Duoethnography as a dialogic and collaborative form of curriculum inquiry for resident professionalism and self-care education

Abstract

Medical residency is an important time in the development of physician professionalism, as residents’ identities and medical responsibilities shift from student-learners to practitioner-leaders. During this transition time, many residents struggle with stress due to the unique pressures of their post-graduate training. This, in turn, can potentially hinder successful professional identity development. In response, the Royal College of Physicians and Surgeons of Canada (RCPSC) has incorporated physician health into its CanMEDS professional competency framework.Although this framework identifies enabling self-care professional competencies (e.g., capacity for self-regulation and resilience for sustainable practice), it does not specify the types of educational strategies best suited to teach and assess these competencies. To support the prevention and rehabilitation of resident health issues, residency training programs are faced with the complex challenge of developing socially accountable curricula that successfully foster self-care competencies. Duoethnography, a dialogic and collaborative form of curriculum inquiry, is presented as a pedagogical model for resident professionalism and self-care education. Merits of duoethnography centers on its: 1) capability to foster self-reflexive and transformative learning; 2) versatility to accommodate learner diversity; and 3) adaptability for use in different social, situational, and ethical contexts.

Transformative Learning in Graduate Medical Education: A Scoping Review

“…19,21,24,25,[30][31][32][33] The remaining articles were either first person accounts of experiences or curricula [35][36][37] or were entirely conceptual. 7, [38][39][40][41] Nineteen articles (69%) explicitly mentioned ''transformative learning'' or ''transformational learning.'' 7, [16][17][18][19][21][22][23]26,27,29,31,33,34,36,[38][39][40][41] In the case of empirical work and first person accounts, the educational venues were in the United States, [15][16][17][18][19][20][21][23][24][25]27,30,32,33,36,37 Kenya,…”

“…7, [38][39][40][41] Nineteen articles (69%) explicitly mentioned ''transformative learning'' or ''transformational learning.'' 7, [16][17][18][19][21][22][23]26,27,29,31,33,34,36,[38][39][40][41] In the case of empirical work and first person accounts, the educational venues were in the United States, [15][16][17][18][19][20][21][23][24][25]27,30,32,33,36,37 Kenya, 29,35 the Netherlands, 26 Norway, 28 Mexico, 31 or described international health electives across multiple countries. 22 The majority of articles described traditional GME (ie, internship, residency, fellowship), with the primary care fields (internal medicine, family medicine, pediatrics, general practice, or unspecified primary care) being most represented (TABLE 1).…”

“…Journal of Graduate Medical Education, December 2021 809 REVIEW residents). 31 Mentors created content on which to reflect (eg, sharing personal stories, introducing or recognizing ''entry points'' 22,39 ) and facilitated critical reflection (eg, unpacking assumptions, bringing awareness to the subconscious). Cruess et al 43 argued that combined with the accrual of individual experience, mentorship and role-modeling are the most powerful influencers on socialization and professional identity formation.…”