participants felt GSCPs should be offered as part of medical school programming (n=33, 97%). Conclusion: This study suggests that GSCPs increase interest and competence in caring for older adults and increase interest in a career in geriatrics. GSCPs should be implemented across medical schools.
Collapse
Affiliation(s)
- Lindsay Wilson
- Department of Medicine, Division of Geriatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA
| | - Casey Kelley
- Department of Medicine, Division of Geriatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA
| | - C Ray Cheever
- Department of Medicine, Division of Geriatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA
| | | | | |
Collapse
|
11
|
Faisal E. Understanding the interplay of self-regulated learning strategies in medical education: A cross-sectional structural equation modeling study. Health Sci Rep 2023; 6:e1689. [PMID: 38028700 PMCID: PMC10630747 DOI: 10.1002/hsr2.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aims Although previous studies have investigated self-regulated learning strategies, a holistic study has not been conducted on note-taking, environmental structuring, self-evaluation, and self-consequence strategies among medical students. The current study focused on the relationships between these four self-regulated learning strategies in a medical context. Methods A conceptual model of the four strategies was developed, supported by the relevant literature. This cross-sectional study used an electronic structured questionnaire. The sample consisted of 557 medical undergraduates. The data were analysed using confirmatory factor analysis and structural equation modeling to investigate the hypothetical model. Results The conceptual model fits the data well. All relationships between the strategies were significantly positive, except for a regression between environmental structuring and self-evaluation, which was nonsignificant. Self-evaluation strategies represented the highest mean, whereas self-consequence strategies represented the lowest. Conclusion The findings of this study have implications for medical students, their teachers, and their universities regarding ways to enhance learners' regulated learning strategies. Future research should be conducted to develop additional statistical and comparison models for use in experimental studies and longitudinal investigations.
Collapse
Affiliation(s)
- Eman Faisal
- Department of Curriculum & InstructionKing Saud UniversityRiyadhSaudi Arabia
| |
Collapse
|
12
|
Glucina TT, Krägeloh CU, Spencer K, Holt K. Defining chiropractic professional identity: A concept analysis. J Bodyw Mov Ther 2023; 35:75-83. [PMID: 37330807 DOI: 10.1016/j.jbmt.2023.04.047] [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: 12/19/2021] [Revised: 01/12/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The concept of professional identity within chiropractic is often discussed and debated, however in the field to date, there is no formal definition of chiropractic professional identity (CPI). This article aims to create a coherent definition of CPI and to formalise the conceptual domains that may encompass it. METHODS Using the Walker and Avant (2005) process, a concept analysis methodology was employed to clarify the diffuse concept of CPI. This method initially involved selecting the concept (CPI), determining the aims and purpose of the analysis, identifying concept uses, and defining attributes. This was achieved from a critical literature review of professional identity across health disciplines. Chiropractic-related model, borderline and contrary cases were used to exemplify characteristics of CPI. The antecedents required to inform CPI, consequences of having, and ways to measure the concept of CPI were evaluated. RESULTS From the concept analysis data, CPI was found to encompass six broad attributes or domains: knowledge and understanding of professional ethics and standards of practice, chiropractic history, practice philosophy and motivations, the roles and expertise of a chiropractor, professional pride and attitude, and professional engagement and interaction behaviours. These domains were not mutually exclusive and may overlap. CONCLUSION A conceptual definition of CPI may bring together members and groups within the profession and promote intra-professional understanding across other disciplines. The CPI definition derived from this concept analysis is: 'A chiropractor's self-perception and ownership of their practice philosophies, roles and functions, and their pride, engagement, and knowledge of their profession'.
Collapse
Affiliation(s)
- Tanja T Glucina
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand.
| | - Christian U Krägeloh
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Kirsten Spencer
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Kelly Holt
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
| |
Collapse
|
13
|
Incongruous identities: Mental distress and burnout disparities in LGBTQ+ health care professional populations. Heliyon 2023; 9:e14835. [PMID: 37009240 PMCID: PMC10039783 DOI: 10.1016/j.heliyon.2023.e14835] [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: 02/15/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/28/2023] Open
Abstract
Health care professionals are chronically overworked due to structural workplace demands and institutional challenges [1]. During the COVID-19 pandemic, US biomedical health care professionals experienced additional environmental strain [2]. Health care professionals who occupy socio-politically minoritized identities are more likely to report symptoms of distress and workplace overburden than their counterparts [2]. While minority stress and identity formation theories explain the relationship between socially constructed identity and environmental strain, these theories remain largely unexplored in LGBTQ+ health care professional populations. Furthermore, contemporary investigations into health care professional burnout and mental distress fail to include differential impacts of identity-based stress, particularly within LGBTQ+ groups. This paper proposes a theoretical explanation for differential stress experiences by health care professionals and calls for research to investigate identity congruence as a key aspect of professionalization in medical schools. Health professions researchers need to attend to identity-based stress models to address discriminatory experiences with burnout and mental distress.
Collapse
|
14
|
Callaghan JP, Freimane KZ, Kearney GP, Hart ND. (L)earning: Exploring the value of paid roles for medical students. CLINICAL TEACHER 2023; 20:e13563. [PMID: 36808878 DOI: 10.1111/tct.13563] [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: 06/27/2022] [Accepted: 01/06/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND The Medical Student Technician (MST) role is a paid position established in Northern Ireland in 2020. The Experience-Based Learning (ExBL) model is a contemporary medical education pedagogy advocating supported participation to develop capabilities important for doctors-to-be. In this study, we used the ExBL model to explore the experiences of MSTs and how the role contributed to students' professional development and preparedness for practice. METHODS A convenience sampling strategy was used to recruit a total of 17 MSTs in three focus groups. Semi-structured interviews were transcribed verbatim and analysed using the ExBL model as a framework. Transcripts were independently analysed and coded by two investigators and discrepancies resolved with the remaining investigators. RESULTS The MST experiences reflected the various components of the ExBL model. Students valued earning a salary; however, what students earned transcended the financial reward alone. This professional role enabled students to meaningfully contribute to patient care and have authentic interactions with patients and staff. This fostered a sense of feeling valued and increased self-efficacy amongst MSTs, helping them acquire various practical, intellectual and affective capabilities and subsequently demonstrate an increased confidence in their identities as future doctors. CONCLUSION Paid clinical roles for medical students could present useful adjuncts to traditional clinical placements, benefiting both students and potentially healthcare systems. The practice-based learning experiences described appear to be underpinned by a novel social context where students can add value, be and feel valued and gain valuable capabilities that better prepare them for starting work as a doctor.
Collapse
Affiliation(s)
| | | | - Grainne P Kearney
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
| | - Nigel D Hart
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
| |
Collapse
|
15
|
Faihs V, Heininger S, McLennan S, Gartmeier M, Berberat PO, Wijnen-Meijer M. Professional Identity and Motivation for Medical School in First-Year Medical Students: A Cross-sectional Study. MEDICAL SCIENCE EDUCATOR 2023; 33:431-441. [PMID: 37261015 PMCID: PMC10226964 DOI: 10.1007/s40670-023-01754-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 06/02/2023]
Abstract
Background Professional identity formation (PIF) is a life-long process, starting even before professional education. High levels of motivation for medical school are essential for effective learning and academic success. Both are key factors in future physicians' professional and personal development, and according to self-determination theory, professional identity (PI) and students' levels of motivation could be closely linked. Therefore, we sought to investigate whether PI and strength of motivation for medical school are associated in new medical students. Methods In a cross-sectional survey, all new medical students in Munich, Germany, were asked to complete the Macleod Clark Professional Identity Scale (MCPIS-9) and the Strength of Motivation for Medical School-Revised questionnaire (SMMS-R) as well as to provide information about age, gender, and waiting time before starting medical school. Results Eight hundred eleven out of 918 new medical students participated in the survey. A positive correlation between the MCPIS-9 and the SMMS-R (p < 0.001) was found. Female students showed higher scores in the SMMS-R (p < 0.05) and the SMMS-R-subscale Readiness to Start (p < 0.001). The amount of waiting semesters showed a positive correlation with the total SMMS-R score (p < 0.01) as well as with the subscales Readiness to Start and Persistence (both p < 0.001). Discussion We found an association between PI and strength of motivation for medical school in a large cohort of new medical students. Female gender and more waiting semesters were associated with higher levels of self-perceived motivation and higher scores on the SMMS-R-subscale Readiness to Start. More research is needed to better understand this topic to further improve medical education.
