Applying to medical school with undiagnosed dyslexia: a collaborative autoethnography

Recent statistics found the prevalence of dyslexia in UK medical schools to be 7%, sitting below the national prevalence of 10%. The factors contributing to this discrepancy are currently unknown, but may result from an interplay of individual and systemic barriers to entering medicine. This collaborative, analytic autoethnography aimed to use the experiences of 'Meg', a fourth-year medical student who was diagnosed as dyslexic whilst at medical school, to explore how the lack of a diagnosis during the admissions process may have impacted her journey into medicine. The data were collected using reflective writing and an interview before conducting a thematic analysis. Our analysis resulted in the construction of two meta-themes, relating to the negative emotional impact of not having a diagnosis and feelings of inferiority. Seven themes were also constructed. Some explored how Meg's personal experience of undiagnosed dyslexia acted as a barrier to entering medicine. Others explored the impact of external factors, such as socio-economic background and the provision of support, on an individual's chance of successfully applying to medical school. Finally, we explored the inadvertent impact undiagnosed (and unrecognised) dyslexia had on Meg's life course, including how medicine-specific aptitude tests, such as the BMAT and UKCAT, may have contributed to this. These results provide a unique window into the culture of applying to medical school as an undiagnosed dyslexic person, whilst discussing the need for medical schools to consider how their admissions processes may inadvertently disadvantage undiagnosed dyslexic applicants.

Practicing Confidence: An Autoethnographic Exploration of the First Years as Physicians

Phenomenon: Every year is heralded with a cohort of newly-minted medical school graduates. Through intense residency training and supervision, these learners gradually develop self-assurance in their newfound skills and ways of practice. What remains unknown, however, is how this confidence develops and on what it is founded. This study sought to provide an insider view of this evolution from the frontline experiences of resident doctors. Approach: Using an analytic collaborative autoethnographic approach, two resident physicians (Internal Medicine; Pediatrics) documented 73 real-time stories on their emerging sense of confidence over their first two years of residency. A thematic analysis of narrative reflections was conducted iteratively in partnership with a staff physician and a medical education researcher, allowing for rich, multi-perspective input. Reflections were analyzed and coded thematically and the various perspectives on data interpretation were negotiated by consensus discussion. Findings: In the personal stories and experiences shared, we take you through our own journey and development of confidence, which we have come to appreciate as a layered and often non-linear process. Key moments include fears in the face of the unknown; the shame of failures (real or perceived); the bits of courage gained by everyday and mundane successes; and the emergence of our personal sense of growth and physicianship. Insights: Through this work, we - as two Canadian resident physicians - have ventured to describe a longitudinal trajectory of confidence from the ground up. Although we enter residency with the label of 'physician,' our clinical acumen remains in its infancy. We graduate from residency still as physicians, but decidedly different in terms of our knowledge, attitudes, and skills. We sought to capitalize on the vulnerability and authenticity inherent in autoethnography to enrich our collective understanding of confidence acquisition in the resident physician and its implications for the practice of medicine.

Moving Through a Textual Space Autistically

This article is an investigation of neurodivergent reading practices. It is a collectively written paper where the focus is as much on an autoethnographic exploration of our autistic readings of autism/autistic fiction as it is on the read texts themselves. The reading experiences described come primarily from Yoon Ha Lee's Dragon Pearl (2019) and Dahlia Donovan's The Grasmere Cottage Mystery (2018), which we experience as opposite each other in how they depict their neurodivergent characters and speak to us as autistic readers. Through the article, we describe a formation of neurodivergent (critical) collective readings of autism/autistic fiction. The article contributes to an academic and activistic discourse around neurodivergent reader responses and power relations between neurodivergent and neurotypical readers and authors.

Autoethnographic Reflections on Mental Distress and Medication Management: Conceptualising Biomedical and Recovery Models of Mental Health

This article uses autoethnography to explore the author's lived experiences of mental distress and how she has conceptualised and explained these symptoms to herself using both the biomedical and recovery models of care. Autoethnography is a process of personal reflection that enables connection between the personal and the political. Experiences of mental distress are recounted alongside the decision to reduce medication. This personal experience is then explored in the context of limited evidence base on the effectiveness of reducing medication and the situation in which prescribers often feel reluctant to recommend and support service users in these choices. Shared decision-making in medication management is introduced which is an approach which draws on the models of recovery and co-production challenging traditional biomedical approaches which locate the prescriber as expert. Moreover, the radical service user led model is highlighted, within which, the Hearing Voices Network and Open Dialogue offer alternative approaches which promote co-production and empowerment. The author connects the personal to the political and reflects on her dual identity as an expert-by-experience and social work academic. She details how she has drawn on biomedical explanations to describe her distress yet has been challenged by the recovery model throughout her journey of recovery. She concludes that her own position, in identifying herself as an academic and expert-by-experience is an important step in challenging notions of expertise and approaches to mental health care.

"Stop acting like a child - you're immature": The reversed ageism of practicing self-injury as adult women and the reclaiming of our bodies

The practice of self-injury is considered deviant and pathological, and the stereotype of a self-injuring individual is a young, white, middle-class woman. By using an autoethnographic approach, I elucidate how four women and I, aged 35-51, with experiences of self-injury in adulthood, use, internalize, and speak through dominant discourses of self-injury. The practice of self-injury is an embodied one, and self-injury is stereotypically associated with immature, irresponsible, and emotionally unstable young women. As adult women who self-injure, we use and speak through this representation, which, to some extent, affects our self-image and identity as we are often "misrecognized" as full partners in everyday social interaction or when we represent our professions. Still, we resist the idea of self-injury as stemming from immaturity, and we work to reclaim our bodies and agency from the medicalized, ageist assumptions of the practice of self-injury. By doing this, we can also rewrite and transform the meaning of this practice. Our self-inflicted wounds or scars do not define who we are nor our level of maturity, intelligence, and attractiveness. Thus, we acknowledge that we have the right to our own bodies and what we do to that body.

