Abstract:Introduction
Health professional identity transitions involve a dynamic period of liminality prompting a time of considerable uncertainty and self‐doubt. For postgraduate trainees in the United Kingdom, the transition to medical registrar can be a significant deterrent to recruitment and retention. Narrative analysis offers insight into identity work during transitions with potential to inform strategies for developing professional identities. This study aimed to use narrative analysis to explore trainees' exp… Show more
“…‘This study adds to the claim that through narrative analysis, there is an opportunity for learners to make sense of their experiences and reflect on developing identities’ 3 ,p19…”
mentioning
confidence: 92%
“…Not only do the narratives capture the readers in these studies, both highlight the importance of learners having the opportunity to revisit their reflections and make sense of experiences: ‘Being confronted with their reflections was beneficial for them to make meaning of their experiences and developing identity’ 2 ,p20 ‘This study adds to the claim that through narrative analysis, there is an opportunity for learners to make sense of their experiences and reflect on developing identities’ 3 ,p19 …”
mentioning
confidence: 97%
“…With the donning of each new title, learners are constantly changing and becoming to ‘cross a boundary’ into their new roles 2 . What follows can be a ‘dynamic period of liminality prompting a time of considerable uncertainty and doubt’ 3 . p1…”
mentioning
confidence: 99%
“…‘Just pretending’: Narratives of professional identity transitions in internal medicine uses narrative analysis from linguistic and agentive lenses to explore the experience of internal medicine residents as they reflected on transitioning to medical registrar 2 . ‘Longitudinally exploring new clerkship students' identity formation using research poetry’ similarly focuses on narrative, though in a longitudinal approach, to better understand sociocultural aspects of the transitional period from pre‐clerkship to clerkship 3 . In both studies, the narrative stories are reconstructed into research poems, ensuring the reader approaches an understanding of what learners are experiencing during transitions to new roles and the ways in which participants are constructing their identities through these experiences 2,3 …”
mentioning
confidence: 99%
“…Identity can be conceptualised as cognitive, owned by the individual through a process of identification, multiple, constructed in social interaction, shaped through language and shared social worlds or somewhere in between 6 . While both studies in this issue emphasise the importance of social interactions, where identity resides differs 2,3 . And yet, they come to a similar position on narrative and reflection through careful analysis of participant stories.…”
Health advocacy is conceptualised as behaviours at an individual and system level that overlap with an internalised sense of 'going above and beyond'. 2 We believe health advocacy for patients is important for learners and physicians caring for patients in all specialities. In this commentary, we consider the role of health
“…‘This study adds to the claim that through narrative analysis, there is an opportunity for learners to make sense of their experiences and reflect on developing identities’ 3 ,p19…”
mentioning
confidence: 92%
“…Not only do the narratives capture the readers in these studies, both highlight the importance of learners having the opportunity to revisit their reflections and make sense of experiences: ‘Being confronted with their reflections was beneficial for them to make meaning of their experiences and developing identity’ 2 ,p20 ‘This study adds to the claim that through narrative analysis, there is an opportunity for learners to make sense of their experiences and reflect on developing identities’ 3 ,p19 …”
mentioning
confidence: 97%
“…With the donning of each new title, learners are constantly changing and becoming to ‘cross a boundary’ into their new roles 2 . What follows can be a ‘dynamic period of liminality prompting a time of considerable uncertainty and doubt’ 3 . p1…”
mentioning
confidence: 99%
“…‘Just pretending’: Narratives of professional identity transitions in internal medicine uses narrative analysis from linguistic and agentive lenses to explore the experience of internal medicine residents as they reflected on transitioning to medical registrar 2 . ‘Longitudinally exploring new clerkship students' identity formation using research poetry’ similarly focuses on narrative, though in a longitudinal approach, to better understand sociocultural aspects of the transitional period from pre‐clerkship to clerkship 3 . In both studies, the narrative stories are reconstructed into research poems, ensuring the reader approaches an understanding of what learners are experiencing during transitions to new roles and the ways in which participants are constructing their identities through these experiences 2,3 …”
mentioning
confidence: 99%
