Dismantling medical education’s incompatible ideology

Varpio, Lara

doi:10.1080/0142159x.2022.2159796

Cited by 10 publications

(8 citation statements)

References 26 publications

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“…As we gain greater insight into the nature and impacts of this ideology, we can take active steps to reform the elements that undermine healthy, engaged identity formation processes, that marginalise and/or traumatise individuals and that are misaligned with our shared goal of creating competent, empathic and wholehearted physicians. Ideology has been constructed and maintained by our community; accordingly, we have the power to change it 38 …”

Section: Discussionmentioning

confidence: 99%

“…As residents face these disorienting tensions, they seek to reclaim a sense of why they went into medicine or reframe their ideals to help them deal with these tensions, 8,37 an effort that may seem futile in the face of medicine's irreconcilable ideology. 38 The consequences of ignoring these ideology-based tensions are becoming clearer. For example, in recent research on the shame experiences of pre-medical learners, ideology, communicated by 'ideological agents' such as pre-medical advisors, online forums and students/faculty, provided powerful messages about who students should be, how they should act and what they should value, to be admitted to-and achieve success within-the practice of medicine.…”

Section: Discussionmentioning

confidence: 99%

“…Ideology has been constructed and maintained by our community; accordingly, we have the power to change it. 38 Second, ideological reform will take time and will never be fully realised. We must equip learners to recognise ideology and proactively engage with the identity struggle it may induce.…”

Section: Discussionmentioning

confidence: 99%

“…Third, our study suggests that ideologically fuelled identity struggle is particularly acute during residency, where residents are asked to ‘reconcile [the] dissonance between the stated values of the medical profession and the realities of medicine as practiced in the real world’ 36 (p. 757). As residents face these disorienting tensions, they seek to reclaim a sense of why they went into medicine or reframe their ideals to help them deal with these tensions, 8,37 an effort that may seem futile in the face of medicine's irreconcilable ideology 38 …”

Section: Discussionmentioning

confidence: 99%

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Professional identity struggle and ideology: A qualitative study of residents' experiences

et al. 2023

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IntroductionTo enter a profession is to take on a new identity. Professional identity formation can be difficult, with medical learners struggling to adopt professional norms. The role of ideology in medical socialisation may offer insight into these tensions experienced by medical learners. Ideology is the system of ideas and representations that dominates the minds of individuals or social groups and calls individuals into certain ways of being and acting in the world. In this study, we use the concept of ideology to explore residents' experiences with identity struggle during residency.MethodsWe conducted a qualitative exploration of residents in three specialties at three academic institutions in the United States. Participants engaged in a 1.5‐hour session involving a rich picture drawing and one‐on‐one interview. Interview transcripts were coded and analysed iteratively, with developing themes compared concurrently to newly collected data. We met regularly to develop a theoretical framework to explain findings.ResultsWe identified three ways that ideology contributed to residents' identity struggle. First was the intensity of work and perceived expectations of perfectionism. Second were tensions between the developing professional identity and pre‐existing personal identities. Many residents perceived messages regarding the subjugation of personal identities, including the feeling that being more than physicians was impossible. Third were instances where the imagined professional identity clashed with the reality of medical practice. Many residents described how their ideals misaligned with normative professional ideals, constraining their ability to align their practice and ideals.ConclusionThis study uncovers an ideology that shapes residents' developing professional identity—an ideology that creates struggle as it calls them in impossible, competing or even contradictory ways. As we uncover the hidden ideology of medicine, learners, educators and institutions can play a meaningful role in supporting identity development in medical learners through dismantling and rebuilding its damaging elements.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Professional identity struggle and ideology: A qualitative study of residents' experiences

et al. 2023

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“…We no longer question why it is used in applicant selection. It has become part of medical education's ideology , often passing ‘unseen as normal or as factual’ 3 like water to our parabolic fish. However, the suboptimal diversity, equity and inclusion of medical education's assessment and selection practices are being increasingly recognised as a wicked problem, 4 leading to more frequent scrutiny of sacred (or unseen) ideologies.…”

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confidence: 99%