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Kerins J, Phillips EC, Smith SE, Tallentire VR. The Rubik's cube of doing and being: Factors influencing professional identity transition to the medical registrar. CLINICAL TEACHER 2024; 21:e13713. [PMID: 38069581 DOI: 10.1111/tct.13713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/07/2023] [Indexed: 09/03/2024]
Abstract
BACKGROUND Professional identity transitions, such as the transition to medical registrar, are challenging. How minoritised identities influence transitions during medical training requires further study. This study aimed to explore the factors influencing the transition to the medical registrar in Scotland to guide support during training. METHODS Interviews exploring this transition with internal medicine trainees were audio recorded, transcribed verbatim and double-coded using template analysis. We applied an initial coding template informed by multiple and multidimensional transition theory of individual, interpersonal, systemic and macro-level factors. Using a critical theory lens, a further template analysis specifically sought to understand how trainees' social identities interacted with the various levels. FINDINGS Nineteen IM trainees were interviewed between January 2021 and February 2022. Influential factors reflected a parallel process of competence (doing) and identity (being) development. The interaction of social identities, such as gender (being a woman) and country of origin (being an international medical graduate), occurred across levels. This can be conceptualised as a Rubik's cube with the interplay between doing and being from an individual to a macro level with trainees' social identities interacting at all levels. CONCLUSION The transition to the medical registrar is multifaceted; with a challenging balance between support and independence in providing opportunities to perform (doing) whilst identity develops (being). Identity transitions involve multiple Rubik's-cube-like rotations between the facets of 'doing' and 'being,' until these align. Taking heed of influential factors and the interaction of minoritised social identities could guide a trainee-centred and smoother transition.
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Affiliation(s)
- Joanne Kerins
- Scottish Centre for Simulation and Clinical Human Factors, Larbert, UK
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | - Samantha E Smith
- Scottish Centre for Simulation and Clinical Human Factors, Larbert, UK
- NHS Lothian, Edinburgh, UK
| | - Victoria R Tallentire
- Scottish Centre for Simulation and Clinical Human Factors, Larbert, UK
- NHS Lothian, Edinburgh, UK
- NHS Education for Scotland, Edinburgh
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Rashid MA, Grant J. Power and place: Uncovering the politics of global medical education. MEDICAL EDUCATION 2024; 58:930-938. [PMID: 38888045 DOI: 10.1111/medu.15459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/26/2024] [Accepted: 05/24/2024] [Indexed: 06/20/2024]
Abstract
CONTEXT Politics is characterised by power relations, and the deployment of power is inescapably political. In an increasingly globalised and interconnected modern world, politics is shaping the field of medical education more than ever before. Global frameworks that classify peoples and places are political tools that are fundamentally shaped by hegemonic knowledge systems. Despite this, they continue to form the basis for global thinking and practices, including in medical education. Political analysis can help to expose and challenge such thinking. APPROACH To better understand impacts of globalisation in medical education, we explore the previously under-examined political dimensions that underpin it, focusing particularly on deconstructing power relations. We situate our analysis of global medical education in political terms, including through examination of ideology, economics, market and the enduring effects of colonialism. We interrogate the construct of the Global South (GS), considering the geopolitical and historical ideas that have enabled it to be widely propagated. We go on to examine the consequences of the GS construct in medical education and consider what this tells us about how power is enacted in the field. CONCLUSIONS In analysing the politics of global medical education, we shed light on how power is exerted and draw attention to forces that permit and enable trends, policies and positions. Notwithstanding the emancipatory rhetoric that has been associated with the GS construct, we highlight its reductive potential and argue that it can lead to an oversimplification of power relations and vested interests. Given the growing recognition that educational approaches do not transfer well across countries and cultures, we encourage the medical education community to consider why ideas from more dominant countries continue to be imitated so routinely. In doing so, we urge them to use political lenses to recognise the influence of multiple complex and interconnected forces of global power that shape all aspects of medical education.