Collapse
Affiliation(s)
- Valentina Faihs
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
- Department of Dermatology and Allergy Biederstein, TUM School of Medicine, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Susanne Heininger
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Stuart McLennan
- Institute of History and Ethics in Medicine, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Martin Gartmeier
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Marjo Wijnen-Meijer
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| |
Collapse
|
16
|
Alwazzan L, AlHarithy R, Alotaibi HM, Kattan T, Alnasser M, AlNojaidi T. Dermatology residents as educators: a qualitative study of identity formation. BMC MEDICAL EDUCATION 2023; 23:199. [PMID: 36998009 PMCID: PMC10061385 DOI: 10.1186/s12909-023-04186-4] [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: 07/23/2022] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND One of the many identities a physician comes to form during their career is their identity as an educator. Exploring formation of this identity may enrich our understanding of how physicians make decisions related to their roles as educators, their behaviors, and how this ultimately influences the educational environment. It is the aim of this study to investigate educator identity formation of dermatology residents while early in their careers. METHODS Drawing on a social constructionist paradigm, we conducted a qualitative study, utilizing an interpretative approach. We examined longitudinal data over a 12-month period using dermatology residents' written reflections from their professional portfolios and semi-structured interviews. We collected this data as we progressed through and beyond a 4-month professional development program designed to encourage residents' growth as educators. Sixty residents in their second, third, or final year of residency programs located in Riyadh, Saudi Arabia were invited to take part in this study. Twenty residents participated with sixty written reflections and 20 semi-structured interviews. Qualitative data were analyzed using a thematic analysis approach. RESULTS Sixty written reflections and 20 semi-structured interviews were analyzed. Data was categorized according to themes corresponding to the original research questions. For the first research question regarding identity formation, themes included definitions of education, the process of education, and identity development. For the second research question, 1 theme entitled professional development program included, the following sub-themes: individual act, interpersonal activity, and an organizational undertaking, with many believing that residency programs should prepare residents for their educator roles. Participants also described newfound leadership ambitions of creating new dermatology fellowship programs as a result of taking part in the Resident-as-Educator program. CONCLUSIONS Our study provides insights on the dynamic formation of educator identities amongst dermatology residents. Investment in developing residents as educators through professional development programs may instigate transformational change on the individual physician level and profession's level.
Collapse
Affiliation(s)
- Lulu Alwazzan
- Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.
| | - Ruaa AlHarithy
- Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Thuraya Kattan
- Saudi Commission For Health Specialties, Riyadh, Saudi Arabia
| | | | - Taif AlNojaidi
- Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| |
Collapse
|
17
|
Bawadi H, Shami R, El-Awaisi A, Al-Moslih A, Abdul Rahim H, Du X, Moawad J, Al-Jayyousi GF. Exploring the challenges of virtual internships during the COVID-19 pandemic and their potential influence on the professional identity of health professions students: A view from Qatar University. Front Med (Lausanne) 2023; 10:1107693. [PMID: 36793877 PMCID: PMC9922901 DOI: 10.3389/fmed.2023.1107693] [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: 11/25/2022] [Accepted: 01/04/2023] [Indexed: 01/31/2023] Open
Abstract
Introduction COVID-19 has imposed many shared limitations on medical and health education. Just like other health professions programs at most institutions, the Qatar University health cluster (QU Health) applied a containment approach and shifted all learning online, and onsite training was replaced by virtual internships (VIs) during the first wave of the pandemic. Our study aims to explore the challenges of virtual internships during the COVID-19 pandemic and their influence on the professional identity (PI) of the health cluster students from the College of Medicine, the College of Health Sciences, and the College of Pharmacy at Qatar University. Methods A qualitative approach was employed. In total, eight focus groups with students (N = 43) and 14 semi-structured interviews with clinical instructors from all the health cluster colleges were conducted. Transcripts were analyzed following the inductive approach. Results The major challenges reported by students were mainly related to the lack of the required skills for navigating the VI, professional and social stressors, the nature of VIs and the quality of learning, technical and environmental issues, and the development of students' professional identity in an alternative internship environment. The challenges relating to the development of professional identity included: limited clinical (practical) experience, a lack of experience in fighting a pandemic, a lack of communication and feedback, and a lack of confidence in meeting the internship's goals. A model was constructed to represent these findings. Discussion The findings are important in identifying the inevitable barriers to virtual learning for health professions students and provide a better understanding of how such challenges and different experiences would be affecting the development of their PI. Hence, students, instructors, and policymakers alike should strive to minimize these barriers. Since physical interactions and patient contact are indispensable components of clinical teaching, these extraordinary times demand innovations involving technology and simulation-based teaching. There is a need for more studies that are focused on determining and measuring the short- and long-term effects of the VI on students' PI development.
Collapse
Affiliation(s)
- Hiba Bawadi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Rula Shami
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Alla El-Awaisi
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Ayad Al-Moslih
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Hanan Abdul Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Xiangyun Du
- College of Education, Qatar University, Doha, Qatar
| | - Joyce Moawad
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Ghadir Fakhri Al-Jayyousi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar,*Correspondence: Ghadir Fakhri Al-Jayyousi ✉
| |
Collapse
|
18
|
Leep Hunderfund AN, Kumbamu A, O'Brien BC, Starr SR, Dekhtyar M, Gonzalo JD, Rennke S, Ridinger H, Chang A. "Finding My Piece in That Puzzle": A Qualitative Study Exploring How Medical Students at Four U.S. Schools Envision Their Future Professional Identity in Relation to Health Systems. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1804-1815. [PMID: 35797546 DOI: 10.1097/acm.0000000000004799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Health systems science (HSS) curricula equip future physicians to improve patient, population, and health systems outcomes (i.e., to become "systems citizens"), but the degree to which medical students internalize this conception of the physician role remains unclear. This study aimed to explore how students envision their future professional identity in relation to the system and identify experiences relevant to this aspect of identity formation. METHOD Between December 2018 and September 2019, authors interviewed 48 students at 4 U.S. medical schools with HSS curricula. Semistructured interviews were audiorecorded, transcribed, and analyzed iteratively using inductive thematic analysis. Interview questions explored how students understood the health system, systems-related activities they envisioned as future physicians, and experiences and considerations shaping their perspectives. RESULTS Most students anticipated enacting one or more systems-related roles as a future physician, categorized as "bottom-up" efforts enacted at a patient or community level (humanist, connector, steward) or "top-down" efforts enacted at a system or policy level (system improver, system scholar, policy advocate). Corresponding activities included attending to social determinants of health or serving medically underserved populations, connecting patients with team members to address systems-related barriers, stewarding health care resources, conducting quality improvement projects, researching/teaching systems topics, and advocating for policy change. Students attributed systems-related aspirations to experiences beyond HSS curricula (e.g., low-income background; work or volunteer experience; undergraduate studies; exposure to systems challenges affecting patients; supportive classmates, faculty, and institutional culture). Students also described future-oriented considerations promoting or undermining identification with systems-related roles (responsibility, affinity, ability, efficacy, priority, reality, consequences). CONCLUSIONS This study illuminates systems-related roles medical students at 4 schools with HSS curricula envisioned as part of their future physician identity and highlights past/present experiences and future-oriented considerations shaping identification with such roles. These findings inform practical strategies to support professional identity formation inclusive of systems engagement.
Collapse
Affiliation(s)
- Andrea N Leep Hunderfund
- A.N. Leep Hunderfund is associate professor of neurology and director, Learning Environment and Educational Culture, Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Ashok Kumbamu
- A. Kumbamu is assistant professor of biomedical ethics, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - Bridget C O'Brien
- B.C. O'Brien is professor of medicine and education scientist, Center for Faculty Educators, University of California, San Francisco, San Francisco, California
| | - Stephanie R Starr
- S.R. Starr is associate professor of pediatrics, Mayo Clinic College of Medicine and Science, and director, Science of Health Care Delivery Education, Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Michael Dekhtyar
- M. Dekhtyar is research associate, Department of Medical Education, University of Illinois College of Medicine at Chicago; ORCID: https://orcid.org/0000-0002-8548-3624
| | - Jed D Gonzalo
- J.D. Gonzalo is professor of medicine and public health sciences and associate dean for health systems education, Penn State College of Medicine, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0003-1253-2963
| | - Stephanie Rennke
- S. Rennke is professor of medicine, Division of Hospital Medicine, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California
| | - Heather Ridinger
- H. Ridinger is assistant professor of medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Anna Chang
- A. Chang is professor of medicine, Division of Geriatrics, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California
| |
Collapse
|
19
|
Luman AA, Bagley M, Colbert-Getz JM, Christensen T, Lindsley JE, Chow CJ. " Am I even a med-student anymore?" A Mixed-Methods Study of the Impact of the Initial Disruptions Caused by the COVID-19 Pandemic on Medical Student Professional Identity Formation. MEDICAL SCIENCE EDUCATOR 2022; 32:1387-1395. [PMID: 36277267 PMCID: PMC9579630 DOI: 10.1007/s40670-022-01652-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Developing a professional identity requires learners to integrate themselves into the medical profession and take on the role of doctor. The impact of COVID-19 on medical education has been widely investigated, but little attention has been paid to the impact of students' professional identify formation (PIF). The goal of this study was to investigate the impact that the onset of the COVID-19 pandemic had on medical students' PIF. MATERIALS AND METHODS An embedded mixed-methods design was utilized. Focus groups were conducted with a subset of year 1-4 students and coded using thematic analysis. Year 1-2 students were surveyed about their professional identity integration in the spring of 2020. Responses were analyzed using descriptive statistics and Wilcoxon signed rank and Mann-Whitney U tests. RESULTS Qualitative data were organized into six themes that touched on losses and challenges, reflection, and reevaluation of the physician career. Roughly 50% of MS1s and MS2s reported a change in their professional identity integration, but this was not statistically significant. CONCLUSIONS Medical education does not occur in isolation and is influenced by disruptive local and global events. Students perceived challenges when in-person community interaction and hands-on clinical experiences were interrupted. Additionally, students reflected upon their own role and their future career goals. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-022-01652-4.