Academic contributions to the development of evidence and policy systems: an EPPI Centre collective autoethnography

BACKGROUND

Evidence for policy systems emerging around the world combine the fields of research synthesis, evidence-informed policy and public engagement with research. We conducted this retrospective collective autoethnography to understand the role of academics in developing such systems.

METHODS

We constructed a timeline of EPPI Centre work and associated events since 1990. We employed: Transition Theory to reveal emerging and influential innovations; and Transformative Social Innovation theory to track their increasing depth, reach and embeddedness in research and policy organisations.

FINDINGS

The EPPI Centre, alongside other small research units, collaborated with national and international organisations at the research-policy interface to incubate, spread and embed new ways of working with evidence and policy. Sustainable change arising from research-policy interactions was less about uptake and embedding of innovations, but more about co-developing and tailoring innovations with organisations to suit their missions and structures for creating new knowledge or using knowledge for decisions. Both spreading and embedding innovation relied on mutual learning that both accommodated and challenged established assumptions and values of collaborating organisations as they adapted to closer ways of working. The incubation, spread and embedding of innovations have been iterative, with new ways of working inspiring further innovation as they spread and embedded. Institutionalising evidence for policy required change in both institutions generating evidence and institutions developing policy.

CONCLUSIONS

Key mechanisms for academic contributions to advancing evidence for policy were: contract research focusing attention at the research-policy interface; a willingness to work in unfamiliar fields; inclusive ways of working to move from conflict to consensus; and incentives and opportunities for reflection and consolidating learning.

Understanding The Process of Taoistic-Informed Mindfulness from a Meadian Perspective

In the recent years, mindfulness-based research has experienced a boom. Yet, the majority of those studies treat mindfulness in a positivistic way, thus solely as a variable. Within such a lens of inquiry, we ignore the theoretical and historical underpinnings of mindfulness that are still important, nowadays. For that purpose, I instance a theoretical and historical framework of mindfulness grounded within Taoism - relying on the notion of the polarity of life and wu wei (the principle of not-forcing) and try to bridge that focus with Mead's Social Psychology. By means of an autoethnography, I show that mindfulness-based activities such as meditation unfold the power of an individual to experience and own a new I which then acts in a new fashion upon the demands of the (social) environment (Me). In this process, a new personality is born that integrates wholistically the polar sides of life within himself/herself.

Promotion of research culture among radiographers in one UK NHS trust through journal club activities - An autoethnographic study

INTRODUCTION

The poor research culture within the radiography profession can be addressed through initiatives such journal club activities. The role of a research radiographer is best suited to drive achievement of journal club outcomes for research culture improvement; however, the cultural environment of healthcare providers presents challenges. This is an autoethnographic account of a research radiographer in promoting research culture among diagnostic radiographers in a single UK NHS trust through journal club activities.

METHODS

The study adopts an analytical autoethnography methodology to critically analyse reflective accounts of the research radiographer's experiences and the interplay with the cultural environment in which the experiences occurred. The reflective accounts are supported by locally collected data during a 10-month period of the journal club and published literature.

RESULTS

The establishment of the journal club received encouraging support from the senior management, university academics, library services and radiography professionals. There are initial signs of research culture improvement among participants of the journal club as observed through engagement in research related activities. However, cultural challenges including lack of time to explore gaps in research evidence, and prioritisation of clinical duties over research related activities, may have affected the achievement of expected outcomes of the club.

CONCLUSION

The research radiographer is well placed to encourage research culture within the clinical imaging department through targeted initiatives such as journal clubs. The long-term contributions of such initiative to departmental efficiency and quality service delivery should encourage optimum support to actualize expected outcomes.

IMPLICATIONS FOR PRACTICE

Encouragement of journal clubs as a means of improving research culture within clinical radiography teams, driven by research radiographers. Encouragement of management support for the achievement of set outcomes of journal clubs.

[Inter- and Transdisciplinarity as a Normative Dynamic: Challenges and Opportunities for Political Science]

Inter- and transdisciplinarity (ITD) has been part of political science for quite some time now, but although political science regularly deals with its self-understanding, the consequences for research and researchers of ITD have not yet been systematically considered. To stimulate this debate, we conceptualize ITD as a spectrum of knowledge integration, application, and participation. We use International Relations norm research as a theoretical framework to describe, analyze, and reflect on ITD as a normative dynamic. Autoethnographically and through participatory observation, we examine ITD as a normative dynamic, with insights from three research projects in the field of sustainability. Specifically, we ask what implications ITD has for researchers and research in political science. As a result, we find that ITD offers both opportunities and challenges. In the context of knowledge integration, we discuss the importance of the participation of political science in major societal issues in contrast to ITD's preferences for a particular understanding of knowledge and research. We reflect on ITD's application bias in terms of problem-solving opportunities and output orientation. In addition, we consider the participation postulate of ITD and weigh potential democratizing effects against the conditions under which these might be realized. Finally, we address where further research seems useful to continue reflection on ITD.

