From Intuition to Professionalization: A Qualitative Study About the Development of Teacher Identity in Internal Medicine Senior Residents

Abstract

<jats:p>Objectives: Professional identity can be defined as a developmental process. Literature suggests that residents aiming to practice in a teaching institution should receive support for the development of teaching competencies as much as they do for medical competencies, but there is limited data on how to recognize teacher identity development in residents. Our study focused on the manifestations of teacher identity development in a group of senior residents in a four-week optional pedagogy rotation. In particular, we were interested in seeing teacher identity development towards the end of the residency program, at a time when clinician identity begins to consolidate. Methods: A qualitative and exploratory approach guided our study design. Participants were internal medicine residents, (from Yr4 to Yr6) at University of Montréal, who intended working in a university setting and were interested in developing a teaching project. Focus groups were held at three separate moments: 1) before rotation, 2) after rotation and, 3) six months after rotation. Direct content analysis was chosen to analyze our findings. Results: We observed the emergence and the evolution of teacher identity and furthermore, we identified six development pathways, which underpin the development of teacher professional identity: 1) From awkward and stereotyped usage to mastery of concepts and teaching techniques, 2) From the reproduction of implicit norms of the clinical setting to the establishment of pedagogical norms 3) From the feeling of powerlessness in teaching to a feeling of mastery and taking initiatives 4) From teaching intuitively to reasoning pedagogically 5) From a teacher based paradigm to the discovery of the learner-centered paradigm and 6) From an emerging identity as a clinician to the simultaneous construction of twin identities: clinician and teacher. Six development indicators providing operational cues to help recognize different facets of teacher identity development were then identified. Conclusion: The identity development pathways allowed us to gain deeper insights about how teacher identity develops in internal medicine residents toward the end of a pedagogical rotation. It is our hope that these findings will help educators recognize and support the development of teacher identity in their residents.</jats:p>

Development of complex pedagogical competencies and reflexivity in clinical teachers via distance learning: a mixed methods study

“…The qualitative results enriched those findings by illustrating how the degree of improved pedagogical practice (‘better’ teaching) was intimately linked to the extent of the evolved posture as clinical teachers (‘better’ attitude). This co-construction of pedagogical competencies and professional identity on the path towards excellence as clinical teachers is congruent with works by Starr et al [ 58 ], Steinert et al [ 76 ] and others [ 59 , 68 ]. As the development of supervision skills improved participants’ practice, their self-confidence in establishing pedagogical diagnoses and issuing pedagogical prescriptions improved.…”

“…This instrument has been used as a self-evaluation instrument (modified MCTQ, mMCTQ) to identify self-perceived training needs in clinical teachers [ 55–57 ]. It aims at evaluating the quality of individual clinical teacher’s supervision through the dimensions of Role modeling , Coaching , Articulation , Exploration , and Learning environment ( Table 1 , dimensions 1–5).Qualitative [ 58 , 59 ] and quantitative [ 60 ] evidence has suggested that excellent clinical teachers have a well-developed teacher identity in addition to their clinician identity. To explore the relationship between clinical reasoning supervision competencies and the development of a clinical teacher professional identity, we added questionnaire items on an additional dimension, Professional identity development ( Table 1 , dimension 6).…”

<p>Faculty development program evaluation: a need to embrace complexity</p>

“…An important factor at play with regards to FD generated change at an individual level is related to identity development. Clinical teachers have a dual identity: to provide patient care and to teach 47–50…”

Perceptions of Clinical Supervision in Ambulatory Settings: Do Supervisee and Supervisors See Eye to Eye?

“…Supervisors didn't anticipate the cognitive load required to explain their clinical reasoning processes, the supervision plan-ning, and the emotional load not only of having to "share" their patients with a student, but also to take on the responsibility of their emotional reactions (Muller-Juge et al, 2018). It also appeared that these primary care physicians were surprised to find out that it was a challenge to conjugate their two roles: the role of a clinician who takes care of patients, and the role of teacher (Audétat, Grégoire, Fernandez, & Laurin, 2017).…”