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Affiliation(s)
| | - Janet Grant
- Faculty of Medical Sciences, University College London, London, UK
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Razack S, Richardson L, Pillay SR. The violence of curriculum: Dismantling systemic racism, colonisation and indigenous erasure within medical education. MEDICAL EDUCATION 2024. [PMID: 38992874 DOI: 10.1111/medu.15470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/25/2024] [Accepted: 06/12/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Epistemic violence is enacted in medical curricula in mundane ways all the time, negatively impacting learners, teachers and patients. In this article, we address three forms of such violence: White supremacy, indigenous erasure and heteronormativity. METHODS In this article, we examine the knowledge systems of medicine as a global phenomenon, impacted by Western and European ideologies of race and colonisation, both produced by them, helping to reproduce them through authoritative and hegemonic ideologies. We seek not only to problematise but also to propose alternative teaching approaches rooted in the Global South and in Indigenous ways of knowing. Taking inspiration from Paulo Freire, we advocate for the development of critical consciousness through the integration of critical pedagogies of love, emancipation and shared humanity. Drawing on Irihapeti Ramsden, we advocate for cultural safety, which emphasises power relations and historical trauma in the clinical encounter and calls for a rights-based approach in medical education. Deliberately holding space for our own vulnerabilities and that of our students requires what Megan Boler calls a pedagogy of discomfort. CONCLUSIONS AND SIGNIFICANCE Our perspectives converge on the importance of critical consciousness development for culturally safe practice in medical education, acknowledging the need to emphasise a curriculum of shared humanity, introducing the concept of Ubuntu from Southern Africa. Ubuntu can be encapsulated in the phrase 'I am because we are', and it promotes a collective approach to medical education in which there is active solidarity between the profession and the diverse populations which it serves.
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Affiliation(s)
- Saleem Razack
- Division of Critical Care, Department of Pediatrics, Faculty of Medicine, University of British Columbia; Centre for Health Education Scholarship, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Lisa Richardson
- Temerty School of Medicine, University of Toronto, Toronto, Canada
- Department of Medicine, Temerty School of Medicine, University of Toronto, Toronto, Canada
| | - Suntosh R Pillay
- Department of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Ramadurai D, Shea JA. Leveraging the health equity implementation framework to foster an equity focus in medical education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:1047-1058. [PMID: 37668934 PMCID: PMC10912357 DOI: 10.1007/s10459-023-10277-0] [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: 04/01/2023] [Accepted: 08/13/2023] [Indexed: 09/06/2023]
Abstract
Teaching equitable clinical practice is of critical importance, yet how best to do so remains unknown. Educators utilize implementation science frameworks to disseminate clinical evidence-based practices (EBP). The Health Equity Implementation Framework (HEIF) is one of these frameworks, and it delineates how health equity may be concomitantly assessed and addressed in planning the implementation of an EBP. The HEIF therefore lays a strong foundation to understand and explain barriers and facilitators to implementation through an equity lens, making it well-suited for use by medical educators. Three equity-focused frames of reference within the model include (1) the clinical encounter, (2) societal context, and (3) culturally relevant factors, herein referred to as domains. The HEIF provides a structure for prospective and retrospective assessment of how EBP are taught and ultimately incorporated into clinical practice by trainees, with specific attention to delivering equitable care. We present three examples of common topics in internal medicine, contextualized by the three equity domains of the HEIF. We additionally acknowledge the limitations of this framework as a research tool with complex features that may not be suitable for brief teaching in the clinical environment. We propose a 360-degree learner assessment to ensure implementation of this framework is successful. By encouraging trainees to explore the narrative experiences of their patients and examine their own implicit biases, the HEIF provides a structure to address gaps in knowledge about delivering equitable care.
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Affiliation(s)
- Deepa Ramadurai
- Division of Pulmonary, Allergy and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
| | - Judy A Shea
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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5
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Arnoux S, Hirshfield LE, Abbiati M, Nendaz MR, Savoldelli GL, Bajwa NM. The impact of gendered experiences on the career choice of swiss medical students: A qualitative study protocol. PLoS One 2024; 19:e0302538. [PMID: 38768187 PMCID: PMC11104654 DOI: 10.1371/journal.pone.0302538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 05/22/2024] Open
Abstract
The problem of gender discrimination and sexual harassment in medicine is long-standing and widespread. This project aims to document and understand how gendered experiences encountered by final-year medical students in Switzerland are experienced by these individuals and how they influence their career choice. It also aims to identify representations and stereotypes linked to the different specialties. The project will take place at all Swiss universities offering a master's degree in human medicine, for a total of 9 programs. Around 36 participants will be recruited. Semi-structured qualitative individual interviews will be conducted. Analysis will be based on Grounded Theory principles.