Collapse
Affiliation(s)
| | - Madison Bagley
- School of Medicine, University of Utah, Salt Lake City, UT USA
| | - Jorie M. Colbert-Getz
- Department of Internal Medicine, University of Utah School of Medicine, Rm 210.23, 27 S Mario Capecchi Dr, Salt Lake City, UT 84113 USA
| | | | - Janet E. Lindsley
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Candace J. Chow
- Department of Internal Medicine, University of Utah School of Medicine, Rm 210.23, 27 S Mario Capecchi Dr, Salt Lake City, UT 84113 USA
| |
Collapse
|
20
|
Wainwright D, Harris M, Wainwright E. Trainee doctors' perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study. BMC MEDICAL EDUCATION 2022; 22:702. [PMID: 36195864 PMCID: PMC9533602 DOI: 10.1186/s12909-022-03765-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND The demography of the medical profession is changing as more women join the workforce. Traditional assumptions about the personal qualities required to be a successful surgeon may change as more women join the specialty. While exploring the attitudes and beliefs of doctors in their second 'Foundation' year of post-graduate training (FY2) about their choice of specialty, evidence emerged about how the stereotype of the surgeon influences professional identification and beliefs about person-specialty fit. METHODS Qualitative telephone interviews with 24 FY2 doctors, 17 women and 7 men, in South-West England. RESULTS Many participants reported exposure to stereotypes about the personal qualities desirable in a surgeon. Senior doctors and other trainees were the primary source of these stereotypical views. Experience on surgical placements could either reinforce stereotypes or challenge them, the latter particularly where senior surgeons provided positive role models. As more women enter the surgical specialties, they are increasingly challenging the traditional stereotype and sub-culture. CONCLUSION Gendered stereotypes about surgical roles persist, and for some this can hinder professional identification with the role. Positive role models and mentoring can encourage and support women who are interested a surgical career to identify with the role, but there is a need for a broader debate encompassing job redesign and surgical identities.
Collapse
Affiliation(s)
| | - Michael Harris
- Department for Health, University of Bath, Bath, UK
- Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland
| | - Elaine Wainwright
- Department for Health, University of Bath, Bath, UK
- Epidemiology Group, University of Aberdeen, Aberdeen, UK
| |
Collapse
|
21
|
Noerholk LM, Bader‐Larsen KS, Morcke AM, Vamadevan A, Andreasen LA, Svendsen JH, Jørsboe H, Tolsgaard MG. Business as (un)usual: A qualitative study of clerkship experiences during a health crisis. MEDICAL EDUCATION 2022; 56:805-814. [PMID: 35199378 PMCID: PMC9543617 DOI: 10.1111/medu.14787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/07/2022] [Accepted: 02/18/2022] [Indexed: 06/01/2023]
Abstract
INTRODUCTION During a health crisis, hospitals must prioritise activities and resources, which can compromise clerkship-based learning. We explored how health crises affect clinical clerkships using the COVID-19 pandemic as an example. METHODS In a constructivist qualitative study, we conducted 22 semi-structured interviews with key stakeholders (i.e. medical students and doctors) from two teaching hospitals and 10 different departments. We used thematic analysis to investigate our data and used stakeholder theory as a sensitising concept. RESULTS We identified three themes: (1) emotional triggers and reactions; (2) negotiation of legitimacy; and (3) building resilience. Our results suggest that the health crisis accentuated already existing problems in clerkships, such as students' feelings of low legitimacy, constant negotiation of roles, inconsistencies navigating rules and regulations and low levels of active participation. Medical students and doctors adapted to the new organisational demands by developing increased resilience. Students responded by reaching out for guidance and acceptance to remain relevant in the clinical clerkships. Doctors developed a behaviour of closing in and focused on managing themselves and their patients. This created tension between these two stakeholder groups. CONCLUSION A health crisis can critically disrupt the hierarchical structure within the clinical clerkships and exacerbate existing conflicts between stakeholder groups. When medical students are not perceived as legitimate stakeholders in clinical clerkships during a health crisis, their attendance is perceived as unnecessary or even a nuisance. Despite increased student proactiveness and resilience, their roles inevitably shift from being doctors-to-be to students-to-be-managed.
Collapse
Affiliation(s)
- Laerke Marijke Noerholk
- Copenhagen Academy for Medical Education and Simulation (CAMES)Copenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | - Karlen S. Bader‐Larsen
- Copenhagen Academy for Medical Education and Simulation (CAMES)Copenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | | | - Anishan Vamadevan
- Copenhagen Academy for Medical Education and Simulation (CAMES)Copenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | - Lisbeth Anita Andreasen
- Copenhagen Academy for Medical Education and Simulation (CAMES)Copenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | - Jesper Hastrup Svendsen
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Department of CardiologyCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Hanne Jørsboe
- Nykøbing Falster Sygehus, Region ZealandNykøbing FalsterDenmark
| | - Martin G. Tolsgaard
- Copenhagen Academy for Medical Education and Simulation (CAMES)Copenhagen University Hospital – RigshospitaletCopenhagenDenmark
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Centre for Fetal Medicine, Juliane Marie CentreCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| |
Collapse
|
22
|
Misra SM, Appelbaum NP, Jaramillo MA, Wang R, Hoch CT, Ismail N, Christner J. Becoming a Doctor During a Pandemic: Impact on Medical Student Social Identity Formation. MEDICAL SCIENCE EDUCATOR 2022; 32:917-920. [PMID: 35855894 PMCID: PMC9281296 DOI: 10.1007/s40670-022-01591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic required modifications to undergraduate medical education that likely affected medical students' social identity formation (SIF). SIF is shaped by experiences throughout the medical education continuum. This commentary explores factors potentially affecting medical student SIF during the COVID-19 pandemic focusing on students' perceptions of being part of the healthcare team, their role in medicine, and their engagement during the pandemic. Based on such considerations, we propose that educators should aim to design effective learning environments to support a full educational experience that encompasses acquiring medical knowledge and building strong social identities even during a pandemic.
Collapse
Affiliation(s)
| | - Nital P. Appelbaum
- Division of Evaluation, Assessment and Research, School of Medicine, Baylor College of Medicine, Houston, TX USA
| | | | - Ruifei Wang
- Department of Psychiatry, UT Health Science Center at San Antonio, San Antonio, USA
| | - Connor T. Hoch
- Department of Psychiatry and Behavioral Sciences, Mount Sinai Beth Israel, New York, NY USA
| | - Nadia Ismail
- Department of Education, Innovation and Technology, Baylor College of Medicine, Houston, TX USA
| | - Jennifer Christner
- Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
- School of Medicine, Baylor College of Medicine, Houston, TX USA
| |
Collapse
|
23
|
Ryding EL, Birr A. Becoming the kind of doctor that you want to be. A qualitative study about participation in Balint group work. Int J Psychiatry Med 2022; 57:283-292. [PMID: 34461756 PMCID: PMC9210113 DOI: 10.1177/00912174211042972] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Although wide-spread and appreciated, the benefit of Balint group work has been difficult to determine. Qualitative studies provide new angles for research. The aim of this study is to explore how participants in a Balint group for at least 1.5 years experienced the group work and how they were affected by their participation. METHOD Focus group interviews were conducted with a total of 19 members of four different Balint groups. The participants were experienced residents or younger specialists in general practice as well as from hospital specialities. A thematic analysis was performed. RESULTS The main themes that emerged were: Investigating emotions, Development of the physician's identity as well as Safety in the group and with the leader. The participants reported relief from stress as well as increased ability to understand the emotional side of patient encounters. They struggled to find their identity as doctors and specialists, often gaining a sense of pride in their work and becoming more secure. The group with a certified Balint leader felt like a safe place. CONCLUSIONS For younger doctors, participation in a Balint group for at least 1.5 years can help them build their professional identity by means of a deeper understanding of doctor-patient relationships. The role of Balint group work in relation to professional identity warrants further study.
Collapse
Affiliation(s)
- Elsa Lena Ryding
- Department of Women’s and Children’s Health, Institution of Obstetrics and Gynecology, Karolinska Institutet, Sweden,Elsa Lena Ryding, Institution of Obstetrics and Gynecology, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
| | - Anders Birr
- Diagnostic Center, Helsingborg Hospital, Sweden
| |
Collapse
|
24
|
Noerholk LM, Tolsgaard MG. Structural individualism or collaborative mindsets: Next steps for peer learning. MEDICAL EDUCATION 2022; 56:352-354. [PMID: 34970777 DOI: 10.1111/medu.14721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Laerke Marijke Noerholk
- Copenhagen Academy for Medical Education and Simulation (CAMES)-Rigshospitalet, Copenhagen, Denmark
| | - Martin Grønnebaek Tolsgaard
- Copenhagen Academy for Medical Education and Simulation (CAMES)-Rigshospitalet, Copenhagen, Denmark
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
25
|
Park GM, Hong AJ. "Not yet a doctor": medical student learning experiences and development of professional identity. BMC MEDICAL EDUCATION 2022; 22:146. [PMID: 35246116 PMCID: PMC8896319 DOI: 10.1186/s12909-022-03209-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 02/24/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND To become a good doctor, developing a professional identity is as important as having the right knowledge and skills. Great attention has been given to professional identity in medical school because it plays an important role in the transition from student to doctor. Nonetheless, the necessity of acquiring a tremendous amount of knowledge and skill during medical school training does not create sufficient opportunities for students to develop their professional identities. Thus, this paper pays careful attention to how students' learning experiences in medical school affect this development. The research questions are as follows. 1) How do medical students' perceptions of doctors change or strengthen after entering medical school in the process of professional identity development? 2) What kinds of knowledge have medical students accumulated while attending medical school? How do their learning experiences affect professional identity development? 3) What is a doctor's role and the career's meaning to medical students, and what understanding does this awareness bring to their learning experiences and lives as future doctors? METHODS In-depth semi-structured interviews were conducted with 20 Korean students in their fourth year of medical school; all had more than one year of experience in clinical settings. The students' learning experiences and professional identity development were used to analyze the data using inductive thematic analysis. RESULTS When students first entered medical school, they perceived their identities as "given to" them by society. However, various learning experiences during the medical school years affected them, causing them to think about becoming a doctor according to their own perceptions and the meaning of becoming a doctor in the profession. Although an isolated medical community and a competitive student culture hindered them from searching for their professional identities, informal learning experiences, including active interaction with patients, senior doctors, and others outside the medical community, enabled them to develop their professional identities. The medical students experienced a conflict between individual and professional values as they considered what kind of doctor they would be in the future. CONCLUSIONS The findings noted in this study extend the understanding of professional identity and informal learning experiences in medical school.