Family language policy in retrospect: Narratives of success and failure in an Indian-Iranian transnational family

In this study, we investigate family language policy in a transnational family through a collaborative autoethnography. Following the theoretical underpinnings of family language policy (Spolsky in J Multiling Multicult Dev 31:3-11, 2012), we present parental language beliefs, management, and practices in retrospect to shine a light on the long-term impact of the family's language policy on their daughter's linguistic development in heritage languages (i.e., Persian and Hindi) and English. The components of the family language policy in this cross-cultural transnational family are sketched in the second author's narratives of her experiences of multilingual childrearing and heritage language maintenance. We engage with, and critique, recent family language scholarship that apply postmodernist lens to examine families' translingual use of languages at home to get by their daily life, showing how having failed to set boundaries between the home/heritage languages and English over the past nine years has resulted in their child's predominant proficiency in English. We argue that such failure has its roots in parents' own past lived, and future imagined, experiences, as well as language ideologies that are polycentric and scaled, the consequences of which concern emotional, linguistic, cultural and social frictions across generations. Drawing on the narratives of success and failure in the family, we call for critical adoption of translingual frameworks in examining family language policy paying careful attention to the long-term impact of such practices at home on children's linguistic development.

The Experience of International Students: Biographical Narratives and Identities

This article presents the findings of a qualitative and comparative study on the cultural experience of international students in North and South Europe. I employ a narrative approach and the focus of the research revolves around the autoethnographies of 25 international students in Helsinki and 25 in Florence. The narratives were prompted by in-depth interviews following a template divided into the three phases of travel conceived as a rite of passage: departure-preliminal, transition-liminal, arrival-postliminal. To explore the meaning of geographical mobility in the lives of these young people, I sketched a series of self-identity types connected to mobility experiences: the Fated, whose biographical premises are all pushing-pulling toward the status of international student; the Academic, who is fascinated by the idea of becoming a worldly intellectual and sees the PhD as a natural step; the Globetrotter, whose mobility is an end in itself: the goal is the next city-country; the Explorer, who is abroad looking for new cultural challenges, with a genuine desire to discover and understand specific places and people; the Runaway, who feels like a stranger at home and is escaping abroad for political or existential reasons. I believe that the interpretation of international students' sense of self-identity can be fruitfully achieved through the narrative path I have constructed (or a similar one).

Nature-based tourism as therapeutic landscape in a COVID era: autoethnographic learnings from a visitor's experience in Iceland

One of the few silver linings in the COVID pandemic has been a new appreciation for, interest in, and engagement with nature. As countries open, and travel becomes accessible again, there is an opportunity to reimagine sustainable nature-based tourism from a therapeutic landscape lens. Framed within the therapeutic landscape concept, this paper provides an autoethnographic account of a visitor's experience of three different natural landscapes in Iceland shortly after the country's fourth wave of the pandemic. It adds to the understanding of the healing effects of the multi-colored natural landscapes of Iceland. The natural landscapes of interest herein include: the southern part of the Westfjörd peninsula, Jökulsárlón glacial lagoon, and the Central Highlands. In totality, the natural, built and symbolic environments worked in synchronicity to produce three thematic results: restoration, awe and concern, all which provided reduced stress, renewed attention, as well as enhanced physical and psycho-social benefits for the autoethnographic visiting researcher. Implications of these restorative outcomes for sustainable nature-based tourism in a post-COVID era are discussed. This paper highlights how health and tourism geographers can work collaboratively to recognize, protect, and sustain the therapeutic elements of natural landscapes, recognized as a cultural ecosystem service. In so doing, such collaborations can positively influence sustainable nature-based tourism development and consumption through proper and appropriate planning and development of such tourism destinations.

The trauma and healing of consciousness

BACKGROUND

Throughout my graduate coursework, several classes focused on trauma. Considering my experiences, I searched to gain insight into group level trauma adoptees face due to our unique status and common societal factors that influence adoption. Exploring the trauma literature, I found that none of the terms quite represented the complex characteristics of adoption.

OBJECTIVE

Realizing the limitations of current trauma definitions, I sought to name group trauma for adoptees and thereby legitimize and validate my and other adoptees' experiences.

PARTICIPANTS AND SETTING

I am the sole participant. The research was conducted in St. Louis, Missouri.

METHODS

In this autoethnography, I recount academic experiences that have shaped my emerging and interconnected identities as an adoptee and social worker. I analyze the traumatic and empowering impacts of gaining more information about adoption as a politically and economically influenced system.

RESULTS

Examining my intertwined adoption and academic journeys, I propose a trauma and healing of consciousness framework to understand trauma for groups of individuals like adoptees whose trauma is not recognized using historical, collective, or intergenerational models.

CONCLUSIONS

The term trauma of consciousness expands existing theories of trauma while including social groups for whom group trauma was not previously recognized. Understanding the trauma of consciousness is imperative because healing cannot begin until the existence of the trauma is recognized. Further exploration on the trauma of consciousness is needed to recognize its impact and to develop creative interventions that can provide hope and enable people to move forward.

Torn between two worlds: COVID, it's your fault

The COVID-19 pandemic has had a global reach, impacting each one of us to varying degrees. Research is emerging on the medical, educational, social, and psychological effects of this pandemic; however, little has appeared yet on the impact on immigrant acculturation. We are six higher education immigrant academics in New Zealand and our collaborative autoethnographic study reports on the disruption to our immigrant selves caused by COVID-19. We present findings from our narratives written at two different times: a reflection after the initial eight-week New Zealand lockdown from March to May 2020, and a second meta-reflection one year later. We also illustrate, in graph form, our perceived stress levels associated with being immigrants during COVID-19. The narratives describe strong emotions linked to transnational connections that bound us to loved ones at home in COVID-ravaged countries. While we describe a stronger sense of belonging to our new society, we also identify COVID-19 as a disruptor and interrupter of the acculturation process regardless of our length of settlement in New Zealand. We argue that the increased stress of COVID-19 has triggered an interruption or oscillation that has disrupted our acculturation trajectories, surfacing emotions of acculturative stress even for those well adapted to their new society. These findings may resonate with immigrants in similar contexts and circumstances.

