Making space for relational reflexivity in longitudinal qualitative research

Gordon, Lisi

doi:10.1111/medu.14626

Cited by 3 publications

(5 citation statements)

References 7 publications

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“…Uncertainty is undoubtedly here to stay; whether it is made explicit in the curriculum will have lasting impacts on all stakeholders (Stephens et al, 2022). an appreciation of timescales, a trend that is on the rise in the longitudinal qualitative health professions literature (Reale et al, 2018;de Cates et al, 2019;Gordon, 2021;Balmer & Richards, 2022). This study has the potential to expand longitudinally to interpret further the experiences of educators emerging from the pandemic to redefine anatomy pedagogy.…”

Section: Discussionmentioning

confidence: 97%

“…This study highlights the need for open discussions about what can be done to support the anatomy education community through uncertain times and timescales. Balmer et al (2021) have called for an appreciation of timescales, a trend that is on the rise in the longitudinal qualitative health professions literature (Reale et al, 2018; de Cates et al, 2019; Gordon, 2021; Balmer & Richards, 2022). This study has the potential to expand longitudinally to interpret further the experiences of educators emerging from the pandemic to redefine anatomy pedagogy.…”

Section: Discussionmentioning

confidence: 99%

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“Preparing them for the profession”: An interpretative phenomenological analysis of anatomy educators coping with complexity in the United Kingdom curriculum

Kirkness

Bazira

Finn

et al. 2022

Anatomical Sciences Ed

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Efforts to integrate the basic sciences into the ever‐changing curriculum are a trending area of research in health professions education. Low‐stakes, high‐frequency assessment methods such as the progress test are now widely implemented in the United Kingdom and Northern Ireland as a means of furthering curricular integration toward contemporary goals of competency and professional identity formation. The anatomy educator's experience vis‐à‐vis these curricular changes is not well understood. This study aimed to explore how anatomy educators make sense of the shifting demands of their role. The interviews were semi‐structured, particularly concerned with the phenomenon of teachers adapting to the complexity of their learning environment. The study used interpretative phenomenological analysis (IPA) to focus on the lived experiences of participants coping with the phenomena in question: how do anatomy educators make sense of the learning environment in the United Kingdom? Interviews were transcribed verbatim and interpreted inductively, identifying four key themes: confidence through connectedness, variations in appraisals of curricular integration, managing expectations to perform in paradoxical situations, and the emergence of innovative teaching. Results point to the learning environment as a complex system and highlight the importance of feeling support from and connection to colleagues, enabling individual educators to develop confidence, meet the top‐down demands of changing curricula, and experience personal identity development and uncertainty tolerance within their role. This IPA study offers insight into the lived experiences of anatomy educators whose experiential interpretations of a complex and changing curriculum can uniquely inform stakeholders in health professions education.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

“Preparing them for the profession”: An interpretative phenomenological analysis of anatomy educators coping with complexity in the United Kingdom curriculum

Kirkness

Bazira

Finn

et al. 2022

Anatomical Sciences Ed

View full text Add to dashboard Cite

show abstract

“…This was intentional to attempt to encourage trainees to provide honest reflections at a stage where they were completing their IMT training and to reduce the tendency toward favourable evaluation at the time [ 41 ]. However, a truly longitudinal approach, perhaps with audio-diaries, could have afforded different insights particularly relating to training anticipation and experience [ 42 ]. Whilst we recognise that this data represents findings in our particular context, we hope that through the use of critical realist analysis, we have identified underlying mechanisms which may be applicable and worthy of consideration in other contexts.…”

Section: Discussionmentioning

confidence: 99%

Training as imagined? A critical realist analysis of Scotland’s internal medicine simulation programme