Collapse
Affiliation(s)
- Gyu Mi Park
- Department of Education, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Ah Jeong Hong
- Department of Education, Chung-Ang University, Seoul, 06974, Republic of Korea.
| |
Collapse
|
26
|
Orsmond P, McMillan H, Zvauya R. It's how we practice that matters: professional identity formation and legitimate peripheral participation in medical students: a qualitative study. BMC MEDICAL EDUCATION 2022; 22:91. [PMID: 35139839 PMCID: PMC8830078 DOI: 10.1186/s12909-022-03107-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 01/03/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND The process of Legitimate Peripheral Participation (LPP) within a community of practice framework (CoP) was used to explore graduate entry medical students' professional identity formation (PIF) during their first year of study. A conceptual model has been developed that can be used by medical educators to better understand PIF and to aid the explicit incorporation of PIF activity within the undergraduate curriculum. METHODS Ten students from one UK medical school participated in the longitudinal study and were interviewed at three points during the first year. Semi-structured group interviews were used to explore students' experience of the clinical environment and the nature of their interactions with both clinicians and patients in a community-based medicine practice. The interviews were audio recorded and transcribed. Thematic analysis was used to identify overarching themes which are represented as facets in the model of PIF. RESULTS Results demonstrate that students are legitimately peripherally participating within both medical student CoPs and wider medical CoPs. Themes identified within the narratives have allowed the development of a new model to understand PIF within the context of LPP in a CoP. This has five facets: Awareness, Collaboration, Negotiation, Evaluation and Realisation. Sophisticated reflection-in-action is shown to be an important aspect of PIF and enables a more conscious understanding of the change that is occurring in our students. CONCLUSION PIF is a complex, non-linear process that is supported by reflection-in-action and early student introduction to clinical practice. It can be recognised in students' narratives in their changing use of language, their understanding of the medical COP, and their evolving relational participation with those around them. This study adds to those that have previously explored PIF. The model of PIF developed in this study illustrates how experiences in the clinical environment support PIF. Medical educators may find this model helpful when considering how PIF can be explicitly encouraged in the medical curriculum and how reflection may be used for the purpose of identity change.
Collapse
Affiliation(s)
- Paul Orsmond
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2 TT UK
- Staffordshire Centre of Learning and Pedagogic Practice, Institute of Education Brindley Building, Staffordshire University, ST4 2DF Stoke-on-Trent, England
| | - Helen McMillan
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2 TT UK
| | - Remigio Zvauya
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2 TT UK
| |
Collapse
|
27
|
Douglas AH, Acharya SP, Allery LA. Communication skills learning through role models in Nepal; what are medical students really learning? A qualitative study. BMC MEDICAL EDUCATION 2021; 21:625. [PMID: 34930237 PMCID: PMC8691070 DOI: 10.1186/s12909-021-03049-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 11/18/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Communication skills (CS) are important and teachable, however, many Asian medical schools' curricula do not incorporate them. Patan Academy of Health Sciences in Nepal identifies CS within its' aims and curriculum. CS are taught from commencement of medical school and re-emphasised throughout preclinical learning (first 2 years). There is no explicit CS teaching in clinical years but placements allow students to learn through observation. These 'role-modelling' interactions form part of CS learning and development. METHODS This study is a qualitative evaluation of CS learning in PAHS, through participants' experiences. Through purposive sampling, twenty medical students from 2nd, 4th and Intern years were selected for inclusion. Data were collected via audio recorded, semi-structured interviews, employing a piloted schedule. Transcripts were manually coded and analysed thematically. Codes were organised into themes and subthemes. This paper discusses themes related to role-modelling. RESULTS The majority of participants described role-modelling in CS learning, recounting both positive and negative incidents, reflected in the themes of; Positive and Negative experiences. Subthemes of Personal Qualities and Inspiring, emerged from positive experiences, describing students' desire to imitate or aspire to be like their role models. Learners reported predominantly negative experiences and interns exclusively so. From these emerged subthemes of; Good doctors but.., Contradictory messages, How not to behave, Unprofessional behaviour and Affect-Emotional Distress. Learners received conflicting messages from observing behaviour contradictory to explicit CS teaching. Many identified learning "how not to behave" from such incidents, however, several described feeling distressed. DISCUSSION Role-modelling is a powerful and important CS learning tool, seen as positively reinforcing or negatively contradicting explicit CS teaching. Negative modelling created internal conflict, confusion and distress amongst learners, despite its' potential for positive learning. The worldwide problem of negative role-modelling is also prevalent in Nepal. Medical educators need to ensure the explicit curriculum aligns with implicit learning. Clinical tutors must be alerted to their powerful role-model position and supported in developing intentional modelling skills. Learners' reflections upon their experiences should be facilitated, enabling them to critically evaluate observations and hence consciously adopt or reject role-modelled behaviour and attitudes.
Collapse
Affiliation(s)
- Amanda Helen Douglas
- Department of GP, Patan Academy of Health Sciences (PAHS), Lalitpur, P.O.Box 26500, Kathmandu, Nepal
| | - Samita Pant Acharya
- Department of GP, Patan Academy of Health Sciences (PAHS), Lalitpur, P.O.Box 26500, Kathmandu, Nepal
| | - Lynne A. Allery
- Reader in Medical Education, Centre for Medical Education, Cardiff University, Heath Park, Cardiff, CF14 4YS UK
| |
Collapse
|
28
|
Dennis CA, Davies N. Twelve tips for promoting consistent, good quality medical education across diverse clinical settings through faculty development approaches. MEDICAL TEACHER 2021; 43:1255-1260. [PMID: 33253603 DOI: 10.1080/0142159x.2020.1851021] [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: 06/12/2023]
Abstract
When students attend clinical attachments in diverse locations, a key challenge is in ensuring consistently good teaching over all areas. To meet this challenge, a faculty development intervention called TiMEtoTeach was created with the aim of reaching all involved in teaching medical students. The programme takes a holistic view of workplace (professional clinical attachments) learning with the recognition of all who are part of the student learning journey, including staff in clinical environments, charitable organisations, fellow students and the patients and carers. Empowering and upskilling this diverse group, we create a Universal Faculty. We engage this group with a comprehensive and accessible faculty development programme, enabling a consistent, authentic, and realistic learning experience for students. This supports graduate preparedness for their roles as junior doctors. The twelve tips described in this article relate to simple, achievable processes that faculty developers within medical education can apply to help improve consistency and quality in clinical workplace experience for students, recognising the challenges of engaging the large and diverse group of people who support education within the clinical arena.
Collapse
Affiliation(s)
| | - Nancy Davies
- Leeds Institute of Medical Education, University of Leeds, Leeds, UK
| |
Collapse
|
29
|
Abstract
BACKGROUND Professional identity formation (PIF) in medical students is a multifactorial phenomenon, shaped by ways that clinical and non-clinical experiences, expectations and environmental factors merge with individual values, beliefs and obligations. The relationship between students' evolving professional identity and self-identity or personhood remains ill-defined, making it challenging for medical schools to support PIF systematically and strategically. Primarily, to capture prevailing literature on PIF in medical school education, and secondarily, to ascertain how PIF influences on medical students may be viewed through the lens of the ring theory of personhood (RToP) and to identify ways that medical schools support PIF. METHODS A systematic scoping review was conducted using the systematic evidence-based approach. Articles published between 1 January 2000 and 1 July 2020 related to PIF in medical students were searched using PubMed, Embase, PsycINFO, ERIC and Scopus. Articles of all study designs (quantitative and qualitative), published or translated into English, were included. Concurrent thematic and directed content analyses were used to evaluate the data. RESULTS A total of 10443 abstracts were identified, 272 full-text articles evaluated, and 76 articles included. Thematic and directed content analyses revealed similar themes and categories as follows: characteristics of PIF in relation to professionalism, role of socialization in PIF, PIF enablers and barriers, and medical school approaches to supporting PIF. DISCUSSION PIF involves iterative construction, deconstruction and inculcation of professional beliefs, values and behaviours into a pre-existent identity. Through the lens of RToP, factors were elucidated that promote or hinder students' identity development on individual, relational or societal levels. If inadequately or inappropriately supported, enabling factors become barriers to PIF. Medical schools employ an all-encompassing approach to support PIF, illuminating the need for distinct and deliberate longitudinal monitoring and mentoring to foster students' balanced integration of personal and professional identities over time.