Overcoming institutionalised barriers to digital health systems: an autoethnographic case study of the judicialization of a digital health tool

BACKGROUND

The deployment of digital health systems may be impeded by barriers that are, or are linked to underlying enduring institutions. Attempting to challenge the barriers without addressing the underpinning institution may be ineffective. This study reflects on ways actors may surmount institutionalised barriers to the uptake of digital tools in health systems.

METHODS

I applied Institutional theory concepts to an autoethnographic case study of efforts to introduce a digital tool to provide citizens with medicines information.

RESULTS

The tool's uptake was impeded because of state regulators' institutionalised interpretation of pharmaceutical advertising laws, which rendered the tool illegal. I, along with allies beyond the health sector, successfully challenged the regulators' institutionalised interpretation of pharmaceutical advertising laws through various actions. These actions included: framing the tool as legal and constitutional, litigation, and redefining these concepts: 'advertising', 'health institution', and the role of regulatory bodies vis a vis innovation.

CONCLUSION

After identifying a barrier as being institutionalised or linked to an institution, actors might challenge such barriers by engaging in institutional work; i.e. deliberate efforts to challenge the relevant institution (e.g. a law, norm or shared belief). Institutional work may require the actions of multiple actors within and beyond the health sector, including judicial actors. Such cross-sectoral alliances are efficacious because they provide institutional workers with a broader range of strategies, framings, concepts and forums with which to challenge institutionalised barriers. However, actors beyond the health system (e.g. the judiciary) must be inquisitive about the potential implications of the digital health interventions they champion. This case justifies recent calls for more deliberate explorations within global health scholarships and practice, of synergies between law and health.

Autoethnographic Research to Explore Instructional Design Practices for Distance Teaching and Learning in a Cross-Cultural Context

The purpose of this autoethnography is to share my perspective of course design and delivery considerations based on my professional experience as an instructional designer for a virtual international exchange program during the COVID-19 pandemic. Due to the impact of the global pandemic, the partner institutions decided to take advantage of distance education to continue their exchange program. I was the instructional designer to support faculty's transition to online instruction. Little research has been conducted to explore instructional design practices for distance teaching and learning in an intercultural context. Therefore, I applied an individual autoethnography to collect and analyze data from my narratives and artifacts to understand my perspective of instructional design and delivery practices within a cross-cultural distance learning environment. The findings showed course design in transnational distance contexts was more complicated than in distance education in a single cultural context. My role as an instructional designer was influenced by factors at both micro and macro levels.

The politics of testing positive: an autoethnography of media (mis)representations at the 'start' and 'end' of different pandemics

This paper draws on an autoethnographic 'digital diary' which the author began after testing positive for HIV in July 2016, until May 2021, to critically assess (mis)representations of both the AIDS and COVID-19 pandemics in the media. Drawing on insights from art, literature, queer theory and social anthropology, the paper focuses on dominant moral and political discourses to show how narratives of blame, shame and guilt about viral transmission contribute to the stigmatisation of 'at risk' groups. Concepts of biopower and normative judgement are used to reflect on discourses which construct those who 'test positive' for HIV or SARS-CoV-2 as 'reckless', 'risky' or 'irresponsible' subjects. The paper also analyses notes on recent media appearances made by the author to discuss their participation in the PARTNER study, which showed that HIV antiretroviral therapy eliminates the possibility of HIV transmission, including reports in The Guardian, on BBC News, on Sky News, on Channel 5 News, and in the Metro. As the former had reported that the 'Covid-19 crisis raises hopes of end to UK transmission of HIV', portrayals of the two pandemics are compared to explore tensions between public health and individual responsibility as normative priorities.

Doing autoethnographic drugs research: Some notes from the field

This article is concerned with the processes of doing research with people who use drugs, as someone who has a history of using drugs. It offers a brief introductory review to autoethnographic research methods and how they might be used to enhance the practice of drugs research. Through illustrative examples from the author's own experiences of researching heroin use, the article cautiously makes the case for an increased focus upon our drug-using experiences in drugs research. The positive and negative implications of this for research methods in drug studies are discussed, as well as their potential intersections with drug policy debates.

Capturing the Moments: An Autoethnographic Exploration of Self-Preservation in Clerkship

PhenomenonFor most medical students, clerkship represents a transitional phase into the 'real world' of medicine. This transition is often accompanied by significant mental stressors, burnout, and empathy decline. Educator led resilience curricula designed to support students during this critical period often focus on teaching generalized strategies to promote wellness and lack the student input and perspective in their development. Thus, they may be of minimal value when learners are faced with acute moments of challenge and distress in their day-to-day work. The following project seeks to provide an insider view on the experience, interpretation, and response to these moments of challenge and distress from the frontline perspective of clinical clerks. Approach: Using collaborative autoethnography, two medical students documented 85 reflections on their emerging professional identity over the course of a core clerkship year. A narrative analysis was conducted iteratively in partnership with a staff internist and a medical education researcher experienced in autoethnography, allowing for robust multi-perspective input. Reflections were analyzed and coded thematically; disagreements were resolved by consensus discussion. Findings: A key theme of the reflections was self-preservation, conceptualized within two principal contexts: (i) Clerk-patient relationships, wherein we found ourselves in emotionally difficult situations; and (ii) Clerk-preceptor relationships, in which self-preservation manifested through a series of self-protective mechanisms. Insights: The practice of self-preservation is understood as the conscious act of boundary-setting and psychological defense in situations that pose a real (or perceived) threat to the clerk's wellbeing. At best, self-preservation serves as a temporary compromise to the stressors and burnout of clerkship. We speculate, however, that, left unchecked, acts of self-preservation may lead to habitual selfishness and apathy, qualities that are in diametric opposition to those expected of future physicians, and may manifest later (when these learners progress through the hierarchy) as the unprofessional behaviors that perpetuate the cycle of the hidden curriculum.

