Adam P Sawatsky, Caroline L Matchett, Frederic W Hafferty, Sayra Cristancho, William E Bynum, Jonathan S Ilgen, Lara Varpio
{"title":"身份工作：居民在身份斗争中的定性研究。","authors":"Adam P Sawatsky, Caroline L Matchett, Frederic W Hafferty, Sayra Cristancho, William E Bynum, Jonathan S Ilgen, Lara Varpio","doi":"10.5334/pme.1549","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Medical training traditionally holds a deterministic view of professional socialization wherein many medical learners struggle to construct a professional identity. Previous research has demonstrated the dysfunctional norms and conflicting ideologies that create identity struggle, disproportionally affecting women and individuals underrepresented in medicine. Symbolic interactionism can help explain identity struggles, emphasizing the influence of socio-contextual factors on identity construction. The purpose of this study was to explore how residents navigate identity struggles during residency training.</p><p><strong>Method: </strong>We conducted a qualitative exploration of 12 residents in three specialties at three academic institutions in the United States. Participants engaged in rich picture drawings followed by one-on-one interviews. We coded transcript data and met regularly to identify themes related to residents' experiences with navigating professional identity struggles.</p><p><strong>Results: </strong>We identified three main themes on navigating identity struggles: the weight of identity work, the isolating nature of identity work, and the navigation that occurs with and against socio-contextual currents. Residents described identity work as navigation like a boat at sea. This work felt weighty and at times overwhelming and residents often felt unable to discuss their identity struggles with others. Residents utilized what agency they had to either navigate with the current, navigating towards acceptable-albeit imperfect-paths forward, or attempting to go against the current to forge new paths through resistance.</p><p><strong>Discussion: </strong>This study highlights how context enables and constrains identity construction, how contextual constraints can create dissonance between identities, and the considerable effort required to reconcile dissonance and construct professional identities. Training program adjustments, enhanced resident support, and cultural shifts are required to sustain residents' identity work. Medical professionals should engage in collective identity work to reimagine the profession's identity by addressing dysfunctional cultural norms.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568810/pdf/","citationCount":"0","resultStr":"{\"title\":\"Identity Work: A Qualitative Study of Residents' Experiences Navigating Identity Struggles.\",\"authors\":\"Adam P Sawatsky, Caroline L Matchett, Frederic W Hafferty, Sayra Cristancho, William E Bynum, Jonathan S Ilgen, Lara Varpio\",\"doi\":\"10.5334/pme.1549\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Medical training traditionally holds a deterministic view of professional socialization wherein many medical learners struggle to construct a professional identity. Previous research has demonstrated the dysfunctional norms and conflicting ideologies that create identity struggle, disproportionally affecting women and individuals underrepresented in medicine. Symbolic interactionism can help explain identity struggles, emphasizing the influence of socio-contextual factors on identity construction. The purpose of this study was to explore how residents navigate identity struggles during residency training.</p><p><strong>Method: </strong>We conducted a qualitative exploration of 12 residents in three specialties at three academic institutions in the United States. Participants engaged in rich picture drawings followed by one-on-one interviews. We coded transcript data and met regularly to identify themes related to residents' experiences with navigating professional identity struggles.</p><p><strong>Results: </strong>We identified three main themes on navigating identity struggles: the weight of identity work, the isolating nature of identity work, and the navigation that occurs with and against socio-contextual currents. Residents described identity work as navigation like a boat at sea. This work felt weighty and at times overwhelming and residents often felt unable to discuss their identity struggles with others. Residents utilized what agency they had to either navigate with the current, navigating towards acceptable-albeit imperfect-paths forward, or attempting to go against the current to forge new paths through resistance.</p><p><strong>Discussion: </strong>This study highlights how context enables and constrains identity construction, how contextual constraints can create dissonance between identities, and the considerable effort required to reconcile dissonance and construct professional identities. Training program adjustments, enhanced resident support, and cultural shifts are required to sustain residents' identity work. Medical professionals should engage in collective identity work to reimagine the profession's identity by addressing dysfunctional cultural norms.</p>\",\"PeriodicalId\":48532,\"journal\":{\"name\":\"Perspectives on Medical Education\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2024-11-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568810/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Perspectives on Medical Education\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5334/pme.1549\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"EDUCATION, SCIENTIFIC DISCIPLINES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Perspectives on Medical Education","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5334/pme.1549","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
Identity Work: A Qualitative Study of Residents' Experiences Navigating Identity Struggles.
Introduction: Medical training traditionally holds a deterministic view of professional socialization wherein many medical learners struggle to construct a professional identity. Previous research has demonstrated the dysfunctional norms and conflicting ideologies that create identity struggle, disproportionally affecting women and individuals underrepresented in medicine. Symbolic interactionism can help explain identity struggles, emphasizing the influence of socio-contextual factors on identity construction. The purpose of this study was to explore how residents navigate identity struggles during residency training.