Collapse
|
30
|
Chrisman-Khawam LM, Manzi JA. Empathy in MedicineCultivating an Empathetic Professional Identity in Osteopathic Medical Students Through Service Learning: A Qualitative Analysis of Reflective Essays. J Osteopath Med 2021; 120:263-272. [PMID: 32227151 DOI: 10.7556/jaoa.2020.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Context The role of professional identity development has been established as a significant element of the "hidden curriculum" in medical education. While most programs do not contain explicit instruction on that topic, service learning initiatives are a popular trend in medical education that offer medical students early clinical experience and an opportunity to develop professional identity. Through intentional reflective practices, service learning can also promote empathy development, a critical component missing from current models. Objective To determine the role of service learning participation on the development of empathy and professional identity among osteopathic medical students. Methods Using a grounded theory method, the authors analyzed reflective essays from students who voluntarily participated in a service learning project that provided medical care to patients who are homeless. Essays were completed within 1 week of volunteer experience. Results The authors collected and analyzed 64 reflective essays from 55 students in this study. A review of the 64 texts yielded 5 coding domains and several subdomains. The codes revealed 4 major themes: (1) incoming attitudes, (2) transformative experiences, (3) empathy development, and (4) professional identity formation. Conclusions Structured service learning experiences provide students with an opportunity to develop an empathetic professional identity in the preclinical stage of medical education. This form of volunteer service is a transformative experience that challenges students' incoming perceptions and leads to the development of both empathy and professional identity.
Collapse
|
31
|
Poole C, Patterson A. Fostering the development of professional identity within healthcare education-interdisciplinary innovation. J Med Imaging Radiat Sci 2021; 52:S45-S50. [PMID: 34483083 DOI: 10.1016/j.jmir.2021.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/06/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Historical theories on development of professionalism are no longer sufficient in modern radiation therapy or radiography curricula with the focus moving from 'virtues-based professionalism' to 'professional identity formation'. Professional identity formation is a new concept that is described as a transformative journey from being a layperson to 'becoming' a professional. Knowledge, values, and behaviours are transformative and unique to each individual. The overall aim is to produce a consensus statement outlining evidence based programme initiatives to support healthcare students' professional identity formation. METHODS 'Think tank' methodology was used for individual and final combined group reflective tasks to enable the creation of an evidenced based consensus statement. Participants discussed their personal views and beliefs regarding the process of Professional Identity Formation for teaching, learning, assessment, and evaluation. Discussions were recorded, transcribed, and analysed using thematic analysis from an interpretivist perspective. 'Think Tank' participants were asked to attend masterclasses to gain a greater understanding of professional identity formation from leading experts before the final combined 'Think Tanks'. RESULTS Faculty and students across all Disciplines (N22) within the school of medicine attended the 'Think Tank' sessions. DISCUSSION During each student's transformative process of professional identity formation, healthcare educators need to create evidence based pedagogic opportunities to support them. It is no longer sufficient to leave to chance within a 'hidden' or 'informal' curriculum. Professional identity is more than a set of learned behaviours that are assessed within the clinical environment. CONCLUSION The development of this consensus statement is an innovative educational strategy that will ultimately enhance the education of professionalism in the clinical environment for radiographers and radiation therapists. Through seeking an understanding of the educational needs of students and faculty, the multidisciplinary team were able to create a tailored approach to professional identity formation within the institution. This student-faculty partnership is unique and beneficial to all parties involved and is an effective method of seeking a shared understanding.
Collapse
Affiliation(s)
- Claire Poole
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, School of Medicine, Trinity College, Dublin 2, Ireland.
| | - Aileen Patterson
- Trinity College Dublin, School of Medicine, The Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| |
Collapse
|
32
|
Haruta J, Maeno T, Takayashiki A, Goto R, Ozone S, Maeno T. Validation of the professional self-identity questionnaire for medical students during clinical practice in Japan. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2021; 12:160-165. [PMID: 34465656 PMCID: PMC8411342 DOI: 10.5116/ijme.610d.104b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To validate the Professional Self Identity Questionnaire (PSIQ) for medical students during clinical practice. METHODS We conducted a single-year longitudinal questionnaire study using the PSIQ. The PSIQ rates the nine items of "teamwork", "communication", "conducting assessment", "cultural awareness", "ethical awareness", "using records", "dealing with emergencies", "reflection", and "teaching" on a scale of 1-7 points. The study participants consisted of 118 fifth- and sixth-grade medical students who completed a mandatory 4-week clinical practice in a community-based medical education (CBME) curriculum. The data were collected before and after the CBME curriculum and after clinical practice at the time of graduation. To validate the internal structure of the PSIQ, we calculated Cronbach's alpha in the three phases. Additionally, to assess construct validity, we analyzed the trends and differences in each of the nine items of the PSIQ using repeated measures analysis of variance (ANOVA). We also showed the differences in effect size before and after the CBME curriculum. RESULTS The data of 105 medical students were analyzed. Cronbach's alpha in the three phases was 0.932, 0.936, and 0.939, respectively. PSIQ scores increased progressively for all items, and the F-test for repeated measures ANOVA of nine items' average score across the three phases showed a significant difference F(2,208) = 63.59, p<0.001. The effect size for professional identity of cultural awareness before and after the CBME curriculum was 0.67, or medium. CONCLUSIONS We validated the PSIQ for medical students during clinical practice. Reflecting on professional identity may provide an opportunity for meaningful feedback on readiness to become a doctor.
Collapse
Affiliation(s)
- Junji Haruta
- Medical Education Center, School of Medicine, Keio University, Japan
| | - Takami Maeno
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Japan
| | - Ayumi Takayashiki
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Japan
| | - Ryohei Goto
- Department of General Medicine and Primary Care, Faculty of Medicine, University of Tsukuba, Japan
| | - Sachiko Ozone
- Department of General Medicine and Primary Care, Faculty of Medicine, University of Tsukuba, Japan
| | - Tetsuhiro Maeno
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Japan
| |
Collapse
|
33
|
Thomas J, Kumar K, Chur-Hansen A. How pharmacy and medicine students experience the power differential between professions: "Even if the pharmacist knows better, the doctor's decision goes". PLoS One 2021; 16:e0256776. [PMID: 34437641 PMCID: PMC8389418 DOI: 10.1371/journal.pone.0256776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/15/2021] [Indexed: 11/26/2022] Open
Abstract
Interprofessional Education (IPE) is one approach to improving communication and collaborative practice between professions, which are essential for the optimal delivery of healthcare. Common barriers include negative attitudes, professional stereotypes, professional cultures and power differentials between professional groups. The aim of this qualitative study was to explore how professional hierarchies and power differentials shape interprofessional interactions between preregistration pharmacy and medicine students. Data were gathered via semi-structured interviews and subject to thematic analysis. Four main themes were identified: Reproducing traditional hierarchies; Social norms around respect; Hierarchies in care values and goals; and Challenging the narrative is possible. Students' interactions with and views of the other profession largely reflected traditional stereotypes and power differentials. Hierarchy was evident in how respect was accorded and in how care values and goals were managed. Despite this, students overwhelmingly perceived and reported a sense of agency in changing the status quo. Emerging professional identity and conceptualisation of future roles is heavily influenced by the hierarchical relationship between the professions and can pose a significant barrier to collaborative practice. Greater support for collaborative interprofessional practice is needed at the level of policy and accreditation in health education and healthcare to ensure greater commitment to change.
Collapse
Affiliation(s)
- Josephine Thomas
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Koshila Kumar
- Prideaux Centre for Research in Health Professions Education, Flinders University, Bedford Park, South Australia, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
34
|
Foong CC, Bashir Ghouse NL, Lye AJ, Khairul Anhar Holder NA, Pallath V, Hong WH, Sim JH, Vadivelu J. A qualitative study on self-regulated learning among high performing medical students. BMC MEDICAL EDUCATION 2021; 21:320. [PMID: 34090439 PMCID: PMC8178823 DOI: 10.1186/s12909-021-02712-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 05/04/2021] [Indexed: 06/06/2023]
Abstract
BACKGROUND Self-regulated learning (SRL) is an important contributing element to the academic success of students. Literature suggests that the understanding of SRL among medical students is obscure as there is still some uncertainty about whether high performing medical students use SRL. This study explored the characteristics of high performing medical students from the SRL perspective to gain a better understanding of the application of SRL for effective learning. METHODS Twenty-one students who scored at the 90th percentile in written knowledge-based assessment consented to participate in this study. Each student wrote a guided reflective journal and subsequently attended a semi-structured interview. Students were prompted to explain the rationales for their answers. The data were then analysed using thematic analysis to identify patterns among these students from the SRL perspective. Two coders analysed the data independently and discussed the codes to reach a consensus. RESULTS High performing students set goals, made plans, and motivated themselves to achieve the goals. They put consistent efforts into their studies and applied effective learning strategies. They also employed coping mechanisms to deal with challenges. High performing students regularly evaluated their performance and adopted new strategies. CONCLUSIONS This study reported that high performing students applied SRL and described the rationales of practice. Medical schools could design SRL-driven interventions to enhance the learning experiences of medical students. Recommendations are made for students on how to apply SRL.