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Affiliation(s)
- Sylvie Arnoux
- Faculty of Medicine, Unit of Development and Research in Medical Education, University of Geneva, Geneva, Switzerland
| | - Laura E. Hirshfield
- Department of Medical Education, University of Illinois College of Medicine, Chicago, Illinois, United States of America
| | - Milena Abbiati
- Faculty of Medicine, Unit of Development and Research in Medical Education, University of Geneva, Geneva, Switzerland
| | - Mathieu R. Nendaz
- Faculty of Medicine, Unit of Development and Research in Medical Education, University of Geneva, Geneva, Switzerland
| | - Georges L. Savoldelli
- Faculty of Medicine, Unit of Development and Research in Medical Education, University of Geneva, Geneva, Switzerland
- Department of Anaesthesiology, Division of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Nadia M. Bajwa
- Faculty of Medicine, Unit of Development and Research in Medical Education, University of Geneva, Geneva, Switzerland
- Department of Pediatrics, Division of General Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
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Jain NR, Nimmon L, Bulk LY. How to … bring a JEDI (justice, equity, diversity and inclusion) lens to your research. CLINICAL TEACHER 2024; 21:e13660. [PMID: 37874114 DOI: 10.1111/tct.13660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/31/2023] [Indexed: 10/25/2023]
Affiliation(s)
- Neera R Jain
- Centre for Medical and Health Sciences Education, School of Medicine, Faculty of Medical and Health Sciences, Waipapa Taumata Rau/The University of Auckland, Auckland, New Zealand
| | - Laura Nimmon
- Centre for Health Education Scholarship, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Occupational Science & Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Laura Y Bulk
- Occupational Science & Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
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Maristany D, Hauer KE, Leep Hunderfund AN, Elks ML, Bullock JL, Kumbamu A, O'Brien BC. The Problem and Power of Professionalism: A Critical Analysis of Medical Students' and Residents' Perspectives and Experiences of Professionalism. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:S32-S41. [PMID: 37983394 DOI: 10.1097/acm.0000000000005367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
PURPOSE Professionalism has historically been viewed as an honorable code to define core values and behaviors of physicians, but there are growing concerns that professionalism serves to control people who do not align with the majority culture of medicine. This study explored how learners, particularly those from historically marginalized groups, view the purpose of professionalism and how they experience professionalism as both an oppressive and valuable force. METHOD The authors conducted a qualitative study with a critical orientation. In 2021 and 2022, they interviewed fourth-year medical students and senior residents at 3 institutions about their perceptions and experiences of professionalism. After cataloguing participants' stories, the authors combined critical theory with narrative and thematic analysis to identify mechanisms by which professionalism empowered or disempowered individuals or groups based on identities. RESULTS Forty-nine trainees (31 medical students and 18 senior residents from multiple specialties) participated in interviews; 17 identified as a race/ethnicity underrepresented in medicine and 15 as people of color not underrepresented in medicine. Their stories, especially those of participants underrepresented in medicine, identified professionalism as an oppressive, homogenizing force that sometimes encoded racism through various mechanisms. These mechanisms included conflating differences with unprofessionalism, enforcing double standards of professionalism, and creating institutional policies that regulated appearance or hindered advocacy. Participants described deleterious consequences of professionalism on their learning and mental health. However, participants also described useful aspects of professionalism as a means of advocating for marginalized groups. Additionally, participants described how they reconceived professionalism to include their own identities and values. CONCLUSIONS Trainees, especially those from historically marginalized groups, experience professionalism as a restrictive, assimilative force while also finding value in and constructive adaptations for professionalism. Understanding both the destructive and empowering aspects of professionalism on individual and institutional levels can help improve the framing of professionalism in medical education.
