Identity, identification and medical education: why should we care?

Context: Medical education is as much about the development of a professional identity as it is about knowledge learning. Professional identities are contested and accepted through the synergistic internal–external process of identification that is constituted in and through language and artefacts within specific institutional sites. The ways in which medical students develop their professional identity and subsequently conceptualise their multiple identities has important implications for their own well-being, as well as for the relationships they form with fellow workers and patients. Objectives: This paper aims to provide an overview of some current thinking about identity and identification with the aim of highlighting some of the core underlying processes that have relevance for medical educationists and researchers. These processes include aspects that occur within embodied individuals (e.g. the development of multiple identities and how these are conceptualised), processes specifically to do with interactional aspects of identity (e.g. how identities are constructed and co-constructed through talk) and institutional processes of identity (e.g. the influence of patterns of behaviour within specific hierarchical settings). Implications: Developing a systematic understanding into the processes through which medical students develop their identities will facilitate the development of educational strategies, placing medical students’ identification at the core of medical education. Conclusions: Understanding the process through which we develop our identities has profound implications for medical education and entails that we adopt and develop new methods of collecting and analysing data. Embracing this challenge will provide better insights into how we might develop students’ learning experiences, facilitating their development of a doctor identity that is more in line with desired policy requirements

Solicited audio diaries in longitudinal narrative research: a view from inside

The use of solicited audio diaries in longitudinal qualitative enquiry is rare. Moreover, an understanding of the unique insights that these diaries might give the qualitative researcher has largely been absent in our consideration of appropriate methods for data collection. This article aims to address this deficit by providing a critical reflection on the use of solicited audio diaries in longitudinal narrative research from practical, theoretical and analytical perspectives. The data is drawn from a longitudinal study investigating medical students' professional identity formation. In an attempt to reach the broadest audience, both structural aspects and communicative elements of talk within the data are considered alongside ethical issues and emotional work that the longitudinal audio-diary researcher might encounter. In addition to presenting extracts from a variety of diary entries, a single event narrative is presented in full, alongside an analysis, in order to demonstrate the powerful utility of this underused method

A rapid review of the factors affecting healthcare students' satisfaction with small-group, active learning methods

Phenomenon: Problem-based learning (PBL) and other small-group, active learning methodologies have been widely adopted into undergraduate and postgraduate healthcare curricula across the world. Although much research has examined student perceptions of these innovative teaching pedagogies, there are still questions over which factors influence these views. This article aims to identify these key elements that affect healthcare student satisfaction with PBL and other small-group learning methods, including case-based and team-based learning. Approach: A systematic rapid review method was used to identify high-quality original research papers from the healthcare education literature from between 2009 and 2014. All papers were critically appraised before inclusion in line with published guidelines. Narrative synthesis was achieved using an inductively developed, thematic framework approach. Findings: Fifty-four papers were included in the narrative synthesis. The evidence suggests that, despite an initial period of negative emotion and anxiety, the perspectives of healthcare students toward small-group, active learning methods are generally positive. The key factors influencing this satisfaction level include (a) the facilitator role, (b) tutorial structure, (c) individual student factors, (d) case authenticity, (e) increased feedback, (f) group harmony, and (g) resource availability. Insights: Student satisfaction is an important determinant of healthcare education quality, and the findings of this review may be of value in future curriculum design. The evidence described here suggests that an ideal curriculum may be based on an expert-led, hybrid PBL model

Conceptualisation and Development of a values-based scale of emergency physicians’ professional identities

Abstract Background Physicians’ values about what constitute their professional identities are integral in understanding how they ascribe meaning to their practice. However, there is no general consensus on the conceptualization and measurement of physicians’ professional identities. This study developed and validated a values-based scale for measuring physicians’ professional identities. Methods A hybrid research method was used to gather both qualitative and quantitative data. We employed literature review, semi-structured interview, Q-sorting exercise to examine the conceptualization of emergency physicians’ professional identities and to initially develop a 40-item scale. A panel of five experts assessed the scale’s content validity. Using 150 emergency physicians as our sample, we conducted Confirmatory Factor Analyses (CFA) to test the fit of our hypothesised four-factor model based on our preliminary findings. Results Initial CFA suggested revisions to the model. Following theoretical assumptions and modification indices, the model was revised and adjusted to a four-factor 20 item Emergency Physicians Professional Identities Value Scale (EPPIVS) with acceptable fit statistics χ2 = 389.38, df = 164, Normed χ2 = 2.374, GFI = 0.788, CFI = 0.862, RMSEA = 0.096. The Cronbach’s alpha, McDonald’s Omega reliability and composite reliability of the subscales ranged from α: 0.748 to 0.868, Omega: 0.759 to 0.868 and CR: 0.748 to 0.851, respectively. Conclusion The results indicate that the EPPIVS is a valid and reliable scale for measuring physicians’ professional identities. Further research on the sensitivity of this instrument to important changes over career progression in emergency medicine is warranted