Collapse
Affiliation(s)
- Chan Choong Foong
- Medical Education and Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Nur Liyana Bashir Ghouse
- Medical Education and Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - An Jie Lye
- Medical Education and Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Nurul Atira Khairul Anhar Holder
- Medical Education and Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Vinod Pallath
- Medical Education and Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Wei-Han Hong
- Medical Education and Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Joong Hiong Sim
- Medical Education and Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Jamuna Vadivelu
- Medical Education and Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| |
Collapse
|
35
|
Noerholk LM, Morcke AM, Bader Larsen KS, Tolsgaard MG. Is two a crowd? A qualitative analysis of dyad learning in an OBGYN clinical clerkship. MEDICAL EDUCATION 2021; 55:724-732. [PMID: 33368489 DOI: 10.1111/medu.14444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Dyad learning occurs when two students work together to acquire new skills and knowledge. Several studies have provided evidence to support the educational rationale for dyad learning in the controlled simulated setting. However, the role of dyad learning in the clinical setting remains uncertain. Unlike the simulated setting, learning in the clinical setting depends on a complex interplay between medical students, doctors, nurses and patients potentially making dyad learning less valuable in clerkships. The objective of this study was to explore how key stakeholders perceive the value of implementing dyad learning during medical students' clinical clerkships. METHODS In a constructivist qualitative study, we conducted 51 semi-structured interviews with 36 key stakeholders involved in dyad learning, including 10 medical students, 12 doctors, five nurses and nine patients. Data were coded inductively using thematic analysis, then coded deductively using stakeholder theory as a theoretical framework. RESULTS We found that stakeholders generally perceived the educational impact of dyad learning in the clinical setting similarly but disagreed on its value. Students emphasised that dyad learning made them participate more actively during patient encounters and patients did not mind having two students present. Doctors and nurses considered dyad learning disruptive to the balance between service and training and reported that it did not resonate with their perception of good patient care. CONCLUSION Dyad learning enables students to be more active during their clinical clerkships, but it easily disrupts the balance between service and training. This disruption may be exacerbated by the shifted balance in priorities and values between different stakeholder groups, as well as by making implicit teaching obligations more explicit for supervising doctors and nurses. Consequently, implementing dyad learning may not be perceived as valuable by doctors and nurses in the clinical setting, regardless of its pedagogical rationale.
Collapse
Affiliation(s)
- Laerke Marijke Noerholk
- Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet, Copenhagen, Denmark
| | - Anne Mette Morcke
- Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet, Copenhagen, Denmark
| | - Karlen S Bader Larsen
- Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet, Copenhagen, Denmark
| | - Martin G Tolsgaard
- Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Centre for Fetal Medicine, Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
36
|
Abstract
Perioperative medicine can pose myriad challenges to professionalism and ethical practice. Medicine is a science, but definite end points, and predictable results and outcomes do not consistently occur. There is the potential for error during all steps of a patient's assessment and treatment. Examination findings, laboratory investigations, diagnosis, plans for and outcomes of surgery and long-term outcomes can all be uncertain and/or not meet expectations. Factors including pressures in the workplace, conflicts, ego, prescribed guidelines and pathways, the need to achieve healthcare targets, desire for autonomy and need to maintain multidisciplinary involvement in patient care can lead to an environment in which it is challenging for professionalism and ethics to thrive.
Collapse
Affiliation(s)
- Bid Kumar
- Department of Obstetrics and Gynaecology, Women's Directorate, Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, North Wales, UK
| |
Collapse
|
37
|
Maffoni M, Olson K, Hynes J, Argentero P, Setti I, Giorgi I, Giardini A. A journey through roses and thorns: becoming a physician by learning from patients with life-threatening illnesses. A qualitative study with international medical students. Monaldi Arch Chest Dis 2021; 91. [PMID: 34092073 DOI: 10.4081/monaldi.2021.1800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
The medical students' well-being may be threatened by various stressors associated with providing care to different kinds of patients. This study aims to explore students' clinical experiences with patients who suffer from life-threatening illnesses, focusing on potential risk and protective factors. Audio-recorded and face-to-face interviews were conducted and transcribed verbatim. The "Interpretive Description" approach was used to analyse data. Overall, ten medical students with a mean age of 28 years old were interviewed. Well-being promoting factors were the following: therapeutic relationships, work-life balance, social support and communication, perception of improvement in knowledge and availability of advanced directives. Whilst factors that may reduce well-being included death exposure, managing emotions, communication difficulties, internal conflicts and disagreements, lack of knowledge and subjective concerns. These findings shed light on facets that are inherent parts of clinical experience with patients suffering from a life-threatening illness and that may turn in risk or protective factors for the medical students. Understanding the students' subjective experiences may aid in the improvement of the current educational programs, as well as in the development of tailored supportive and preventative interventions to promote well-being and professional competencies among this kind of students.
Collapse
Affiliation(s)
- Marina Maffoni
- Department of Brain and Behavioral Sciences, Psychology Unit, University of Pavia.
| | - Karin Olson
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton.
| | - Julia Hynes
- Department of Primary Care and Population Health, Medical School, University of Nicosia.
| | | | - Ilaria Setti
- Department of Brain and Behavioral Sciences, Psychology Unit, University of Pavia.
| | - Ines Giorgi
- Psychology Unit, ICS Maugeri IRCCS, Institute of Pavia.
| | - Anna Giardini
- Information Technology Department, ICS Maugeri IRCCS, Institute of Pavia.
| |
Collapse
|
38
|
Yakov G, Riskin A, Flugelman AA. Mechanisms involved in the formation of professional identity by medical students. MEDICAL TEACHER 2021; 43:428-438. [PMID: 33290660 DOI: 10.1080/0142159x.2020.1854706] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Despite in-depth discussions regarding professional identity of doctors, there is still a gap in our understanding of how this professional identity actually evolves. OBJECTIVE To outline some major mechanisms involved in formation of medical students' professional identity. METHODS A qualitative study based on thematic analysis. 296 diary entries, written by eight medical students as part of the three-year course 'Becoming a Physician,' were reviewed. The course, conducted in small groups, gradually exposes students to the clinical field, and emphasizes awareness to marginalized populations, and interpersonal communication skills. RESULTS Following the social constructivist learning theory, where learners individually and socially construct meaning attributed to their experiences, we identified three major mechanisms based on students' written reflections. These include linking current experiences to past; comparing different types or aspects of knowledge, doctors or medicine; and future perspective taking. CONCLUSIONS This study sheds light on the possible mechanisms used by medical students in forming their professional identity prior to their clinical training. Knowing these mechanisms can help medical educators better understand and support their students in formation of their professional identities. Conducting reflective writing could serve as an effective tool for learners to comprehend the meanings of their experiences.
Collapse
Affiliation(s)
- Gila Yakov
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
- Center for the Advancement of Teaching, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Arieh Riskin
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
- Department of Neonatology, Bnai Zion Medical Center, Haifa, Israel
| | - Anath A Flugelman
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
- BRCA Gene Carrier Clinic, Rambam Healthcare Campus, Haifa, Israel
| |
Collapse
|
39
|
Chang YC, Xiao X, Nkambule N, Ngerng RYL, Bullock A, Monrouxe LV. Exploring emergency physicians' professional identities: a Q-method study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:117-138. [PMID: 32383067 PMCID: PMC7900058 DOI: 10.1007/s10459-020-09973-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/27/2020] [Indexed: 06/01/2023]
Abstract
Professional identities research in medical education has made significant contributions to the field. However, what comprises professional identities is rarely interrogated. This research tackles this relatively understudied component of professional identities research by understanding emergency medicine physicians' perspectives on the important elements that comprise their professional identities. Q-methodology was used to identify different clusters of viewpoints on professional identities; by extension, the core components that comprise emergency medicine physicians' professional identities are disclosed. Thirty-three emergency medicine physicians were recruited, through purposive sampling, from five hospitals across Taiwan. R software was used to analyse the Q-sorts, determine loadings on each viewpoint and formulate the viewpoint array. Analysis of interview data enhanced our understanding of these viewpoints. In total, twenty-five emergency medicine physicians loaded onto four distinct viewpoints, reflecting dominant perspectives of emergency medicine physicians' understanding of their professional identities. These distinct viewpoints demonstrated what emergency medicine physicians deemed significant in how they understood themselves. The viewpoints comprised: skills acquisition, capabilities and practical wisdom; coping ability and resilience; professional recognition and self-esteem; and wellbeing and quality of life. All viewpoints stressed the importance of trust between colleagues. These findings demonstrate the multitude of ways in which seemingly unified professional identities diverge across groups of individuals. An enhanced understanding of speciality work culture is gained. By understanding facets of professional identities, the development of future educational interventions and departmental initiatives, which might support key components of professional identities, can be explored.
Collapse
Affiliation(s)
- Yu-Che Chang
- Chang Gung Medical Education Research Centre (CGMERC), Chang Gung Memorial Hospital, Linkou, Taiwan (R.O.C.)
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan (R.O.C.)
