Shall We All Unmute? A Conversation Analysis of Participation in Online Reflection Sessions for General Practitioners in Training

Abstract

The COVID-19 pandemic has induced many changes to education in many contexts. In this study, we describe how general practitioners in training (residents) accomplish participation in collaborative reflection sessions conducted on Zoom. In this online setting, taking part in interactions is understood to be crucial to the creation of educational value. To study forms of participation used on Zoom, we recorded three group reflection sessions and examined them with Conversation Analysis. We focused on how participation is shaped by and is contingent upon the affordances of the online environment. Our analyses show that participants explicitly orient to the interactional accomplishment of participation in frameworks that change in the various phases of case discussion. Participants establish new procedures to deal with both familiar and sometimes new problems of participation introduced by the online environment. We describe these procedures in detail to contribute to the understanding of the accomplishment of participation through situated practices such as embodied talk-in-interaction. The findings can serve training purposes in online education across both medical and non-medical curricula.

‘Oh yes, that is also reflection’—Using discursive psychology to describe how GP registrars construct reflection

“…Furthermore, we drafted participants from two GP specialty training institutes during the COVID pandemic under severe containment measures. While some focus groups occurred on a digital platform and others were in‐person, the digital environment influenced the interactional dynamic 81 . Finally, the focus group conversations may also have been affected by the institutional culture, since they took place in a setting wherein reflection activities were firmly established as educationally important.…”

“…While some focus groups occurred on a digital platform and others were in-person, the digital environment influenced the interactional dynamic. 81 Finally, the focus group conversations may also have been affected by the institutional culture, since they took place in a setting wherein reflection activities were firmly established as educationally important. Consequently, speaking critically about one's institute can be challenging; this might encourage showing oneself as a willing, reflective learner, who also mitigates criticism to show that one is 'being constructive'.…”

When and how teachers intervene in group discussions on experiences from practice in postgraduate medical education: an interactional analysis

“…We focused our analysis on group discussions about experiences from practice (which is commonly part of ‘reflection education’; Uygur et al, 2019 ) in postgraduate education of Dutch General Practitioners in training. During weekly sessions lasting 60–90 min, GP residents reflect on experiences encountered in their residency (van Braak, Giroldi, et al, 2021 ; van Braak, Huiskes, et al, 2021 ; Veen & de la Croix, 2016 ). An experienced GP and/or a behavioral scientist/psychologist facilitates the session.…”

“…Group discussions are social activities. The value of the activity for students partly depends on individual students’ engagement in the activity (Bernabeo et al, 2013 ; Hendry et al, 2003 ; Nieboer & Huiskes, 2020 ; Sandars, 2009 ; van Braak, Giroldi, et al, 2021 ; van Braak, Huiskes, et al, 2021 ). Teachers have an important task in ensuring participation to ensure educational value for all participants (cf.…”

Between teacher candidates’ reflection and teacher educators’ evaluation: Fluctuations in epistemic (a)symmetry in feedback conversations

“…The prospective teachers were among the groups affected multilaterally by the school closures, losing not only their access to in‐person training but also their essential hands‐on experience in the sector (United Nations Educational, Scientific and Cultural Organization [UNESCO], 2020). By establishing a novel configuration, the video‐mediated nature of these meetings may create unique opportunities for the access to and negotiation of knowledge in POCs that are thus far unaccounted for (Van Braak et al., 2021).…”