Kerins,

Ralston,

Stirling

et al. 2024

Adv Simul

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Background Evaluating the impact of simulation-based education (SBE) has prioritised demonstrating a causal link to improved patient outcomes. Recent calls herald a move away from looking for causation to understanding ‘what else happened’. Inspired by Shorrock’s varieties of human work from patient safety literature, this study draws on the concept of work-as-done versus work-as-imagined. Applying this to SBE recognises that some training impacts will be unexpected, and the realities of training will never be quite as imagined. This study takes a critical realist stance to explore the experience and consequences, intended and unintended, of the internal medicine training (IMT) simulation programme in Scotland, to better understand ‘training-as-done’. Methods Critical realism accepts that there is a reality to uncover but acknowledges that our knowledge of reality is inevitably our construction and cannot be truly objective. The IMT simulation programme involves three courses over a 3-year period: a 3-day boot camp, a skills day and a 2-day registrar-ready course. Following ethical approval, interviews were conducted with trainees who had completed all courses, as well as faculty and stakeholders both immersed in and distant from course delivery. Interviews were audio-recorded, transcribed verbatim and analysed using critical realist analysis, influenced by Shorrock’s proxies for work-as-done. Results Between July and December 2023, 24 interviews were conducted with ten trainees, eight faculty members and six stakeholders. Data described proxies for training-as-done within three broad categories: design, experience and impact. Proxies for training design included training-as-prescribed, training-as-desired and training-as-prioritised which compete to produce training-as-standardised. Experience included training-as-anticipated with pre-simulation anxiety and training-as-unintended with the valued opportunity for social comparison as well as a sense of identity and social cohesion. The impact reached beyond the individual trainee with faculty development and inspiration for other training ventures. Conclusion Our findings highlight unintended consequences of SBE such as social comparison and feeling ‘valued as a trainee, valued as a person’. It sheds light on the fear of simulation, reinforcing the importance of psychological safety. A critical realist approach illuminated the ‘bigger picture’, revealing insights and underlying mechanisms that allow this study to present a new framework for conceptualising training evaluation.

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“…Furthermore, collecting diaries meant that thoughts and feelings about experiences were collected in the moment rather than filtered through memory 5 . Indeed, arguably the diaries themselves acted as ‘safe spaces’ for participants to reflect 43 . Third, our team‐based approach to data analysis added rigour and reflexivity to our analysis 44 .…”

Section: Discussionmentioning

confidence: 99%

“…5 Indeed, arguably the diaries themselves acted as 'safe spaces' for participants to reflect. 43 Third, our teambased approach to data analysis added rigour and reflexivity to our analysis. 44 Indeed the large research teams' diversity in terms of gender and background (e.g., psychology, management and clinicians) brought diversity of perspectives to our analysis and resulting interpretations of the data.…”

Section: Methodological Strengths and Limitationsmentioning

confidence: 99%

Heard, valued, supported? Doctors' wellbeing during transitions triggered by COVID‐19

et al. 2021

Self Cite

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Introduction: Supporting doctors' wellbeing is crucial for medical education to help minimise negative long-term impacts on medical workforce retention and ultimately patient care. There is limited study of how doctors' transitions experiences impact wellbeing, particularly socially and culturally. Multiple Multidimensional Transitions (MMT) theory views transitions as dynamic, incorporating multiple contexts and multiple domains.Using MMT as our lens, we report a qualitative analysis of how transitions experienced by doctors during the pandemic impacted on social and cultural aspects of wellbeing. Methods: Longitudinal narrative inquiry was employed, using interviews and audio-diaries. Data were collected over 6 months in three phases: (i) interviews with doctors from across the career spectrum (n = 98); (ii) longitudinal audio-diaries for 2-4 months (n = 71); (iii) second interviews (n = 83). Data were analysed abductively, narrowing focus to factors important to social and cultural wellbeing. Results: Doctors described experiencing multiple interacting transitions triggered by the pandemic in multiple contexts (workplace, role, homelife and education). Patterns identifiable across the dataset allowed us to explore social and cultural wellbeing crosscutting beyond individual experience. Three critical factors contributed to social and cultural wellbeing both positively and negatively: being heard (e.g., by colleagues asking how they are); being valued (e.g., removal of rest spaces by organisations showing lack of value); and being supported (e.g., through regular briefing by education bodies). Conclusions: This study is the first to longitudinally explore the multiple-multidimensional transitions experienced by doctors during the COVID-19 pandemic. Our data analysis helped us move beyond existing perceptions around wellbeing and articulate multiple factors that contribute to social and cultural wellbeing. It is vital that medical educators consider the learning from these experiences to help pinpoint what aspects of support might be beneficial to trainee doctors and their trainers. This study forms the basis for developing evidenced-based interventions that ensure doctors are heard, valued and supported.

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Making space for relational reflexivity in longitudinal qualitative research

Abstract: In this commentary Gordon introduces relational reflexivity and discusses how researchers, participants and the research encounter can be involved in the creation of new knowledge.

Cited by 3 publications

References 7 publications

“Preparing them for the profession”: An interpretative phenomenological analysis of anatomy educators coping with complexity in the United Kingdom curriculum

“Preparing them for the profession”: An interpretative phenomenological analysis of anatomy educators coping with complexity in the United Kingdom curriculum

Training as imagined? A critical realist analysis of Scotland’s internal medicine simulation programme

Heard, valued, supported? Doctors' wellbeing during transitions triggered by COVID‐19

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