Method: We conducted a qualitative exploration of 12 residents in three specialties at three academic institutions in the United States. Participants engaged in rich picture drawings followed by one-on-one interviews. We coded transcript data and met regularly to identify themes related to residents' experiences with navigating professional identity struggles.
Results: We identified three main themes on navigating identity struggles: the weight of identity work, the isolating nature of identity work, and the navigation that occurs with and against socio-contextual currents. Residents described identity work as navigation like a boat at sea. This work felt weighty and at times overwhelming and residents often felt unable to discuss their identity struggles with others. Residents utilized what agency they had to either navigate with the current, navigating towards acceptable-albeit imperfect-paths forward, or attempting to go against the current to forge new paths through resistance.
Discussion: This study highlights how context enables and constrains identity construction, how contextual constraints can create dissonance between identities, and the considerable effort required to reconcile dissonance and construct professional identities. Training program adjustments, enhanced resident support, and cultural shifts are required to sustain residents' identity work. Medical professionals should engage in collective identity work to reimagine the profession's identity by addressing dysfunctional cultural norms.
期刊介绍：
Perspectives on Medical Education mission is support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices.
Official journal of the The Netherlands Association of Medical Education (NVMO).
Perspectives on Medical Education is a non-profit Open Access journal with no charges for authors to submit or publish an article, and the full text of all articles is freely available immediately upon publication, thanks to the sponsorship of The Netherlands Association for Medical Education.
Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy.
Perspectives on Medical Education positions itself at the dynamic intersection of educational research and clinical education. While other journals in the health professional education domain orient predominantly to education researchers or to clinical educators, Perspectives positions itself at the collaborative interface between these perspectives. This unique positioning reflects the journal’s mission to support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Reflecting this mission, the journal both welcomes original research papers arising from scholarly collaborations among clinicians, teachers and researchers and papers providing resources to develop the community’s ability to conduct such collaborative research. The journal’s audience includes researchers and practitioners: researchers who wish to explore challenging questions of health professions education and clinical teachers who wish to both advance their practice and envision for themselves a collaborative role in scholarly educational innovation. This audience of researchers, clinicians and educators is both international and interdisciplinary.
The journal has a long history. In 1982, the journal was founded by the Dutch Association for Medical Education, as a Dutch language journal (Netherlands Journal of Medical Education). As a Dutch journal it fuelled educational research and innovation in the Netherlands. It is one of the factors for the Dutch success in medical education. In 2012, it widened its scope, transforming into an international English language journal. The journal swiftly became international in all aspects: the readers, authors, reviewers and editorial board members.
The editorial board members represent the different parental disciplines in the field of medical education, e.g. clinicians, social scientists, biomedical scientists, statisticians and linguists. Several of them are leading scholars. Three of the editors are in the top ten of most cited authors in the medical education field. Two editors were awarded the Karolinska Institute Prize for Research. Presently, Erik Driessen leads the journal as Editor in Chief.
Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. It is sponsored by theThe Netherlands Association of Medical Education and offers free manuscript submission.
Perspectives on Medical Education positions itself at the dynamic intersection of educational research and clinical education. While other journals in the health professional education domain orient predominantly to education researchers or to clinical educators, Perspectives positions itself at the collaborative interface between these perspectives. This unique positioning reflects the journal’s mission to support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Reflecting this mission, the journal both welcomes original research papers arising from scholarly collaborations among clinicians, teachers and researchers and papers providing resources to develop the community’s ability to conduct such collaborative research. The journal’s audience includes researchers and practitioners: researchers who wish to explore challenging questions of health professions education and clinical teachers who wish to both advance their practice and envision for themselves a collaborative role in scholarly educational innovation. This audience of researchers, clinicians and educators is both international and interdisciplinary.
The journal has a long history. In 1982, the journal was founded by the Dutch Association for Medical Education, as a Dutch language journal (Netherlands Journal of Medical Education). As a Dutch journal it fuelled educational research and innovation in the Netherlands. It is one of the factors for the Dutch success in medical education. In 2012, it widened its scope, transforming into an international English language journal. The journal swiftly became international in all aspects: the readers, authors, reviewers and editorial board members.
The editorial board members represent the different parental disciplines in the field of medical education, e.g. clinicians, social scientists, biomedical scientists, statisticians and linguists. Several of them are leading scholars. Three of the editors are in the top ten of most cited authors in the medical education field. Two editors were awarded the Karolinska Institute Prize for Research. Presently, Erik Driessen leads the journal as Editor in Chief.
Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. It is sponsored by theThe Netherlands Association of Medical Education and offers free manuscript submission.
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