Living with embodied vibrations: Sensory experiences following a traumatic brain injury

Based on autoethnography, this article adopts a (neuro)phenomenological lens to explore sensory experiences following a traumatic brain injury (TBI). Although focussing particularly on pain, vision, hearing, and somatic experiences connected with sleep, we also touch on how these are interwoven with other symptoms associated with TBIs. We use these experiences to enliven, and thereby enrich, clinical constructions and understandings of 'sensitivity' to light and to noise, as well as 'sleep disturbance'. We conclude with a discussion of how these sensory experiences can be understood in relation to embodied dynamics of vibration, oscillation, and (stochastic) resonance. The article closes with the suggestion that an embodied, sensorial, and phenomenologically informed analysis of the experiences of people with TBIs, particularly in relation, for example, to embodied sensations and perceptions of vibration, might provide novel insights for research and clinical practice.

"They're Not Closing This School, We Won't Let Them"

This autoethnography details the story of my personal experience in the field as a social work MSW and Ph.D. student, working as the facilitator of a human rights-based after-school and summer program at an urban high school set for permanent closure in a structurally oppressed community, and my journey to the realization that I was witnessing genocide in the form of structural violence. One purpose in writing this narrative is to provide a social and cultural context to the ubiquity of structurally violent policies, such as closing public schools. This story also testifies to the wealth of strengths that youth possess to resist even the most severe human rights abuses. I also write to show the inextricable political link between individuals and societal structures and systems and to challenge social workers to actively oppose structural violence and its genocidal effects. As I reflect on the genocidal conditions I witnessed, I will at the same time critically consider the profession of social work's role in responding to structural violence, as well as the great potential that our profession has to meaningfully address crises like these.

The geographies of digital health - Digital therapeutic landscapes and mobilities

Digital technologies have long impacted the field of health, causing fundamental changes for the geographies of the production, movement, and consumption of health. Despite this, there is limited health geography engagement with digital health, and an understanding of how digital health affects the spatialities of health remains underdeveloped. Here, using autoethnography, I reflect on personal encounters with digital health in the UK to initiate analytical attention into the geographies of digital health. I demonstrate that digital health technologies are interconnected and increasingly structure access to health, impacting the equality of health; and that digital health disrupts existing, and creates new, therapeutic landscapes and mobilities.

Faculty as reflective practitioners in emergency online teaching: an autoethnography

This study aimed to chronicle and understand the emergency online teaching experience of five faculty members in a liberal arts college located in Tokyo, Japan during the COVID-19 pandemic of 2020, adopting the autoethnographic method. It explored the nature and dimensions of problems the faculty members faced, resources used to make sense of problems encountered, and actions they took to solve the problems as reflective practitioners in emergency online teaching. It also examined differences between faculty members over time. Analysis of seven weeks of autobiographic reflective journals during a 10-week academic term revealed that the faculty members encountered a range of problems during the classes, especially student-related and technology-related issues. When encountering problems, faculty members utilized references such as their past experience in face-to-face classroom teaching. Faculty members with more online teaching experience were more adaptable and flexible in mobilizing other references to solve problems. Overall, all members worked as reflective learners and practitioners who continued to reflect on the problems they faced and find solutions. These findings suggest that engaging in reflection-in-action and reflection-on-action can be effective ways for faculty members to develop their competencies to solve problems in emergency online teaching situations when responding to unprecedented challenges and issues is continuously needed.

The Making of Delusions: From Imagination to Irreality

In this article I aim to understand meaning construction from a cultural psychological stance and investigate how human beings - both individually and collectively - create norms and beliefs that become guidelines for how we perceive. The real and the imaginary are closely intertwined- sometimes to the extent that one of them is taken for the other. Considering some specific product of the imagination as if it is real amounts to a delusion - the topic of this paper. A person constructs and attributes meaning and associations to objects and people and these constructions have been made by both personal and socially shared ideas. The dilemma seems to be concerning perspectives on truth and what lies prior to the determination of this. The attempt of this article and the autoethnographic research is to comprehend the extent and diversity of delusions. This will be examined in the attempt to investigate and distinguish delusions from everyday life to what can be considered pathological hence scrutinize the borderline of healthy versus maladaptive. This borderline will furthermore be discussed with the basis of symptom criteria from the ICD- and DSM diagnosis systems. This seems to be of big importance when diagnostically comprehend the pathological elements of the delusions in the sense that the judgement could come to determine life situation. These discussions lead to an understanding of delusions as semiotically made when distinguishing between general versus pathological psychological conditions.

Considering Covid-19: Autoethnographic reflections on working practices in a time of crisis by two disabled UK academics

COVID-19, an infectious disease caused by novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) caused dramatic changes in all aspects of daily life. As the British public was ordered to stay at home, non-essential businesses shut their doors, resulting in an abrupt shift in working practices towards home working. In higher education, university campuses closed to students and staff. In this article, two disabled lecturers working in higher education in the UK reflect on their experiences during this rapid shift in working practices. With a particular focus on how their different impairments intersected with the changes occurring during this time, they employ autoethnography as an emancipatory method to consider the ways in which their working lives were impacted by the decisions made during this period. As well as illuminating their own individual experiences, they use these accounts to consider the wider implications for disabled students and academics. They conclude that, whilst this has been a period of challenge, uncertainty and rapid change, there are also lessons to be learnt regarding accessibility and the possibility for adaptation going forward, for staff and students alike. They suggest that as we emerge from this period of crisis, we need to use these experiences as leverage for positive change; for designing ways of teaching and learning that accommodate everyone, rather than getting swept up in an unthinking pursuit of returning to 'business as usual'.

