This article discusses a sociocultural approach to processes of identity that has implications for how we understand learning and identity formation in education. Focusing on the socially-constructed and culturally-figured nature of language, tools and interactions in learning contexts, this approach assists in the appreciation of how students navigate through and develop an understanding of themselves in different educational contexts. To this end, reference is made to Wortham's work on interactional positioning in narratives, and the work of Holland and colleagues on figured worlds. Wortham provides the tools for a systematic analysis of how individuals construct their identities by positioning themselves in discursive interaction. Holland and colleagues alert us to the cultural shaping of such positioning in cultural worlds and the artifacts mediating identity formation. To explore the potential of combining these lenses, a case study is described involving a series of interviews with medical students about their selfperceptions in two contexts of clinical training. The case study highlights how different worlds and identities are formed in these educational contexts.
Students' perceptions challenge educational goals, suggesting that there is limited potential for the formation of professional identity through early training. Teacher-doctors must acknowledge how students' low levels of clinical competence and patients' behaviour complicate students' identity formation.
Objectives
This scoping review aims to give a comprehensive and systematic overview of published evaluations and the potential impact of patient education interventions for children, adolescents and young adults who are living with chronic illness and/or impairment loss.
Methods
Relevant literature published between 2008 and 2018 has been comprehensively reviewed, with attention paid to variations in study, intervention and patient characteristics. Arksey and O'Malley's framework for scoping studies guided the review process, and thematic analysis was undertaken to synthesize extracted data.
Results
Of the 7214 titles identified, 69 studies were included in this scoping review. Participant‐reported benefits of the interventions included less distress from symptoms, improved medical adherence and/or less use of medication, and improved knowledge. The majority of studies measuring physical activity and/or physiologic outcomes found beneficial effects. Interventions were also beneficial in terms of decreased use of urgent health care, hospitalization, visits to general practitioner and absence from school. By sharing experiences, participants had learned from each other and attained new insight on how they could manage illness‐related challenges.
Discussion
Study results corroborate previous research suggesting that different types of patient education interventions have a positive impact on children, adolescents and young adults, but research on this field is still in a starting phase. The results summed up in the current review supports the utility of patient education interventions that employ behavioural strategies tailored to the developmental needs of children, adolescents and young adults with different cultural backgrounds.
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