- Chang Gung University College of Medicine, Taoyuan, Taiwan (R.O.C.)
| | - Xaviera Xiao
- Chang Gung Medical Education Research Centre (CGMERC), Chang Gung Memorial Hospital, Linkou, Taiwan (R.O.C.)
| | - Nothando Nkambule
- Chang Gung Medical Education Research Centre (CGMERC), Chang Gung Memorial Hospital, Linkou, Taiwan (R.O.C.)
| | - Roy Y L Ngerng
- Risk Society and Policy Research Center, National Taiwan University, Taipei, Taiwan (R.O.C.)
| | - Alison Bullock
- Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), School of Social Sciences, Cardiff University, Cardiff, Wales, UK
| | - Lynn V Monrouxe
- The Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, NSW, Australia.
| |
Collapse
|
40
|
Boardman N, Munro-Berry J, McKimm J. The leadership and followership challenges of doctors in training during the COVID-19 pandemic. Br J Hosp Med (Lond) 2021; 82:1-9. [PMID: 33646028 DOI: 10.12968/hmed.2021.0021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Research carried out in 2016 by the authors investigated the challenges that doctors in training experience around leadership and followership in the NHS. The study explored contemporary healthcare leadership culture and the role of followership from the perspective of early career doctors. It found that the leadership and followership challenges for these doctors in training were associated with issues of social and professional identity, communication, the medical hierarchy, and relationships with senior colleagues (support and trust). These challenges were exacerbated by the busy and turbulent clinical environment in which they worked. To cope with various clinical situations and forms of leadership, doctors in training engage in a range of different followership behaviours and strategies. The study raised implications for medical education and training and suggested that followership should be included as part of formal training in communication and team working skills. The importance of both leadership and followership in the delivery of safe and effective patient care has been brought sharply into focus by the COVID-19 pandemic. This article revisits these challenges in light of the pandemic and its impact on the experiences of doctors in training.
Collapse
Affiliation(s)
- Nathan Boardman
- Department of General Internal Medicine, Sandwell and West Birmingham Hospitals, Birmingham, UK
| | | | - Judy McKimm
- Department of Medical Education, Swansea University, Swansea, UK
| |
Collapse
|
41
|
Bettin KA. The Role of Mentoring in the Professional Identity Formation of Medical Students. Orthop Clin North Am 2021; 52:61-68. [PMID: 33222985 DOI: 10.1016/j.ocl.2020.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Professional identity formation (PIF) of medical students encompasses how students learn to think, do, and act as physicians. A key component of PIF is socialization, which includes mentoring. Mentoring influences students' career specialty choice, while providing a safe and nurturing environment to form their own professional identities. Mentoring of medical students by orthopedic surgeons may increase interest in the specialty. Suggestions for utilizing mentoring for the PIF of medical students and to increase diversity in orthopedics are discussed.
Collapse
Affiliation(s)
- Kristen A Bettin
- Department of Pediatrics, University of Tennessee Health Science Center College of Medicine, 49 North Dunlap Street, FOB 149, Memphis, TN 38103, USA; Department of Medical Education, University of Tennessee Health Science Center College of Medicine, 49 North Dunlap Street, FOB 149, Memphis, TN 38103, USA.
| |
Collapse
|
42
|
Liang Z, Xu M, Liu G, Zhou Y, Howard PF. Doctors in Chinese public hospitals: demonstration of their professional identities. BMC MEDICAL EDUCATION 2020; 20:501. [PMID: 33302937 PMCID: PMC7725881 DOI: 10.1186/s12909-020-02339-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 10/29/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND An increase in the number of medical disputes and violence against doctors indicates a lack of trust in the medical profession by society in Chinese public hospitals. Empirical evidence confirms that one cause is the lack of professional identity demonstrated by doctors. Medical professionals are required to maintain high standards of competence and moral responsibility, and demonstrate qualities such as respect, compassion, integrity, responsiveness to needs, and commitment to sound ethical practice in order to maintain professional privilege. These principles and appropriate professional conduct are the foundation of the professional identity of the medical profession. METHODS A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China. FINDINGS In total, 614 doctors and 1184 inpatients on discharge from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the variation amongst doctors in demonstrating their professionalism in terms of respecting patients' views and preferences when determining diagnostic procedures and treatment plans, and when making ethical decisions. Although 90% patients indicated that they showed respects to doctors, close to 20% of the doctors disagreed that they received high respect from patients. About 12% of doctors prescribed unnecessary diagnostic procedures to patient for the purpose of generating profit and more than 20% of patients indicated that they gave gifts to doctors in order to receive better treatment. CONCLUSIONS Although about 80% of doctors demonstrated certain aspects of professionalism required by practitioners, the inconsistency across the medical workforce may exacerbate tense doctor-patient relationships. A review of medical curricula and focus of the internship program is required in order to assist medical graduates with forming required professional identity in order to improve patient satisfaction and better clinical outcomes. To be effective, a more systematic approach is recommended.
Collapse
Affiliation(s)
- Zhanming Liang
- The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, China
- La Trobe University, Bundoora, Vic, Australia
| | - Min Xu
- The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, China.
- La Trobe University, Bundoora, Vic, Australia.
| | - Guowei Liu
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Yongli Zhou
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Peter F Howard
- The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, China
| |
Collapse
|
43
|
Gilligan C, Loda T, Junne F, Zipfel S, Kelly B, Horton G, Herrmann-Werner A. Medical identity; perspectives of students from two countries. BMC MEDICAL EDUCATION 2020; 20:420. [PMID: 33172441 PMCID: PMC7654572 DOI: 10.1186/s12909-020-02351-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The development of professional identity is a fundamental element of medical education. There is evidence that in Germany, students' perceptions of the ideal and real doctor differ, and that of themselves as physicians falls between these constructs. We sought to compare students' perceptions of themselves, the ideal doctor, and the 'real' doctor and investigate differences from first to final year in the relationships between these constructs, as well as differences between Australian and German cohorts. METHOD Students in the first and final years of their medical program at one Australian and one German university were invited to complete the Osgood and Hofstatter polarity profile, involving the description of their mental image of the ideal and real doctor, and the doctor they hope to become, with adjectives provided. RESULTS One hundred sixty-seven students completed the survey in Australia (121 year 1, 46 year 5) and 188 in Germany (164 year 1, 24 year 6). The perception of the ideal doctor was consistent across all respondents, but that of the real doctor and self-image differed between country and year. Differences existed between country cohorts in perceptions of 'confidence', 'strength', 'capability' and 'security'. CONCLUSIONS The pattern previously reported among German students was maintained, but a different pattern emerged among Australian students. Differences between countries could reflect cultural differences or variations in the overt and hidden curricula of medical schools. Some of the constructs within the profiles are amenable to educational interventions to improve students' confidence and sense of capability.
Collapse
Affiliation(s)
- Conor Gilligan
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Teresa Loda
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Osianderstr. 5, D-72076, Tuebingen, Germany.
- School of Medicine, University of Tuebingen, Tuebingen, Germany.
| | - Florian Junne
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Osianderstr. 5, D-72076, Tuebingen, Germany
- School of Medicine, University of Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Osianderstr. 5, D-72076, Tuebingen, Germany
- School of Medicine, University of Tuebingen, Tuebingen, Germany
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Graeme Horton
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Anne Herrmann-Werner
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Osianderstr. 5, D-72076, Tuebingen, Germany
- School of Medicine, University of Tuebingen, Tuebingen, Germany
| |
Collapse
|
44
|
Kline CC, Park SE, Godolphin WJ, Towle A. Professional Identity Formation: A Role for Patients as Mentors. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1578-1586. [PMID: 32618605 DOI: 10.1097/acm.0000000000003561] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Medical education should foster professional identity formation, but there is much to be learned about how to support learners in developing their professional identity. This study examined the role that patients can play in supporting professional identity development during the University of British Columbia Interprofessional Health Mentors Program (HMP), a longitudinal preclinical elective in which patients, or their caregivers, act as mentors and educate students about their lived experience of a chronic condition or disability. METHOD The authors interviewed 18 medical residents in 2016, 3 to 4 years after they completed the HMP. Professional identity was explored by asking participants how the HMP had influenced their ideas about the ideal physician and the kind of doctor they aspire to become. The authors analyzed the data using the identify status paradigm as a conceptual framework. RESULTS The authors identified 7 themes: patient as more than disease, patient as autonomous, patient as expert, doctor as partner, doctor as collaborator, self-aware doctor, and empathic doctor. They found firm commitments to patient partnership, interprofessional collaboration, and holistic care for patients rooted in the exploration of professional values that was prompted by patient mentors during HMP. CONCLUSIONS Patient mentors can help medical students begin to construct their professional identity during the preclinical period by supporting exploration of and commitment to the professional values that society expects of physicians.
Collapse
Affiliation(s)
- Cathy C Kline
- C.C. Kline is research coordinator, Patient and Community Partnership for Education, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: https://orcid.org/0000-0003-2254-0721
| | - So Eyun Park
- S. Park is a family medicine resident, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: https://orcid.org/0000-0002-0088-8527
| | - William J Godolphin
- W.J. Godolphin is professor emeritus, Department of Pathology and Laboratory Medicine, Faculty of Medicine, and codirector, Patient and Community Partnership for Education, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: https://orcid.org/0000-0003-0113-1339
| | - Angela Towle
- A. Towle is associate professor, Department of Medicine, Faculty of Medicine, and codirector, Patient and Community Partnership for Education, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: https://orcid.org/0000-0002-7164-0959
| |
Collapse
|
45
|
Ruan B, Yilmaz Y, Lu D, Lee M, Chan TM. Defining the Digital Self: A Qualitative Study to Explore the Digital Component of Professional Identity in the Health Professions. J Med Internet Res 2020; 22:e21416. [PMID: 32990636 PMCID: PMC7556376 DOI: 10.2196/21416] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 01/13/2023] Open
Abstract
Background Recent medical education literature pertaining to professional identity development fails to reflect the impact social media has on professional identity theory. Social media is transforming the field of medicine, as the web-based medium is now an avenue for professional development and socialization for medical students and residents. Research regarding identity development in social media has been primarily confined to electronic professionalism through best practice guidelines. However, this neglects other potential aspects pertinent to digital identity that have not yet been explored. Objective This study aims to define the properties and development of the digital self and its interactions with the current professional identity development theory. Methods A qualitative study was conducted using thematic analysis. A total of 17 participants who are social media education and knowledge translation experts were interviewed. The initial participants were from emergency medicine, and a snowball sampling method was used following their respective web-based semistructured interviews to enable global recruitment of other participants from interprofessional disciplines. The research team consisted of a diverse group of researchers including one current social media knowledge translation physician clinician educator, one postdoctoral researcher who is regularly engaged in social media knowledge translation, and 3 nonphysician research assistants who are not social media users. Half of the team conducted the initial coding and analysis, whereas the other 2 investigators audited the procedures followed. Results A total of 4 themes were identified that pertain to digital identity. In the first theme, origins of initial digital identity formation were found to be derived from perceived needs in professional roles (eg, as a medical student or resident). The second theme consisted of the cultivation of digital identity, in which digital identity was developed parallel to professional identity. The third theme that emerged was the management between the professional and personal components of digital identity. Participants initially preferred keeping these components completely separate; however, attempts to do so were inadequate while the integration of both components provided benefits. The fourth theme was the management of real-life identity and digital identity. Participants preferred real-life identity to be wholly represented on the web. Instances of misalignment resulted in identity conflict, compromising one of the identities. Conclusions Social media introduces new features to professional identity in the digital world. The formation of digital identity, its development, and reconciliation with other identities were features captured in our analysis. The virtual component of professional identity must not be neglected but instead further explored, as educational institutions continue to give more importance to navigating professional identity development.
