Autonomy and professional identity formation in residency training: A qualitative study

Sawatsky, Adam P.; Santivasi, Wil L.; Nordhues, Hannah C.; Vaa, Brianna E.; Ratelle, John T.; Beckman, Thomas J.; Hafferty, Frederic W.

doi:10.1111/medu.14073

Cited by 65 publications

(85 citation statements)

References 42 publications

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“…Addressing potential barriers related to help‐seeking decisions should, therefore, be addressed on different levels. Supervisors could address residents’ credibility concerns 40,56 by having regular conversations with them about expectations regarding residents’ level of training and when they should seek help 43,44 . Furthermore, given the important role of other (non‐physician) health care team members in lowering the threshold for residents to ask for help, both formal and informal feedback conversations with fellow residents and allied health professionals could be actively stimulated in training programmes.…”

Section: Discussionmentioning

confidence: 99%

An act of performance: Exploring residents’ decision‐making processes to seek help

et al. 2021

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Context Residents are expected to ask for help when feeling insufficiently confident or competent to act in patients’ best interests. While previous studies focused on the perspective of supervisor‐resident relationships in residents’ help‐seeking decisions, attention for how the workplace environment and, more specifically, other health care team members influence these decisions is limited. Using a sociocultural lens, this study aimed to explore how residents’ decision‐making processes to seek help are shaped by their workplace environment. Methods Through a constructivist grounded theory methodology, we purposively and theoretically sampled 18 residents: 9 juniors (postgraduate year 1/2) and 9 seniors (postgraduate year 5/6) at Amsterdam University Medical Centers. Using semi‐structured interviews, participating residents’ decision‐making processes to seek help during patient care delivery were explored. Data collection and analysis were iterative; themes were identified using constant comparative analysis. Results Residents described their help‐seeking decision‐making processes as an ‘act of performance’: they considered how asking for help could potentially impact their assessments. They described this act of performance as the product of an internal ‘balancing act’ with at its core the non‐negotiable priority for providing safe and high‐quality patient care. With this in mind, residents weighed up demonstrating the ability to work independently, maintaining credibility and becoming an accepted member of the health care team when deciding to seek help. This ‘balancing act’ was influenced by sociocultural characteristics of the learning environment, residents’ relationships with supervisors and the perceived approachability of other health care team members. Conclusions This study suggests that sociocultural forces influence residents to experience help‐seeking as an act of performance. Especially, a safe learning environment resulting from constructive relationships with supervisors and the approachability of other health care team members lowered the barriers to seek help. Supervisors could address these barriers by having regular conversations with residents about when to seek help.

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Section: Discussionmentioning

confidence: 99%

An act of performance: Exploring residents’ decision‐making processes to seek help

et al. 2021

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“…Teachers can foster collaborative learning through active learning strategies (e.g., think-pair-share, debate, problem-solving task) [14,15]. Such collaborative learning within a clinical department will help to shape the development of the learner's professional identity as a team member [16]. As the current generation of learners grow up playing games and have gamer's mindset (e.g., adopt a challenge, prefer options, cultivate connectedness), the use of game elements (e.g., by using a reward system of points, levels, or leaderboards) stimulates engagement and allows learners to explore, fail, and learn within safe boundaries [17].…”

Section: Foster Collaborative Learning Using Active Learning Techniquesmentioning

confidence: 99%

The physiology of learning: strategies clinical teachers can adopt to facilitate learning

Thammasitboon

Brand

2021

Eur J Pediatr

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Almost all pediatricians working in a hospital or office environment have teaching responsibilities to learners such as medical students and residents. Although teaching and supporting learning in a busy work environment imposes challenges to clinical teachers, these clinical settings provide an ideal setup for experiential learning, learning from daily experiences with patients. Advances in the science of learning derived from various fields have informed us how adults learn best. Many techniques and strategies based on this “physiology of learning” have shown their educational values in everyday pediatric practice. This article outlines how clinical teachers can create the conditions to optimize experiential learning for individual or a group of learners. We highlight practical implications of educational theories and evidence-based educational practices for clinical teachers seeking to enhance their teaching effectiveness. These include promoting active learning and engaging learners in deliberate practice; retrieval of knowledge and prior experiences to enhance motivation; supporting a psychologically safe learning environment; helping learners to set goals; fostering collaborative learning; structuring teaching to link it to authentic roles and tasks; and customizing content to individual learners.Conclusion: Applying adult learning principles in everyday teaching activities will support busy pediatricians to be successful in their tasks as clinical teachers, and contribute to work satisfaction. What is Known:• Most pediatricians provide clinical teaching to medical students and residents, but few have had formal training in educational techniques.• Learning from clinical experiences (experiential learning) is of key importance to becoming and maintaining a competent pediatrician. What is New:• This review presents an up-to-date overview of the physiology of learning, i.e., how people learn.• Knowledge of the principles of how people learn helps pediatricians shape their clinical teaching effectively and contribute to their work satisfaction.

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“… 15 A recent study investigated the connection between autonomy and professional identity formation. 24 While it is known that PIF is crucial to the development of learners becoming physicians, it is still unclear what the impact of this formation is throughout their transition from medical student to trainee to practicing physician. Does accepting and understanding the professional role of a doctor earlier in the learning process produce better physicians with more empathy, compassion and greater confidence in making clinical decisions?…”

Section: Discussionmentioning

confidence: 99%

First year medical students’ perceptions of the impact of wearing scrubs on professional identity: a narrative analysis in the United Arab Emirates

Sorrell

Ibrahim

2020

BMJ Open

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ObjectivesMedical school serves as a critical developmental period for future physicians, during which students begin to form a professional identity. Just as personal appearance, particularly clothing, is an important external expression of one’s personal identity, ‘uniforms’ in healthcare, including white coats and scrubs, symbolise status and a group identity. There are, however, limited studies on the impact of physician attire on medical students’ formation of professional identity. Accordingly, through qualitative analysis of written narratives, we sought to analyse medical students’ experiences of wearing professional physician attire, namely scrubs, and how the uniform impacted their confidence level, performance and behaviours, as well as their identity as future physicians.DesignQualitative analysis of medical student’s written narratives.SettingKhalifa University College of Medicine and Health Sciences (KU CMHS) is a new medical school in the United Arab Emirates, with an inaugural class of 30 students admitted in August 2019. It is the only medical school in the city of Abu Dhabi, and the only school in the country that follows a postgraduate medical curriculum.ParticipantsAll first year medical students at KU CMHS were purposively sampled.MethodsStudents completed a voluntary online anonymous questionnaire. We employed a social identity approach to data analysis. Thematic content analysis was conducted on their narratives to identify themes.ResultsWe identified three major themes, namely (1) emotions, (2) logistics and (3) interpersonal relationships.ConclusionsMedical students form early perceptions regarding physician attire and its impact on their professional identity. Engaging in conversations regarding professional attire with educators or mentors could provide an important opportunity for students to discuss and explore professional identity early in training.

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Autonomy and professional identity formation in residency training: A qualitative study

Cited by 65 publications

References 42 publications

An act of performance: Exploring residents’ decision‐making processes to seek help

An act of performance: Exploring residents’ decision‐making processes to seek help

The physiology of learning: strategies clinical teachers can adopt to facilitate learning

First year medical students’ perceptions of the impact of wearing scrubs on professional identity: a narrative analysis in the United Arab Emirates

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