The potential of narrative analysis for HPE research: Highlighting five analytic lenses

Context Health professions education (HPE) has increasingly turned to qualitative methodology to address a number of the field's difficult research problems. While several different methodologies have been widely accepted and used in HPE research (e.g., Grounded Theory), others remain largely unknown. In this methodology paper, we discuss the value of narrative analysis (NA) as a set of analytic approaches that offer several lenses that can support HPE scholars' research. Methods After briefly discussing the 'narrative turn' in research, we highlight five NA lenses: holistic, situated, linguistic, agentive and sequential. We explore what each lens can offer HPE scholars-highlighting certain aspects of the data-and how each lens is limited-obscuring other aspects. To support these observations, we offer an example of each lens from contemporary HPE scholarship. The manuscript also describes methods that can be employed in NA research and offers two different typologies of NA methods that can be used to access these lenses. Conclusions We conclude with a discussion of how different analytic methods can be used to harness each of the lenses. We urge the deliberate selection and use of NA methods and point to the inherent partiality of any NA approach. Reflecting on our position as narrative scholars, we acknowledge how our own lenses illuminate some areas and conceal others as we tell the story of NA. In conclusion, we invite other researchers to benefit from the potential NA promises

Understanding context specificity:the effect of contextual factors on clinical reasoning

Background: Situated cognition theory argues that thinking is inextricably situated in a context. In clinical reasoning, this can lead to context specificity: a physician arriving at two different diagnoses for two patients with the same symptoms, findings, and diagnosis but different contextual factors (something beyond case content potentially influencing reasoning). This paper experimentally investigates the presence of and mechanisms behind context specificity by measuring differences in clinical reasoning performance in cases with and without contextual factors. Methods: An experimental study was conducted in 2018-2019 with 39 resident and attending physicians in internal medicine. Participants viewed two outpatient clinic video cases (unstable angina and diabetes mellitus), one with distracting contextual factors and one without. After viewing each case, participants responded to six open-ended diagnostic items (e.g. problem list, leading diagnosis) and rated their cognitive load. Results: Multivariate analysis of covariance (MANCOVA) results revealed significant differences in angina case performance with and without contextual factors [Pillai's trace = 0.72, F=12.4, df=(6, 29), p Conclusions: Using typical presentations of common diagnoses, and contextual factors typical for clinical practice, we provide ecologically valid evidence for the theoretically predicted negative effects of context specificity (i.e. for the angina case), with large effect sizes, offering insight into the persistence of diagnostic error

The Impact of Multimodal Composing on Youth Transformative Disciplinary Identity Work Across Settings

Purpose: Research on the maker movement is framed in terms of three complementary lenses: making as a set of activities, makerspaces as communities of practice, and makers as identities of participation (Halverson & Sheridan, in press). While our work explores all of these lenses, in this paper we focus on findings from our work in the Learning in the Making lab related to when and how identities are constructed through participation in making activities and in makerspaces. Theoretical Framework: In earlier work, we have described how participating in art-making processes can support both individualistic and collectivistic conceptions of identity (Halverson, Lowenhaupt, Gibbons & Bass, 2009). Researchers who study identity development in art-making tend to conceive of “identity” as a property of an individual (e.g. Fleetwood, 2005; Wiley & Feiner, 2001; Worthman, 2002). However, in some communities, the collective group itself has a prominent role in both the process and the products of students\u27 art (Bing-Canar & Zerkel, 1998; Mayer, 2000). In more collectivist-oriented communities, groups (as opposed to individuals) often determine the topics of youth art and co-compose the products, taking over from one another based on availability, expertise, and interest. Halverson et al. (2009) provided evidence that adolescents use artistic production to explore collective identity development, especially in places where young people toward community-oriented visions of identity. Methods & Data Sources: We rely on a range of data sources to understand identity in the maker movement including: (1) case studies of successful makerspaces including field note observations, interviews, and artifact collection; (2) design experiments with experienced and novice makers; (3) meta-analyses of the public communication channels used by makerspaces. Results: Our findings confirm and extend earlier observations around identity and participation in artistic production. First, we find that making affords a range of identity stances – artist, engineer, and entrepreneur – all of which are equally viable within the makerspace. However, we also find that makerspaces construct and communicate desired identity stances through their public communications in ways that likely constrain who comes to see themselves as makers. So while making activities support a range of identities in practice, makerspaces seem to have a strong sense of ethos that constrains who can identify as a maker. Scholarly Significance: The question “what makes a maker” is a fascinating conversation to have in light of potential parallels with schooling. In studies of schooling and learning we never ask, “what makes a student?” and we rarely ask, “what makes a learner?” When we do, the inquiry is framed in terms of the sociocognitive habits of individuals or in terms of becoming a learner despite school (Nasir, Hand, & Taylor 2008). Understanding how young people become makers, what their identity kit looks like, and how identities are afforded and constrained in makerspaces has the potential to contribute to the conversation around competency-based learning across the contexts of young peoples’ lives

I, we and they: A linguistic and narrative exploration of the authorship process

INTRODUCTION: While authorship plays a powerful role in the academy, research indicates many authors engage in questionable practices like honorary authorship. This suggests that authorship may be a contested space where individuals must exercise agency-a dynamic and emergent process, embedded in context-to negotiate potentially conflicting norms among published criteria, disciplines and informal practices. This study explores how authors narrate their own and others\u27 agency in making authorship decisions. METHOD: We conducted a mixed-methods analysis of 24 first authors\u27 accounts of authorship decisions on a recent multi-author paper. Authors included 14 females and 10 males in health professions education (HPE) from U.S. and Canadian institutions (10 assistant, 6 associate and 8 full professors). Analysis took place in three phases: (1) linguistic analysis of grammatical structures shown to be associated with agency (coding for main clause subjects and verb types); (2) narrative analysis to create a \u27moral\u27 and \u27title\u27 for each account; and (3) dialectic integration of (1) and (2). RESULTS: Descriptive statistics suggested that female participants used we subjects and material verbs (of doing) more than men and that full professors used relational verbs (of being and having) more than assistant and associate. Three broad types of agency were narrated: distributed (n = 15 participants), focusing on how resources and work were spread across team members; individual (n = 6), focusing on the first author\u27s action; and collaborative (n = 3), focusing on group actions. These three types of agency contained four subtypes, e.g. supported, contested, task-based and negotiated. DISCUSSION: This study highlights the complex and emergent nature of agency narrated by authors when making authorship decisions. Published criteria offer us starting point-the stated rules of the authorship game; this paper offers us a next step-the enacted and narrated approach to the game