My Autohistoria-Teoría (trans)formational experience: An autoethnographical case study of a transgender BIPOC teacher's experience with racial healing

BACKGROUND

Visibility of the transgender community has increased, particularly in the media. Trans teachers face a challenge, as their professional roles are both public and private. In an effort to seek personal and professional support, trans teachers have turned to social media outlets. Additionally, current research does not always encompass intersectional experiences of trans BIPOC teachers.

AIM

This paper presents an autohistoria-teoría, or autoethnographical case study account of the author's experience coming out in the workplace as a trans teacher in Texas.

METHODS

Guided by Slavin et al. multicultural model of the stress process coupled with intersectionality, this paper attempts to describe how a trans teacher of color navigates the workplace. The data for this study are a collection of all of the author's social media posts from 2005 to 2015.

RESULTS

Findings reveal that allies provided some support, and that this trans teacher used deflection as a coping strategy in posts.

CONCLUSION

The results suggest that administrative and peer support can impact transgender workers' mental well-being. In this paper, autohistoria-teoría is used as a powerful way for a trans BIPOC teacher's narrative to be told, which contributed to cultural healing.

An application of activity theory to the "problem of e-books"

The “problem of e-books” is defined as the difficulty improving the adoption rates of e-books by students. The adoption rates of e-books for academic use remain low, and research into the reasons for this have resulted in inconclusive findings. Factors such as student perception, and variations in experimental methodology and technology, contribute to difficulties in generalising findings and establishing conclusive causes for this problem. To better understand the causal factors for low adoption rates and the student's experience with ereaders and digital text, an investigation was conducted by the lead researcher as a student enrolled in a postgraduate course. The experiment was designed using e-book and digital text documents on an ereader for academic study and the results analysed with the framework of Activity Theory. This methodology allowed exploration of the problem within the authentic experience of a student to examine the effects of this social environment on ereader and e-book use.

Analysis of the work domain was conducted and a comparative assessment of the observed effect of using the digital documents on an ereader compared with the paper book. Findings show that attempts to apply self-regulation and metacognitive learning techniques within the activity using the ereader were abandoned due to breakdowns in operations, and that this resulted in a perceived lower quality of achievement. The effect on the processes used by the student were extreme and were observed to be highly dependent on the student's use of specific learning strategies. The experimental methodology employed in this investigation enabled identification of the role of the social environment in the use of course documents on an ereader for academic study. The functionality of the ereader was such an extremely poor fit with the observed academic processes that a redesign approach for ereader and e-book technology is proposed as a solution to the low adoption rates of e-books.

Making her end of life her own: further reflections on supporting a loved one with motor neurone disease

BACKGROUND

People can live for many months without knowing why their body is failing prematurely before being diagnosed with motor neurone disease (MND); a terminal neurodegenerative disease which can be experienced as 'devastating' for the person and their family.

AIM

This study aimed to explore the meaning of supporting a loved one with MND to die.

METHODS

This study uses reflection and autobiographical story to connect with broader cultural, political and social meaning and understandings of dying.

FINDINGS

Four themes were identified relating to the end-of-life trajectory of MND. Loss of person (lived body experienced in silence); loss of relationships (lived relations are challenged); loss of home and loss of time (lived space and lived time take on new meaning); loss of future (dying-facing it alone).

CONCLUSION

Dying with MND is a complex phenomenon. When a person can no longer move and communicate, relationships between those involved in end-of-life care are challenging. A person with MND needs the support from those acting as power of attorney to make their end of life their own, and they themselves need support to find meaning in their suffering. This autoethnographic reflection provides vicarious experiences for nurses and other healthcare professionals working with people with MND and similar conditions.

Reframing health and illness: a collaborative autoethnography on the experience of health and illness transformations in the life course

In this collaborative autoethnography, we examine the processes whereby people may reframe their interpretations and understandings of health and illness as a result of new diagnostic information. In so doing, we utilise the first author's experience receiving a conclusive diagnosis of cystic fibrosis after years of misdiagnosis to outline some ways changes in diagnosis facilitate shifts in illness management, the nature of health and illness and the experience of the self in relation to health and medicine. Furthermore, we discuss the ways this case reveals the importance of examining and comparing the social construction and transformation of health and illness within and between different individual and collective lived experiences over time. In closing, we draw out theoretical and empirical implications for understanding transformations in the nature of health and illness over the life course as well as future directions for research investigating shifts in illness management and understanding over time (A virtual abstract of this paper is available to view at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA).

Thrown into the world of independent practice: from unexpected uncertainty to new identities

One of the most exciting yet stressful times in a physician's life is transitioning from supervised training into independent practice. The majority of literature devoted to this topic has focused upon a perceived gap between clinical and non-clinical skills and interventions taken to address it. Building upon recent streams of scholarship in identity formation and adaptation to new contexts, this work uses a Heideggerian perspective to frame an autoethnographical exploration of the author's transition into independent paediatric practice. An archive of reflective journal entries and personal communications was assembled from the author's first 3 years of practice in four different contexts and analyzed using Heidegger's linked existentials of understanding, attunement and discourse. Insights from his journey suggest this period is a time of anxiety and vulnerability when one questions one's competence and very identity as a medical professional. At the same time, it illustrates the inseparable link between practitioners and the network of relationships in which they are bound, how these relationships contextually vary and how recognizing and tuning to these differences may allow for a more seamless transition. While this work is the experience of one person, its insights support the ideas that change is a constant in professional practice and competence is contextual. As a result, developing educational content that inculcates contextual flexibility and an increased comfort level with uncertainty may prepare our trainees not just to navigate the unavoidable novelty of transition, but lay the groundwork for professional identities attuned to engage more broadly with change itself.