“…Identity can be conceptualised as cognitive, owned by the individual through a process of identification, multiple, constructed in social interaction, shaped through language and shared social worlds or somewhere in between 6 . While both studies in this issue emphasise the importance of social interactions, where identity resides differs 2,3 . And yet, they come to a similar position on narrative and reflection through careful analysis of participant stories.…”
Health advocacy is conceptualised as behaviours at an individual and system level that overlap with an internalised sense of 'going above and beyond'. 2 We believe health advocacy for patients is important for learners and physicians caring for patients in all specialities. In this commentary, we consider the role of health
BackgroundEnsuring that students transition smoothly into the identity of a doctor is a perpetual challenge for medical curricula. Developing professional identity, according to cultural‐historical activity theory, requires negotiation of dialectic tensions between individual agency and the structuring influence of institutions. We posed the research question: How do medical interns, other clinicians and institutions dialogically construct their interacting identities?MethodsOur qualitative methodology was rooted in dialogism, Bakhtin's cultural‐historical theory that accounts for how language mediates learning and identity. Reasoning that the COVID pandemic would accentuate and expose pre‐existing tensions, we monitored feeds into the Twitter microblogging platform during medical students' accelerated entry to practice; identified relevant posts from graduating students, other clinicians and institutional representatives; and kept an audit trail of chains of dialogue. Sullivan's dialogic methodology and Gee's heuristics guided a reflexive, linguistic analysis.ResultsThere was a gradient of power and affect. Institutional representatives used metaphors of heroism to celebrate ‘their graduates’, implicitly according a heroic identity to themselves as well. Interns, meanwhile, identified themselves as incapable, vulnerable and fearful because the institutions from which they had graduated had not taught them to practise. Senior doctors' posts were ambivalent: Some identified with institutions, maintaining hierarchical distance between themselves and interns; others, along with residents, acknowledged interns' distress, expressing empathy, support and encouragement, which constructed an identity of collegial solidarity.ConclusionsThe dialogue exposed hierarchical distance between institutions and the graduates they educated, which constructed mutually contradictory identities. Powerful institutions strengthened their identities by projecting positive affects onto interns who, by contrast, had fragile identities and sometimes strongly negative affects. We speculate that this polarisation may be contributing to the poor morale of doctors in training and propose that, to maintain the vitality of medical education, institutions should seek to reconcile their projected identities with the lived identities of graduates.
IntroductionHealthcare systems worldwide are facing a workforce crisis; meanwhile, refugee doctors throughout the world face difficulties in accessing work. The aims of this review were to explore the integration needs of refugee doctors into host healthcare systems from the refugee perspective, synthesise the literature to construct a theory of refugee doctor integration needs and explore how these needs are met or challenged on the pathway to full integration.MethodsIn this integrative literature review, 11 databases and eight grey literature sources were searched by combining terms for refugee doctor and social integration and limiting to research published in or after 2003. Data were extracted, and quality scoring was completed independently by two researchers. This study utilised template analysis to perform a qualitative synthesis of the data. The multidimensional template included a pre‐defined template based on a theoretical framework and a concurrent fully inductive template.ResultsTwenty‐two papers were included, incorporating the views of 339 doctors from 30 different home countries and 10 different host countries. The resultant theory included ‘foundations’ (rights and responsibilities) and three pillars. The ‘learning’ pillar included required knowledge and skills acquisition. The ‘being’ pillar encompassed necessary identity work. The ‘connecting’ pillar comprised social connections, which impacted all other domains. The random and non‐linear path to integration faced by refugee doctors was also presented as a serious game.DiscussionThis study produced a theory exploring refugee doctors' integration needs and how these are met or challenged. Medical educators developing courses for refugee doctors should attend not only to knowledge and skills acquisition but also social connections, identity work and rights and responsibilities. The theory highlights the central importance of social connections. Medical educators can therefore have a transformative impact on refugee doctors' integration. This may also contribute to society by helping to alleviate the workforce crisis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