Collapse
Affiliation(s)
- Brandon Ruan
- McMaster Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Yusuf Yilmaz
- McMaster Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Department of Medical Education, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Daniel Lu
- Psychiatry Residency Training Program, Department of Psychiatry, University of British Columbia, Vancouver, ON, Canada
| | - Mark Lee
- McMaster Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Teresa M Chan
- McMaster Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,McMaster Program for Faculty Development / Office of Continuing Professional Development, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Division of Emergency Medicine / Division of Education and Innovation, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
46
|
Stoddart R, Simpson P, Haire B. Medical advocacy in the face of Australian immigration practices: A study of medical professionals defending the health rights of detained refugees and asylum seekers. PLoS One 2020; 15:e0237776. [PMID: 32822404 PMCID: PMC7442262 DOI: 10.1371/journal.pone.0237776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 08/03/2020] [Indexed: 11/29/2022] Open
Abstract
While medical advocacy is mandated as a core professional commitment in a growing number of ethical codes and medical training programs, medical advocacy and social justice engagement are regularly subordinated to traditional clinical responsibilities. This study aims to provide insight into factors that motivate clinician engagement and perseverance with medical advocacy, so as to inform attempts by policymakers, leaders and educators to promote advocacy practices in medicine. Furthermore, this study aims to provide an analysis of the role of medical advocates in systems where patients' rights are perceived to be infringed and consider how we might best support and protect these medical advocates as a profession, by exploring the experiences and perspectives of Australian clinicians defending the health of detained asylum seekers. In this qualitative study thirty-two medical and health professionals advocating on asylum seeker health in immigration detention were interviewed. Transcripts were coded both inductively and deductively from interview question domains and thematically analysed. Findings suggested that respondents' motivations for advocacy stemmed from deeply intertwined professional and personal ethics. Overall, advocacy responses originated from the union of three integral stimuli: personal ethics, proximity and readiness. We conclude that each of these three integral factors must be addressed in any attempt to foster advocacy within the medical profession. In light of current global trends of increasingly protectionist immigration practices, promoting effective physician advocacy may become essential in ensuring patients' universal right to health.
Collapse
Affiliation(s)
- Rohanna Stoddart
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Paul Simpson
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Bridget Haire
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
47
|
Hayashi M, Son D, Nanishi K, Eto M. Long-term contribution of international electives for medical students to professional identity formation: a qualitative study. BMJ Open 2020; 10:e039944. [PMID: 32801209 PMCID: PMC7430439 DOI: 10.1136/bmjopen-2020-039944] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Globalisation has given medical university students the opportunity to pursue international electives in other countries, enhancing the long-term socialisation of medical professionals. This study identified the long-term effects of international electives on the professional identity formation of medical students. DESIGN This is a qualitative study. SETTING The authors interviewed Japanese medical professionals who had completed their international electives more than 10 years ago, and analysed and interpreted the data using a social constructivism paradigm. PARTICIPANTS A total of 23 medical professionals (mean age 36.4 years; range 33-42 years) participated in face-to-face, semistructured in-depth interviews. RESULTS During the data analysis, 36 themes related to professional identity formation were identified, and the resulting themes had five primary factors (perspective transformation, career design, self-development, diversity of values and leadership). It was concluded that international electives for medical students could promote reflective self-relativisation and contribute to medical professional identity formation. Additionally, such electives can encourage pursuing a specialisation and academic or non-academic work abroad. International electives for medical students could contribute to medical professional identity formation on the basis of cross-cultural understanding. CONCLUSIONS This study addressed a number of issues regarding the long-term impact of international elective experiences in various countries on the professional identity formation of Japanese medical professionals. This study offers some guidance to mentors conducting international electives and provides useful information for professional identity formation development in medical professionals.
Collapse
Affiliation(s)
- Mikio Hayashi
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Daisuke Son
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Community-based Family Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Keiko Nanishi
- Office of International Academic Affairs, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Masato Eto
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
48
|
Quinn G, Lucas B, Silcock J. Professional Identity Formation in Pharmacy Students During an Early Preregistration Training Placement. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:ajpe7804. [PMID: 32934384 PMCID: PMC7473226 DOI: 10.5688/ajpe7804] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 12/16/2019] [Indexed: 05/13/2023]
Abstract
Objective. To explore the lived experiences of pharmacy students undertaking an early preregistration training placement in the United Kingdom, particularly with respect to the development of different aspects of their professionalism. Methods. Fourteen students returning from an early preregistration placement (during the third year of their pharmacy degree) were interviewed, using a semi-structured approach. Grounded theory methods were used to analyze the transcripts and a theory was developed. Results. Developing a professional identity was the core process that occurred during the placement. This included four stages: reflection, selection of attributes, professional socialization, and perception of role. As a consequence of developing a professional identity, participants had a strong vision of the kind of pharmacist they wanted to be when qualified. They articulated an increased responsibility as students, and began to see themselves as a "trainee professional." Conclusion. The findings of this study strongly support having an early preregistration period for pharmacy students to develop a sense of professional identity and strengthen their motivation to learn.
Collapse
Affiliation(s)
- Gemma Quinn
- University of Bradford, Bradford, United Kingdom
| | | | | |
Collapse
|
49
|
Haruta J, Ozone S, Hamano J. Doctors' professional identity and socialisation from medical students to staff doctors in Japan: narrative analysis in qualitative research from a family physician perspective. BMJ Open 2020; 10:e035300. [PMID: 32665385 PMCID: PMC7365484 DOI: 10.1136/bmjopen-2019-035300] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Becoming a doctor involves transforming a lay person into a medical professional, which is known as professional socialisation. However, few studies have clarified differences in the professional socialisation process in detail. The aim of this study was to clarify the process of professional socialisation of medical students to residents to staff doctors. DESIGN We used narrative analysis in qualitative research as a theoretical framework. SETTING This study was conducted in Japan. PARTICIPANTS Participants were collected using a purposive sample of doctors with over 7 years of medical experience. We conducted semistructured interviews from September 2015 to December 2016, then used a structured approach to integrate the sequence of events into coherent configurations. RESULTS Participants were 13 males and 8 females with medical careers ranging from 8 to 30 years. All participants began to seriously consider their own career and embodied their ideal image of a doctor through clinical practice. As residents, the participants adapted as a member of the organisation of doctors. Subsequently, doctors exhibited four patterns: first, they smoothly transitioned from 'peripheral' to 'full' participation in the organisation; second, they could no longer participate peripherally but developed a professional image from individual social interactions; third, they were affected by outsiders' perspectives and gradually participated peripherally; fourth, they could not regard the hospital as a legitimate organisation and could not participate fully. CONCLUSION The professional socialisation process comprises an institutional theory, professional persona, legitimate peripheral participation and threshold concepts. These findings may be useful in supporting professional development.
Collapse
Affiliation(s)
- Junji Haruta
- Medical Education Center, Keio University, Shinjuku, Tokyo, Japan
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Sachiko Ozone
- Department of General Medicine and Primary Care, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Jun Hamano
- Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| |
Collapse
|
50
|
Khamees D, Brown CA, Arribas M, Murphey AC, Haas MRC, House JB. In Crisis: Medical Students in the COVID-19 Pandemic. AEM EDUCATION AND TRAINING 2020; 4:284-290. [PMID: 32704600 PMCID: PMC7369493 DOI: 10.1002/aet2.10450] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 05/04/2023]
Affiliation(s)
- Deena Khamees
- Department of Emergency MedicineUniversity of MichiganAnn ArborMI
| | - Charles A. Brown
- Department of Emergency MedicineUniversity of MichiganAnn ArborMI
| | - Miguel Arribas
- Department of Emergency MedicineUniversity of MichiganAnn ArborMI
| | | | - Mary R. C. Haas
- Department of Emergency MedicineUniversity of MichiganAnn ArborMI
| | - Joseph B. House
- Department of Emergency MedicineUniversity of MichiganAnn ArborMI
| |
Collapse
|