Experiences of a gender non-conforming lesbian in the "ladies' (rest)room"

Public restrooms in U.S. culture are highly gendered, politicized, problematic spaces. Gender non-conforming lesbians may feel especially at risk for various forms of harassment or policing by other occupants in the "ladies' (rest)room." Using auto-ethnographic lived experiences as observations, this essay explores reactions of other women/female occupants in public restrooms designated for female persons to the presence of a gender non-conforming lesbian (the author). Reactions include no response, fear and flight or fight, screaming/shrieking, and active policing. Differences by location and region, and changes in responses over time, are also explored.

Reflections of a community-based participatory researcher from the intersection of disability advocacy, engineering, and the academy

This article uses an evocative autoethnographic approach to explore the experience of being an insider-researcher in a community-based participatory research setting. Taking a holistic perspective and using the form of narrative story-telling, I examine the dynamics between the typically marginalizing (but sometimes empowering) experience of being an autistic woman and the typically privileging (but sometimes oppressive) experience of being an engineering professional, during a time of career upheaval. Themes of motivations and mentors, adversity from social services and the academy, belonging, the slipperiness of intersectional positioning, feedback cycles of opportunity, dichotomies of competence and inadequacy, heightened stakes, and power and resistance are explored through the narrative. While primarily leaving the narrative to speak for itself per the qualitative approach taken, the article concludes with a discussion of how the personal experiences described relate both to the broader work of insider-researchers within disability-related fields, and to misconceptions about self-reflection and capacity for story-telling in individuals on the autism spectrum.

An autoethnographic exploration of the use of goal oriented feedback to enhance brief clinical teaching encounters

Supervision in the outpatient context is increasingly in the form of single day interactions between students and preceptors. This creates difficulties for effective feedback, which often depends on a strong relationship of trust between preceptor and student. Building on feedback theories focusing on the relational and dialogic aspects of feedback, this study explored the use of goal-oriented feedback in brief encounters with learners. This study used autoethnography to explore one preceptor's feedback interactions over an eight-month period both in the ambulatory setting and on the wards. Data included written narrative reflections on feedback interactions with twenty-three learners informed by discussions with colleagues and repeated reading of feedback literature. Thematic and narrative analyses of data were performed iteratively. Data analysis emphasized four recurrent themes. (1) Goal discussions were most effective when initiated early and integrated throughout the learning experience. (2) Both learner and preceptor goals were multiple and varied, and feedback needed to reflect this complexity. (3) Negotiation or co-construction of goals was important when considering the focus of feedback discussions in order to create safer, more effective interactions. (4) Goal oriented interactions offer potential benefits to the learner and preceptor. Goal oriented feedback promotes dialogue as it requires both preceptor and learner to acknowledge and negotiate learning goals throughout their interaction. In doing so, feedback becomes an explicit component of the preceptor-learner relationship. This enhances feedback interactions even in relatively brief encounters, and may begin an early educational alliance that can be elaborated with longer interactions.

When Research "Unravels": One Community Psychologist's Tale of Becoming a Nepantlera

This is an autoethnography of one community psychologist's reflections on the abrupt conclusion of a project that resulted in the dismantlement of a Latinx Student Union at a public middle school in the Pacific Northwest. Gloria Anzaldúa's (Borderlands/La Frontera: The new mestiza, Aunt Lute Books, San Francisco, 2002) notion of nepantla is used to situate how an individual's personal identities often intersects with their professional identities in ways that collide within the research environment. Drawing on the "heart work" core competencies within the field of community psychology (The Community Psychologist, 45, 2012, 8; American Journal of Community Psychology, 55, 2015, 266) and extending the dialogue of feminist community psychologists engaged in narrative work (American Journal of Community Psychology, 37, 2006, 157; American Journal of Community Psychology, 37, 2006, 267; Feminist research practice: A primer, Sage, Los Angeles, 2014; American Journal of Community Psychology, 28, 2000, 883), the author addresses why it is important for researchers of Color engaged in community collaborations to reflect on projects that have unraveled to understand how their positionality shifts within social contexts.

"I'm Not Waving, I'm Drowning": An Autoethnographical Exploration of Biographical Disruption and Reconstruction During Recovery From Prescribed Benzodiazepine Use

Benzodiazepines are group of drugs used mainly as sedatives, hypnotics, muscle relaxants, and anti-epileptics. Tapering off benzodiazepines is, for some users, a painful, traumatic, and protracted process. In this article, I use an autoethnographic approach, adopting the metaphor of water, to examine heuristically my experience of iatrogenic illness and recovery. I draw on personal journals and blog entries and former users' narratives to consider the particular form of biographical disruption associated with benzodiazepines and the processes involved in identity reconstruction. I emphasize the role of the online community in providing benzodiazepine users such as myself with a co-cultural community through which to share a voice and make sense of our experiences. I explain how the success stories of former users provided me with the hope that I, the "medical victim," could become the "victor" and in the process construct a new life and fresh identity.

