The UK General Medical Council (GMC) requires all UK Medical Schools to formally recognise trainers performing 'named roles' in undergraduate medical education. A staff development programme has been designed and implemented by the School of Medicine, University of Dundee. The programme has been made available to staff working within the School of Medicine and its partner organisations. Lessons learned through the process include, a need for: face-to-face interaction and dialogue with educators, readily available and accessible local CPD opportunities, establishment of local communities of practice, and a clear message to educators that the complexity of the 'Recognition of Trainers' process is at the organisational (rather than the individual) level.

Background: This project aimed to explore which metaphors, similies, or other forms of imagery medical educators use to express their identity as a ‘medical educator’ and to discuss what these expressions might tell us about their connection to, attitude to, and views of this identity. Medical educators are essential stakeholders in effective learning experiences for our future healthcare workforce and gaining insight into their identity development will be valuable in supporting them in their crucial roles. Methods: Utilising a constructivist grounded theory approach, two focus group/workshop hybrids were carried out with a total of 16 participants in January and February of 2020. The focus group/workshops were used to encourage participant discussion about their educator identity, which included the use of visual prompts to promote use of metaphor in their expressions. Data were analysed using open and then focused coding. Iterative reviews of the literature relating to the study area took place throughout the timeframe of the project. Results: Participants used a range of metaphors for their medical educator identity which fell into the themes of: metaphors around movement, entertainment and environment. The metaphors used included that of a gardener, farmer, role model, traveller, formula 1 pitstop team, and orchestral conductor. When expressing their educator identity, participants spoke of the burden of juggling clinical and educator workload and of the impact of the clinical learning environment upon their ability to do so. Conclusions: Using a creative approach to collect data through metaphors and imagery, our study gave a valuable insight into how medical educators’ view their identity and experiences. It gave insight into the influence of environment upon their identity and the potential role for faculty development in promoting medical educators to converse with each other about the challenges faced when juggling roles and making sense of differing and clashing identities.

Context Medical schools are complex organisations existing at the intersection of higher education and healthcare services. This complexity is compounded by many competing pressures and drivers from professional and regulatory bodies, the wider political environment and public expectations, producing a range of challenges for those involved in all stages of medical education. There are established approaches that have been used to address research questions related to these challenges; some focus on organisational structures, characteristics and performance; others on the interactions that take place in a particular setting. Less common are approaches that integrate data on macro‐level structures with the micro‐level interactions of the people who inhabit those structures. Looking at the interaction of the macro and the micro opens up possibilities for the new insights. Framework We propose using an approach with roots in social theory—Inhabited Institutionalism (II)—that is largely unexplored in medical education. II has been described as Janus‐faced, looking both outwards, at the broader context of medical education, and inwards, at the ways in which meanings are constructed and re‐constructed by participants within a particular setting. Methods After describing the theoretical framework of II, we explain how it can be used to understand medical education as subject to both broader societal structures (the macro level) and interactions between people (the micro level), as well as—crucially—their mutual influence. Conclusion II offers the opportunity to combine macro‐ and micro‐level perspectives, leading to a more expansive understanding of the operation of medical education which sees its form and function as neither entirely determined by structures nor a construction of individuals engaged in it. In doing so, it potentially offers a valuable way of considering the intractable problem of how to successfully manage change, offering a combined top‐down and bottom‐up perspective.