Longitudinal qualitative research in medical education: Time to conceptualise time

Balmer, Dorene F.; Varpio, Lara; Bennett, Deirdre; Teunissen, Pim W.

doi:10.1111/medu.14542

Cited by 37 publications

(44 citation statements)

References 46 publications

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“…Balmer et al have advocated greater use of longitudinal qualitative research in medical education, as recursive data allows exploration of the student’s own journey through time , and where time is fluid . [ 33 ] Respondents can reflect on the past and how their perceptions change in the light of recent experience. It is suggested that the trust and safe space generated in recursive data collection may encourage rather than discourage retention of participants in the research.…”

Section: Discussionmentioning

confidence: 99%

Student assistantship programme: an evaluation of impact on readiness to transit from medical student to junior doctor

et al. 2022

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Background Studies report that medical graduates are not prepared for practice as expected, and interventions have been developed to prepare them for practice. One such intervention is the assistantship, which provides hands-on opportunities to hone clinical skills and undertake responsibilities under supervision. The Lee Kong Chian School of Medicine (LKCMed) is Singapore’s newest medical school, and students undergo a Student Assistantship Programme (SAP) to prepare for practice as junior doctors (PGY1). This study evaluated the SAP from the students’ and clinical supervisors’ perspectives. Methods Students completed online questionnaires to assess readiness for practice before and after SAP, and a subsample were interviewed about their experiences of SAP and its impact on their preparedness for PGY1. In addition, after our graduates had begun work as PGY1 doctors, their clinical supervisors completed an online questionnaire and were interviewed about the perceived benefits of SAP and the attributes of our graduates as junior doctors. Results Fifty (96%) students completed the pre-SAP questionnaire and 46 (92%) completed the post-SAP questionnaire. Levels of preparedness increased post-SAP (mean scores range pre-SAP: 2.38 to 4.32 vs post-SAP: 3.08 to 4.48); so did opportunities to undertake PGY1 duties (pre-SAP: 56% vs post-SAP: 96%), and hands-on experience in medical emergencies (pre-SAP: 76% vs post-SAP: 89%).Experience of acute care situations increased except “paracetamol overdose”. Readiness to be first respondents in ten acute situations improved (statistically significant for asthma, chronic obstructive pulmonary disease exacerbation, gastrointestinal bleed, sepsis, and adverse drug reactions). Three themes emerged from twenty-five student interviews: learning about the work environment, opportunities to learn in a safe environment, and enhancing SAP for future students. Thirty-three supervisors completed the questionnaire, and 70% rated SAP positively in preparing students for PGY1. Eight supervisors interviewed shared positively about the content, timing, and duration of SAP; and suggested future SAPs help students to develop coping and reflective skills. Conclusions The SAP improved students’ preparedness and experience across clinical areas, and students felt the SAP helped bridge undergraduate curriculum and work, provided opportunities to hone their skills and learn from junior doctors. Most clinical supervisors rated the SAP effective in preparing students for PGY1. This is the first formal evaluation of an assistantship in Singapore, and the findings are encouraging from the perspective of students and PGY1 supervisors.

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Section: Discussionmentioning

confidence: 99%

Student assistantship programme: an evaluation of impact on readiness to transit from medical student to junior doctor

et al. 2022

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“…By contrast to discrete, crosssectional qualitative studies, longitudinal qualitative studies ask researchers to partner with participants and gain a rich understanding of their journeys as their journeys unfold. 22 This approach is also flexible enough to incorporate meaningful change not only in the participants but also the researchers. 21,22 In this four-year study, we initially conceptualised the graduate programme in medical education in which this study was situated as a community of practice.…”

Section: Methodological Underpinningsmentioning

confidence: 99%

“…22 This approach is also flexible enough to incorporate meaningful change not only in the participants but also the researchers. 21,22 In this four-year study, we initially conceptualised the graduate programme in medical education in which this study was situated as a community of practice. We realised, like Wenger, that we needed to broaden our perspective when the community of practice dissipated as participants graduated and moved on to others.…”

Section: Methodological Underpinningsmentioning

confidence: 99%

Navigating landscapes of practice: A longitudinal qualitative study of physicians in medical education

2021

Self Cite

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Introduction: Despite its widespread application in medical education, belonging to a single community of practice does not reflect the overall experience of physicianeducators. Knowing how physician-educators find their way among different communities of practice (ie their landscape of practice) has implications for professional development but the limited description in the literature. In this longitudinal qualitative research, we explored how physicians who pursue graduate degrees in medical education navigate their landscape of practice.Methods: 11/29 physicians in one cohort of a masters in medical education programme were interviewed annually from 2016 (programme start) to 2020 (2 years post-graduation). We iteratively collected and analysed data, creating inductive codes and categorising coded data by mode of identification (engagement, imagination, alignment) and time. We organised narratives into time-ordered data matrices so that final analysis wove together mode, time and participant.Results: All participants consistently spoke of navigating their landscape of practice, which included the community created in the graduate programme; but that single community 'doesn't define the journey itself'. They shifted engagement from teaching individual learners to translating what they learned in the graduate programme to develop educational projects and produce scholarship. They shifted the imagination from relying on internal and external assessments to experience-inspired versions of their future self. And they shifted alignment from belonging to the graduate programme's community of practice, then belonging to different communities in their landscape of practice and ultimately focussing on communities that mattered most to them. Discussion: Physicians in a graduate programme in medical education navigated their dynamic landscape of practice by shifting how they engaged in medical education, as well as what they imagined and who they aligned with as physician-educators. Our work offers novel insights into how knowledgeability emerges through time as overlapping modes of identification.

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“…59 Moreover, longitudinal qualitative ego network research may overcome the limitations of rendering social relations as occurring in fixed, discrete moments of time. 60…”

Section: A Snapshot In Timementioning

confidence: 99%

Qualitative ego networks in health professions education: Capturing the self in relation to others

Nimmon

Atherley

2021

Medical Education

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Longitudinal qualitative research in medical education: Time to conceptualise time

Cited by 37 publications

References 46 publications

Student assistantship programme: an evaluation of impact on readiness to transit from medical student to junior doctor

Student assistantship programme: an evaluation of impact on readiness to transit from medical student to junior doctor

Navigating landscapes of practice: A longitudinal qualitative study of physicians in medical education

Qualitative ego networks in health professions education: Capturing the self in relation to others

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