What's in a "research passport"? A collaborative autoethnography of institutional approvals in public involvement in research

PLAIN ENGLISH SUMMARY

The article analyses the process of securing permissions for members of the public (we refer to them as "research partners") and academics involved in a qualitative study of public involvement in research (PIR) across eight health sciences projects in England and Wales. All researchers, including research partners, need to obtain a "research passport" from UK NHS trusts where they intend to carry out research. The article presents the experiences and observations of the authors, who all went through the process.Research partners encountered many challenges, as the overall bureaucratic procedures proved burdensome. The effects were felt by the academics too who had to manage the whole process. This influenced the way research partners and academics built social and personal relationships required for the successful conduct of the project. We also discuss the tensions that emerged around the issue of whether research partners should be treated as a professional category on their own, and other issues that influenced the PIR processes.In the concluding section, we make a number of practical recommendations. Project teams should allow enough time to go through all the hurdles and steps required for institutional permissions, and should plan in advance for the right amount of time and capacity needed from project leaders and administrators. Bureaucratic and organisational processes involved in PIR can sometimes produce unanticipated and unwanted negative effects on research partners. Our final recommendation to policy makers is to focus their efforts on making PIR bureaucracy more inclusive and ultimately more democratic.

ABSTRACT

Background In the growing literature on public involvement in research (PIR), very few works analyse PIR organizational and institutional dimensions in depth. We explore the complex interactions of PIR with institutions and bureaucratic procedures, with a focus on the process of securing institutional permissions for members of the public (we refer to them as "research partners") and academics involved in health research. Methods We employ a collaborative autoethnographic approach to describe the process of validating "research passports" required by UK NHS trusts, and the individual experiences of the authors who went through this journey - research partners and academics involved in a qualitative study of PIR across eight health sciences projects in England and Wales. Results Our findings show that research partners encountered many challenges, as the overall bureaucratic procedures and the emotional work required to deal with them proved burdensome. The effects were felt by the academics too who had to manage the whole process at an early stage of team building in the project. Our thematic discussion focuses on two additional themes: the emerging tensions around professionalisation of research partners, and the reflexive effects on PIR processes. Conclusions In the concluding section, we make a number of practical recommendations. Project teams should allow enough time to go through all the hurdles and steps required for institutional permissions, and should plan in advance for the right amount of time and capacity needed from project leaders and administrators. Our findings are a reminder that the bureaucratic and organisational structures involved in PIR can sometimes produce unanticipated and unwanted negative effects on research partners, hence affecting the overall quality and effectiveness of PIR. Our final recommendation to policy makers is to focus their efforts on making PIR bureaucracy more inclusive and ultimately more democratic.

Creation of a personality garden--a tool for reflection and teacher development; an autoethnographical research paper

BACKGROUND

This paper focuses on the Creation of a Personality Garden as a development tool. The original concept of the Garden was born from an autoethnographical study on the effects of self-concept on the teaching and learning experience.

OBJECTIVES

To explore the effects of self-concept on the teaching and learning experience.

DESIGN

An autoethnographical study.

SETTING

The study was undertaken in London, UK.

PARTICIPANTS

The researcher was also the sole participant in line with the autoethnographical approach.

METHODS

Data was collected through the means of a reflective diary, personal memory data, interview and other creative genres. A thematic analysis approach was then used to code and group core concepts.

RESULTS

Three key areas were identified: emotional connection, growth, and resilience, with a fourth as an over-arching driver for the study; the audience and act of teaching. These elements appeared to underpin a teaching philosophy which recognises the benefits of self-awareness in teachers and an ability and willingness to connect with learners and respond to individual needs. The Garden was one element of self-reflective data which was later re-designed to embrace the personal transformation of the researcher throughout the study.

CONCLUSIONS

Educationalists must have a willingness to explore self-perception as it can facilitate a sense of transparency and connection between the teacher and the learner. The Garden works as a dynamic tool and a sustainable model for confronting the on-going challenges of embracing risk-taking and emotionally connecting with learners within the educational context. It allows exploration of the nuances of personality and how the uniqueness of self interacts with the role of the teacher; a sometimes uncomfortable, yet safe, place to sit and experience a virtual reality check questioning assumptions and the theories that the individual espouses to use.

Autoethnography: Exploring Gender Diversity

Academic discourse proscribes a particular way of writing that may leave the reader informed but uninspired. There are three intentions for this paper: to create a counter-discourse for academic writing, to illustrate autoethnograpy as a compelling approach to nursing inquiry, and to demonstrate how autoethnography is well suited to research the experience of people who identify as transgender or transsexual. The setting is a doctoral nursing seminar where the student is introducing autoethnography to fellow students. All characters are fictionalized compositions. The writing is in the style of creative non-fiction and illustrates the use of evocative prose and poetry.

Using autoethnography to reclaim the 'place of healing' in mental health care

Geographies of mental health in the era of deinstitutionalisation have examined a range of places, policy processes and people's experiences associated with community care. However, such assessments have tended, given their community focus, to necessarily be silent on the character of inpatient spaces of care. There is silence too on the potential of such spaces to assist in the healing journey. While there have been a few investigations of hospital design, there has been little consideration of users' experiences of hospital spaces as critical sites and spaces of transition on the illness journey. In this paper, we critically reflect on a project that seeks, two decades after the closure of the last major institution in New Zealand, to investigate the acute care environment with an emphasis on its capacity for healing. The vehicle facilitating this investigation is a novel approach to understanding the inpatient journey: autoethnography. This methodology allows the first author (JL) to critically reflect on her multiple roles as compassionate observer, service-user and mental health professional, and developing transdisciplinary insights that, in conversation with the other authors' geographical (RK) and psychological (PA) vantage points, assist in the reconsideration of the place of the inpatient unit as a place of healing. The paper reveals how voice, experience and theory become mutually entwined concerns in an investigation which potentially stretches the therapeutic landscape idea through critical attention to the redemptive qualities of place by means of attentiveness to both the world within and the world without.