Comment les diplômés internationaux immigrants réussissent-ils à affronter avec succès des défis socioculturels complexes ?

Background: While immigrant international medical graduates (I-IMGs) contribute significantly to the physician workforce in North America, researchers have highlighted the myriad of ways sociocultural challenges can negatively impact their success. Conceptual understanding that unpacks the complex processes of how I-IMGs effectively manage sociocultural challenges is relatively sparse. In addressing this critical knowledge gap, this study explored how I-IMGs successfully manage sociocultural differences as postgraduate residents. Methods: We interviewed eleven I-IMGs from diverse backgrounds who are in training or recently trained in a distributed multi-site postgraduate medical training program in Canada. We used the lens of sociocultural learning theory to gain insights into the processes of how I-IMGs describe successful management of sociocultural challenges. Results: The overarching storyline of participants emphasized that their experiences were humbling as they grappled with inner struggles, emotions, and vulnerabilities while embracing the ambiguity of not knowing what was expected of them. The following dominant themes from their narratives encapsulate the salient processes for how I-IMGs conceptualize and successfully manage sociocultural challenges: 1) successfully navigating transitions; 2) resisting or altering elements of prior sociocultural norms while embracing the new; 3) living and being in community and having supportive social networks; 4) risk taking to self-advocate and actively seek help. Conclusion: Understanding the strengths and positive strategies for how I-IMGs interface with complex sociocultural challenges has application for medical training institutions. Our insights suggest the need for practical, effective, and continuous assistance within I-IMG training programs to better support future trainees dealing with sociocultural challenges.Contexte : Alors que les diplômés internationaux en médecine immigrants (DIMI) contribuent de manière significative à la main-d'œuvre médicale en Amérique du Nord, des travaux ont mis en évidence le fait que des défis socioculturels peuvent de manières diverses entraver leur réussite. Les processus complexes par lesquels les DIMI réussissent à affronter les défis socioculturels sont peu compris sur le plan conceptuel. Pour combler cette importante lacune, la présente étude a exploré les façons dont les DIMI affrontent avec succès les différences socioculturelles pendant leur résidence. Méthodes : Nous avons interrogé onze médecins résidents étrangers d'origines diverses qui suivent ou qui ont récemment suivi une formation dans le cadre d'un programme de résidence multi-sites au Canada. Nous nous sommes basés sur la théorie socioculturelle de l'apprentissage pour mieux comprendre les processus employés par les DIMI pour faire face efficacement aux défis socioculturels. Résultats : Le récit dominant des participants est d’être aux prises avec des luttes intérieures, des émotions et des vulnérabilités, sans savoir ce que l'on attendait d'eux, une leçon d’humilité. Les thèmes principaux qui en ressortent et qui résument la manière dont les DIMI conceptualisent et gèrent avec succès les défis socioculturels sont les suivants : 1) réussir les transitions ; 2) résister ou revoir des éléments des normes socioculturelles qu’ils respectaient par le passé tout en adoptant de nouvelles normes; 3) participer à la vie de la collectivité et avoir des réseaux sociaux de soutien ; 4) prendre le risque de se faire entendre et de chercher activement de l'aide. Conclusion : Comprendre les points forts et les stratégies positives employées par les DIMI pour faire face aux défis socioculturels complexes serait fort utile pour les établissements d’enseignement médical. Nos observations plaident en faveur de la mise en place d’une assistance pratique, efficace et continue dans les programmes de formation pour mieux soutenir les futurs DIMI confrontés à des défis socioculturels

"And BAM. You Have a Connection”: Blind/Partially Blind Students and the Belonging in Academia Model

Belonging has significant impacts on success in postsecondary. Blind people are underrepresented in postsecondary and lack equitable opportunities to develop a sense of belonging. To build a better understanding of this underrepresented experience, this study shares narratives of 28 Blind students from across Turtle Island (and what is colonially called Canada) using Teng et al.’s (2020) Belonging in Academia Model (BAM) as a conceptual framework. Thematically analyzed findings suggest that blind students’ perspectives offer nuance to the BAM’s conceptualization of how belonging develops. For blind students, external factors such as class size are especially important in determining affiliation with an institution. Blind students elucidated the importance of familiarity with different ways of being in the world, including blindness. Third, acceptance involved having their blind embraced in postsecondary contexts. Forth, interdependence was key to building trusting connections for blind students. Fifth, blind participants discussed equity at length related to access, the added work of trying to obtain access, and the emotional work involved. This study helps fill a gap regarding the experiences of these traditionally underrepresented postsecondary students in Canada. The BAM may raise the consciousness of stakeholders in considering the unique factors impacting belonging for blind people. By attending to these perspectives, stakeholders can become more responsive to the experiences of people from equity-deserving groups. Understanding facilitators and barriers to belonging could result in culturally safer practices and inclusive pedagogical practices and system policies. Only when we create a space where everyone can belong will higher education be truly inclusive

