Thrown into the world of independent practice: from unexpected uncertainty to new identities

Schrewe, Brett

doi:10.1007/s10459-018-9815-4

Cited by 2 publications

(1 citation statement)

References 32 publications

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“…However, other articles 45,48,51,[55][56][57]66,68,71,77,83,95,[99][100][101][102][103][104] described the impact of relationships on PIF, which was occasionally evidenced in trainees' discourses. 56,75 These articles underscore how identity construction occurs in relation to others and never in isolation.…”

Section: Individual Versus Sociocultural Influencesmentioning

confidence: 99%

‘Whispers and shadows’: A critical review of the professional identity literature with respect to minority physicians

et al. 2020

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Objectives: Professional identity formation (PIF) is a growing area of research in medical education. However, it is unclear whether the present research base is suitable for understanding PIF in physicians considered to be under-represented in medicine (URM). This meta-ethnography examined the qualitative PIF literature from 2012 to 2019 to assess its capacity to shine light on the experiences of minoritised physicians. Methods: Data were gathered using a search of six well-known medical education journals for the term 'professional identit*' in titles, keywords, abstracts and subheadings, delineated with the date range of 2012-2019. All non-relevant abstracts were removed and papers were then further reduced to those that focused only on learners' experiences. This left 67 articles in the final dataset, which were analysed using a collaborative approach among a team of researchers. The team members used their professional expertise as qualitative researchers and personal experiences as minoritised individuals to synthesise and interpret the PIF literature. Results: Four conceptual categories were identified as impacting PIF: Individual versus Sociocultural Influences; the Formal versus the Hidden Curriculum; Institutional versus Societal Values; and Negotiation of Identity versus Dissonance in Identity. However, a major gap was identified; only one study explored experiences of PIF in URM physicians and there was an almost complete absence of critical stances used to study PIF. Combined, these findings suggest that PIF research is building on existing theories without questioning their validity with reference to minoritised physicians. Conclusions: From a post-colonial perspective, the fact that race and ethnicity have been largely absent, invisible or considered irrelevant within PIF research is problematic. A new line of inquiry is needed, one that uses alternative frameworks, such as critical theory, to account for the ways in which power and domination influence PIF for URM physicians in order to foreground how larger sociohistorical issues influence and shape the identities of minoritised physicians. | 149 WYATT eT Al.

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Section: Individual Versus Sociocultural Influencesmentioning

confidence: 99%

‘Whispers and shadows’: A critical review of the professional identity literature with respect to minority physicians

et al. 2020

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Into the Unknown: Characterizing Fellow Uncertainty During the Transition to Unsupervised Practice

Herchline

Cohen

Ambrose

et al. 2023

Journal of Graduate Medical Education

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Background Helping fellows confront and manage uncertainty in the course of diagnosis and treatment of patients has been a growing focus of medical education. How these same fellows confront uncertainty as they make a transition in their professional development is less commonly a focus of training programs. Better understanding of how fellows experience these transitions will allow fellows, training programs, and hiring institutions to navigate transitions more easily. Objective This study aimed to explore how fellows in the United States experience uncertainty during the transition to unsupervised practice. Methods Using constructivist grounded theory, we invited participants to engage in semi-structured interviews exploring experiences with uncertainty as they navigate the transition to unsupervised practice. Between September 2020 and March 2021, we interviewed 18 physicians in their final year of fellowship training from 2 large academic institutions. Participants were recruited from adult and pediatric subspecialties. Data analysis was conducted using an inductive coding approach. Results Experiences with uncertainty during the transition process were individualized and dynamic. Primary sources of uncertainty identified included clinical competence, employment prospects, and career vision. Participants discussed multiple strategies for mitigating uncertainty, including structured graduated autonomy, leveraging professional networks locally and non-locally, and utilizing established program and institutional supports. Conclusions Fellows' experiences with uncertainty during their transitions to unsupervised practice are individualized, contextual, and dynamic with several shared overarching themes.

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Thrown into the world of independent practice: from unexpected uncertainty to new identities

Cited by 2 publications

References 32 publications

‘Whispers and shadows’: A critical review of the professional identity literature with respect to minority physicians

‘Whispers and shadows’: A critical review of the professional identity literature with respect to minority physicians

Into the Unknown: Characterizing Fellow Uncertainty During the Transition to Unsupervised Practice

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