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Affiliation(s)
- Daniela Maristany
- D. Maristany is assistant professor, Department of Medicine, University of California, San Francisco, San Francisco, California; ORCID: https://orcid.org/0009-0000-3928-3608
| | - Karen E Hauer
- K.E. Hauer is associate dean for competency assessment and professional standards and professor, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0002-8812-4045
| | - Andrea N Leep Hunderfund
- A.N. Leep Hunderfund is associate professor of neurology and medical director, Office of Applied Scholarship and Education Science, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; ORCID: https://orcid.org/0000-0002-7784-504X
| | - Martha L Elks
- M.L. Elks is professor of medical education and senior associate dean of educational affairs, Morehouse School of Medicine, Atlanta, Georgia; ORCID: https://orcid.org/0000-0003-2239-025X
| | - Justin L Bullock
- J.L. Bullock is a research fellow, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington; ORCID: https://orcid.org/0000-0003-4240-9798
| | - Ashok Kumbamu
- A. Kumbamu is assistant professor of biomedical ethics, Mayo Clinic Alix School of Medicine, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-2538-2618
| | - Bridget C O'Brien
- B.C. O'Brien is professor of medicine and education scientist, Department of Medicine and Center for Faculty Educators, University of California, San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0002-3050-0108
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Seymour R, Scher C, Frasso R, Truong S, Ziring D, Ankam N. Exposing the disability-related hidden curriculum in case-based learning: A qualitative study. Disabil Health J 2023; 16:101483. [PMID: 37344272 DOI: 10.1016/j.dhjo.2023.101483] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/15/2023] [Accepted: 05/21/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND People with disabilities face significant health disparities. Studies show that healthcare professionals harbor negative attitudes towards disability, compromising the quality of care. These attitudes, in unwritten, unofficial, and even unintended ways can be passed from providers to learners in the medical education setting. OBJECTIVE Using a Critical Disability Studies (CDS) paradigm, the authors uncovered the disability-related hidden curriculum within Case-Based Learning (CBL) and proposed guidelines for promoting a disability-conscious medical education that resists ableism. METHODS The study team conducted a qualitative analysis of all CBL cases from the pre-clerkship curriculum (n = 53) at Sidney Kimmel Medical College. The authors employed a directed content analysis approach to develop a codebook based on case examination, literature review, and CDS concepts. Two researchers coded all cases and assessed intercoder reliability. The results informed the development of an explanatory model. RESULTS Only four of 53 cases overtly mentioned disability, none of which defined disability according to CDS. Coding did not identify content challenging stereotypical views of disability. Additionally, two cases included content fueling negative attitudes of disability. CONCLUSION By inadequately addressing disability from a CDS perspective, harmful assumptions of disability may go unchallenged, driving a hidden curriculum within CBL. This phenomenon leaves medical students ill-prepared to care for people with disabilities and creates physicians ill-equipped to teach the next generation. Since many health professions utilize CBL to educate students, these cases provide an untapped opportunity to resist ableism and better prepare students to address the negative attitudes driving health disparities experienced by people with disabilities.
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Affiliation(s)
- Rory Seymour
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Carly Scher
- University College Dublin School of Medicine, Dublin, Ireland
| | - Rosemary Frasso
- College of Population Health at Thomas Jefferson University, Philadelphia, PA, USA; Asano-Gonnella Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College, Thomas Jefferson University, USA
| | - Susan Truong
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Deborah Ziring
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Nethra Ankam
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
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Fluet A, Essakow J, Ju M. Standardized Patients' Perspectives on Bias in Student Encounters. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:S29-S34. [PMID: 35947468 DOI: 10.1097/acm.0000000000004925] [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 Standardized patient (SP) encounters are widely used in health professional education to evaluate trainees' clinical skills. Prior literature suggests that bias can influence the evaluations of student learners in SP-student encounters. Understanding how SPs perceive bias in their work and how they view their role in mitigating or perpetuating bias in simulation is an important first step in addressing bias in the SP-student encounter. METHOD Researchers designed a qualitative interview study and conducted 16 semistructured interviews with SPs at the University of California, San Francisco Kanbar Simulation Center from July through September of 2020. Participants were selected using purposive sampling. The interviews were transcribed and analyzed by researchers using inductive thematic analysis. Researchers met iteratively to reconcile codes and identify themes. RESULTS SPs identified bias occurring in multiple directions: SP-to-student, student-to-SP, student-to-character, and SP-to-character. SPs were hesitant to label their own biases and instead used words such as "comfort" or "preference." SPs reported little bias from students, because students were being evaluated and therefore behaving carefully. Additionally, SPs perceived bias in the implementation of health care simulation, which manifests as underrepresentation of certain groups amongst actors and character descriptions. Most SPs felt that they should play a role in mitigating bias in SP-student encounters, including addressing bias that occurs, challenging stereotypes, teaching about cultural differences, and/or being conscious of bias in their assessments of learners. CONCLUSIONS In the SP-student encounter, bias can occur on many levels and between many individuals, including between the SP and the character they are portraying. Identifying the areas in which bias can exist can help simulation educators mitigate bias.
