How do medical students learn professionalism and develop professional identities? An institutional ethnography of the curriculum at one medical school

Professionalism and professional identity are becoming central topics in educating tomorrow’s physicians. This dissertation is an institutional ethnography of the curriculum on professionalism and professional identity at one medical school. By examining the three types of curricula – the formal curriculum, the informal curriculum, and the hidden curriculum – and highlighting the gaps between them, this study provides a detailed account and an explanation of medical students’ learning experiences with professionalism and professional identity. Utilizing the methodology of IE, I conduct document analysis, participant observation, and in-depth interviews with medical students and faculty to reveal institutional practices, identify social relations, and describe students’ learning experiences. I apply a combination of Giddens’s structuration theory of understanding the complexity of social practice, and Lave and Wenger’s understanding of the context of social practice – community – to analyze the processes and consequences of students’ development of professionalism and professional identity formation in medical education. In pre-clerkship, the medical school’s institutional practices of narrowly defining professionalism and equating the concept to student professionalism and professionalism in professionals is not effective in transformative learning to support students’ development of medical professionalism and professional identity formation. Clerkship is a more significant stage of learning of professionalism and professional identity formation as students’ immersion in the community of medical practice provides not only explicit but also tacit knowledge to master the practice of medicine. Through legitimate peripheral participation in a situated learning environment, students develop a more realistic understanding of medical professionalism and physician roles and develop a specialty-defined professional identity. Many changes have been made to the formal curriculum and, to some extent, the informal curriculum in medical education to support students’ learning of professionalism and development of a professional identity that performs more roles than simply the medical expert. However, the gap between what students are taught in classroom and what they observe and are taught in practice is still significant. Medical students continue to develop and negotiate their professional identities in the context of competing discourses where the other physician roles often lose the battle to the role of medical expert

Hidden curriculum and students' development of professionalism in medical education

Medical students need to acquire not only biomedical knowledge and clinical skills, but also a professional identity to become future qualified physicians. However, much of the professionalization of medical students comes not from the formal curriculum, but the implicit hidden curriculum. This thesis is based on a content and discourse analysis of 75 articles that employ the term “hidden curriculum” or “hidden curricula” in the article title or abstract in two medical education journals Medical Education and Academic Medicine. The study tries to answer two main research questions: what the components of hidden curriculum are, and why hidden curriculum is becoming a popular discourse in medical education. The purpose of this research is to use the key concepts informed by theories developed by Bourdieu and Goffman to build a theoretical framework to understand the usage and interpretation of hidden curriculum from the medical educators’ perspective. I conclude that hidden curriculum is used in a distinct and ambiguous way in medical education literature, emphasizing institutional culture, role modeling, and socialization process. A discrepancy between the usage of hidden curriculum in medical education literature and sociological study is found. Though many innovations have been initiated in both practical pedagogy and the model of medical education, there has been little change in the legitimate knowledge in medicine, the ways in which medical education is organized, the underlying institutional hierarchy, and medical students’ learning experiences

The upgrade to hybrid incubators in China:a case study of Tuspark Incubator

Purpose This study aims to explore key factors and specific ways for the upgrade to hybrid incubators in the context of China. A hybrid incubator means that a technology-based business incubators (TBIs) can implement various distinct value creation processes with the integration of the advantages of non-for-profit and for-profit TBIs at same time as Chinese government now requires government-sponsored non-for-profit TBIs to be profitable self-sustainability with less dependent on direct public subsidies, aiming to motivate these TBIs to provide higher quality services for their tenant new technology-based firms (NTBFs). Design/methodology/approach This study conducts a single in-depth case-study of Tuspark Incubator (located in Tsinghua Science Park [TSP]) with categorical analysis. Findings Three factors, i.e. incubation subdivision, intermediary platform and proactive approach, are found to be essential for a formerly government-sponsored TBI’s upgrading. Incubation subdivision enables Tuspark Incubator to create multiple incubation processes with incubator characteristic variables of both non-for-profit and for-profit incubators; with the establishment of intermediary platform, Tuspark Incubator provides specialized business support and high-quality networking from relevant specialized service organizations external to the incubator; more proactive approach with equity investment on incubating firms from Tuspark Incubator help to generate social welfare and financial profit at the same time. Practical implications For the incubators’ managers, incubation subdivision enables TBIs to operate for-profit and non-for-profit processes at the same time and provides different specific needs; more open intermediary service platforms can leverage the full potential of the actors in innovation system and help TBIs to save resource when upgrading to hybrid incubators; proactive approaches nurture learning climate and entrepreneurship environment to enhance the successful rate on NTBFs inside incubators and provide main profit source for incubators. For policy makers, using proactive approaches including creating a good milieu for incubation on technology-based start-ups and the design of public guidance funds is increasingly crucial. Originality/value This research is a pioneering study on the key factors and specific ways for the upgrade of government-sponsored non-for-profit TBIs in China to hybrid for-profit and non-for-profit incubators. </jats:sec

Clustering Dependencies over Relational Tables

Integrity constraints have proven to be valuable in the database field. Not only can they help schema design (functional dependencies, FDs [1][2]), they can also be used in query optimization (ordering dependencies, ODs [4][5][8][9]), or data cleaning (conditional functional dependencies, CFDs [12] and denial constraints, DCs [14]). In this thesis, however, we will introduce a new type of integrity constraint, called a clustering dependency (CD). Similar to ordering dependencies which rely on the database operation ORDER BY, clustering dependencies focus on studying the operation GROUP BY. Furthermore, we claim that clustering dependencies are useful not only in query optimization as most integrity constraints do, but also useful in data visualization, data analysis and MapReduce. In this thesis, we first introduce some examples of clustering dependencies in a real-life dataset. We then formally define clustering dependencies and elaborate on our motivation. We will also look into the reasoning system for clustering dependencies including the implication problem, consistency problem and influence rules for clustering dependencies. After that, we will propose two algorithms for clustering dependencies, first a checking algorithm that is able to check if a given dependency is valid in a table within O(N*M) time, with N being the number of rows and M being the size of potentially aggregated attributes, a.k.a, the size of the right-hand-side attributes. Secondly, we propose a mining algorithm that is able to discover all potential clustering dependencies occurring in a table. Finally, we will use both synthetic and real-life data to test the performance of our mining algorithm

Fused Text Segmentation Networks for Multi-oriented Scene Text Detection

In this paper, we introduce a novel end-end framework for multi-oriented scene text detection from an instance-aware semantic segmentation perspective. We present Fused Text Segmentation Networks, which combine multi-level features during the feature extracting as text instance may rely on finer feature expression compared to general objects. It detects and segments the text instance jointly and simultaneously, leveraging merits from both semantic segmentation task and region proposal based object detection task. Not involving any extra pipelines, our approach surpasses the current state of the art on multi-oriented scene text detection benchmarks: ICDAR2015 Incidental Scene Text and MSRA-TD500 reaching Hmean 84.1% and 82.0% respectively. Morever, we report a baseline on total-text containing curved text which suggests effectiveness of the proposed approach.Comment: Accepted by ICPR201