Exploring how immigrant international medical graduates successfully manage complex sociocultural challenges

Background: While immigrant international medical graduates (I-IMGs) contribute significantly to the physician workforce in North America, researchers have highlighted the myriad of ways sociocultural challenges can negatively impact their success. Conceptual understanding that unpacks the complex processes of how I-IMGs effectively manage sociocultural challenges is relatively sparse. In addressing this critical knowledge gap, this study explored how I-IMGs successfully manage sociocultural differences as postgraduate residents. Methods: We interviewed eleven I-IMGs from diverse backgrounds who are in training or recently trained in a distributed multi-site postgraduate medical training program in Canada. We used the lens of sociocultural learning theory to gain insights into the processes of how I-IMGs describe successful management of sociocultural challenges. Results: The overarching storyline of participants emphasized that their experiences were humbling as they grappled with inner struggles, emotions, and vulnerabilities while embracing the ambiguity of not knowing what was expected of them. The following dominant themes from their narratives encapsulate the salient processes for how I-IMGs conceptualize and successfully manage sociocultural challenges: 1) successfully navigating transitions; 2) resisting or altering elements of prior sociocultural norms while embracing the new; 3) living and being in community and having supportive social networks; 4) risk taking to self-advocate and actively seek help. Conclusion: Understanding the strengths and positive strategies for how I-IMGs interface with complex sociocultural challenges has application for medical training institutions. Our insights suggest the need for practical, effective, and continuous assistance within I-IMG training programs to better support future trainees dealing with sociocultural challenges

Students' social networks are diverse, dynamic and deliberate when transitioning to clinical training

Context: Transitions in medical education are dynamic, emotional and complex yet, unavoidable. Relationships matter, especially in times of transition. Using qualitative, social network research methods, we explored social relationships and social support as medical students transitioned from pre-clinical to clinical training. Methods: Eight medical students completed a social network map during a semi-structured interview within two weeks of beginning their clinical clerkships (T0) and then again four months later (T1). They indicated meaningful interactions that influenced their transition from pre-clinical to clinical training and discussed how these relationships impacted their transition. We conducted mixed-methods analysis on this data. Results: At T0, eight participants described the influence of 128 people in their social support networks; this marginally increased to 134 at T1. People from within and beyond the clinical space made up participants’ social networks. As new relationships were created (eg with peers and doctors), old relationships were kept (eg with doctors and family) or dissolved over time (eg with near-peers and nurses). Participants deliberately created, kept or dissolved relationships over time dependent on whether they provided emotional support (eg they could trust them) or instrumental support (eg they provided academic guidance). Conclusions: This is the first social networks analysis paper to explore social networks in transitioning students in medicine. We found that undergraduate medical students’ social support networks were diverse, dynamic and deliberate as they transitioned to clerkships. Participants created and kept relationships with those they trusted and who provided emotional or instrumental support and dissolved relationships that did not provide these functions

Meaning making within the social activity domain of health maintenance : the role of social networks

This research explores how people embedded in their social networks actively engage in human meaning making about information and issues of health. Framed by a theoretical perspective of literacy as socially situated, it sought to investigate the ways that social network interactions mediate meaning making within the social activity domain of health maintenance. Using an ethnographic research design and a social network analysis orientation, this study explores patterns of social interaction and both macro- and micro-level aspects of social relations as they occur within socially situated contexts. Data collection involved social network surveys, interviews, field notes, transcribed spontaneous talk, and the focal participant’s health maintenance literacy practices diary from December 2011 to December 2012. Analysis of data included a social network analysis approach that gave macro level insights into the social structure of networks, as well as ethnographic qualitative analysis that explored the meanings by which participants understood and constructed their life worlds and the social meanings they linked to health information exchanges. Analysis revealed how exchanges of health information within social networks were accomplished primarily through oral interactions, and how multiple individual and social factors intersected to create patterns of knowledge construction and meaning making around health information and issues in social network interactions. Insights drawn from the data analysis also illustrated the ways health information flows through social networks that were shaped by different gradients of institutional and relational power dynamics. These results of the analysis suggested that the processes of making meaning around health information and issues cannot be extricated from structures of power and the social networks within which these processes occur.Education, Faculty ofLanguage and Literacy Education (LLED), Department ofGraduat