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Affiliation(s)
- Angelina Fluet
- A. Fluet is a medical student, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Jenna Essakow
- J. Essakow is a clinical fellow, Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Mindy Ju
- M. Ju is assistant clinical professor, Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, and associate education director, University of California, San Francisco Kanbar Center for Simulation, San Francisco, California
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McClintock AH, Fainstad TL, Jauregui J. Clinician Teacher as Leader: Creating Psychological Safety in the Clinical Learning Environment for Medical Students. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:S46-S53. [PMID: 35947474 DOI: 10.1097/acm.0000000000004913] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Psychological safety is the perception that a group environment is safe for interpersonal risk taking, exposing vulnerability, and contributing perspectives without fear of negative consequences. The presence of psychological safety has been tied to wellness, retention, and inclusiveness. National data demonstrate that many of the fundamental components of psychological safety are lacking in clinical learning environments. There is evidence that leadership behaviors can create psychological safety in traditional work environments. The authors sought to understand how clinical teachers' leadership behaviors can create, destroy, and rescue psychological safety in the clinical learning environment. METHOD This was a multicenter, cross-sectional, qualitative study of fourth-year medical students from 2 institutions using semistructured interviews. Verbatim transcripts underwent constant comparison and iterative data reduction and analysis, continuing beyond thematic sufficiency. RESULTS Eighteen students participated in interviews. Participants described key themes of relationships, an emphasis on learning, clear expectations, autonomy, and frequent feedback as promoting psychological safety. Safe environments lead to a sense of belonging and agency. They reported educator disinterest in students, dismissal of questions, lack of autonomy, and unclear expectations as destructive of psychological safety. Unsafe environments lead to withdrawal and a high extraneous cognitive load. Most students were unable to describe a time psychological safety was restored if lost. CONCLUSIONS Clinical teachers' leadership behaviors can directly impact students' perception of psychological safety in the clinical learning environment. Psychological safety increases students' sense of belonging, self-efficacy, and engagement. The findings demonstrate that while it is difficult to repair an atmosphere that is psychologically unsafe, there are several actions that can be put into motion early on to ensure the learning environment is safe and remains so. Future research should investigate whether psychologically safe environments lead to meaningful differences in assessments of student learning and effective cultural change.
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Affiliation(s)
| | - Tyra Leigh Fainstad
- T.L. Fainstad is associate professor of medicine, University of Colorado Anschutz School of Medicine, Aurora, Colorado
| | - Joshua Jauregui
- J. Jauregui is associate professor of emergency medicine, University of Washington, Seattle, Washington
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Wyatt TR. "The sins of our forefathers": reimagining research in health professions education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:1195-1206. [PMID: 35380319 DOI: 10.1007/s10459-022-10111-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/19/2022] [Indexed: 06/14/2023]
Abstract
As HPE begins to turn their attention to the lived experiences of minoritized groups in society, health professions education (HPE) researchers need to be aware of the history of social science research and the ways it contributes to creating systems of oppression. This is because as 'knowledge producers,' we make decisions about how to design our studies, analyze and interpret data, and report it in ways that are frequently oblivious to the harmful legacy of social science research, and how it continues to bring harm to minoritized communities. To not do so is to perpetuate a system that has historically served the dominant group at the expense of those who are limited in representing the world for themselves. This article proposes that HPE researchers engage in disruptive research practices by delinking with their disciplinary training, and reimagine their role in the research process. To accomplish this, I suggest that they engage in three strategies: attend to the research team's composition, embrace critical theory and investigate epistemological ignorance. These strategies are nowhere close to exhaustive, and they do not extend as far as the conversation must go in reimagining our role in the research enterprise. However, in providing some initial thoughts on this topic, I hope to invite the HPE community into discussion on how we might harness our collective responsibility to resist research practices that are harmful and unjust to minoritized communities.
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Affiliation(s)
- Tasha R Wyatt
- Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
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