“I AM a Doctor”

Frost, Heather; Regehr, Glenn

doi:10.1097/acm.0b013e3182a34b05

Cited by 184 publications

(79 citation statements)

References 64 publications

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“…This is based upon the belief that identity is not something fixed that we are born with. “We construct and reconstruct our identities out of the various social cultural material” [ 24 ]. Hence the environment, both the open and the hidden curriculum at medical educational institutions, contributes in various ways to the process by which each individual medical student achieves a professional identity as a doctor [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our material displays how different issues become important in various semesters and how the gradually increased experience combined with the varied content in the two semesters influence the students’ professional attitudes and reflections. Others have focused more on the problematic issues of this process – how an individual student can get squeezed in between his/her own convictions and the agenda of the medical institution [ 25 ]; how a non-coherent discourse from the institution causes problem for the students [ 24 ]. Our material, however, did not contain any of this kind of witnesses.…”

Section: Discussionmentioning

confidence: 99%

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We lived and breathed medicine - then life catches up: Medical students’ reflections

2014

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BackgroundReflective writing enhances personal and professional development. It is essential for the teachers to be familiar with the students’ perceptions to improve the students’ learning. Our aim was to deepen the understanding of the medical students’ perceptions of the studies and the coming profession.MethodsOur theoretical perspective is constructivist, based upon the relativist view that individuals construct realities to understand and navigate the world. Constructivist methodologies are hermeneutic, with the focus on understanding rather than explaining. Thirty-five written reflections were collected in the first and fifth semesters at Lund University Medical School, Sweden. We used a thematic analysis, close to editing style analysis, inspired by K Malterud, who has modified Giorgi’s phenomenological method.ResultsFor first-semester students the focus is on studies and methods to structure them. The fifth semester is permeated by strategies for achieving a sense of ‘good enough’, qualities of a good doctor and applicability. Clinical placement as a motivating element is important for both semesters.ConclusionsA sense of ‘good enough’ is crucial for students to get by. Reflective writing can illuminate the strategies for achieving this. Clinical placement is vital for motivation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

We lived and breathed medicine - then life catches up: Medical students’ reflections

2014

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“…From a literary perspective, with its emphasis on multiple, often contradictory perspectives and the importance of acknowledging the specifics of every situation, a “standardized” approach to professional attitudes, behaviors, and identity may not be possible. While elements of both standardization and diversity are likely important in formulating sufficiently complex views of professionalism [ 67 ], literature’s forte is to challenge “standardized” views of professionalism by invoking nuance and context. The role of literature is to cultivate a thoughtful examination of the implications and consequences of a spectrum of different attitudes, behaviors, and identities; and to situate these within a larger socioeconomic, cultural, and political context of power and privilege.…”

Section: Implications Of the Study Of Literature For Medical Professimentioning

confidence: 99%

Medical professionalism: what the study of literature can contribute to the conversation

Shapiro

Nixon

Wear

et al. 2015

Philos Ethics Humanit Med

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Medical school curricula, although traditionally and historically dominated by science, have generally accepted, appreciated, and welcomed the inclusion of literature over the past several decades. Recent concerns about medical professional formation have led to discussions about the specific role and contribution of literature and stories. In this article, we demonstrate how professionalism and the study of literature can be brought into relationship through critical and interrogative interactions based in the literary skill of close reading. Literature in medicine can question the meaning of “professionalism” itself (as well as its virtues), thereby resisting standardization in favor of diversity method and of outcome. Literature can also actively engage learners with questions about the human condition, providing a larger context within which to consider professional identity formation. Our fundamental contention is that, within a medical education framework, literature is highly suited to assist learners in questioning conventional thinking and assumptions about various dimensions of professionalism.

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“…What are the hazards of the transference/counter-transference mechanism – especially bearing in mind the diversity/uniformity discourse highlighted by Frost and Regehr [ 15 ]. If students engage in counter-transference and may step up to the identity expectations of others, just how damaging are adverse identity expectations?…”

Section: Discussionmentioning

confidence: 99%

“…Cruess et al advocate a need to better understand this socialization process so that we can engage our students and support them in their ‘determination of the nature of their future professional selves’ [ 8 ]. Frost and Regehr critically analysed seminal publications and found evidence of two competing discourses regarding identity formation [ 15 ]. They articulate that ‘the discourse of diversity emphasizes individuality, difference, and a plurality of possibilities and advances the notion that heterogeneity is beneficial to medical education and to patients.…”

Section: Introductionmentioning

confidence: 99%

A model of professional self-identity formation in student doctors and dentists: a mixed method study

2015

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BackgroundProfessional self-identity [PSI] can be defined as the degree to which an individual identifies with his or her professional group. Several authors have called for a better understanding of the processes by which healthcare students develop their professional identities, and suggested helpful theoretical frameworks borrowed from the social science and psychology literature. However to our knowledge, there has been little empirical work examining these processes in actual healthcare students, and we are aware of no data driven description of PSI development in healthcare students. Here, we report a data driven model of PSI formation in healthcare students.MethodsWe interviewed 17 student doctors and dentists who had indicated, on a tracking questionnaire, the most substantial changes in their PSI. We analysed their perceptions of the experiences that had influenced their PSI, to develop a descriptive model. Both the primary coder and the secondary coder considered the data without reference to the existing literature; i.e. we used a bottom up approach rather than a top down approach.ResultsThe results indicate that two overlapping frames of reference affect PSI formation: the students’ self-perception and their perception of the professional role. They are ‘learning’ both; neither is static. Underpinning those two learning processes, the following key mechanisms operated: [1] When students are allowed to participate in the professional role they learn by trying out their knowledge and skill in the real world and finding out to what extent they work, and by trying to visualise themselves in the role. [2] When others acknowledge students as quasi-professionals they experience transference and may respond with counter-transference by changing to meet expectations or fulfil a prototype. [3] Students may also dry-run their professional role (i.e., independent practice of professional activities) in a safe setting when invited.ConclusionsStudents’ experiences, and their perceptions of those experiences, can be evaluated through a simple model that describes and organises the influences and mechanisms affecting PSI. This empirical model is discussed in the light of prevalent frameworks from the social science and psychology literature.

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“I AM a Doctor”

Abstract: To influence medical students' professional identity construction, the authors advocate that educators seek change across the profession-faculty must acknowledge and take advantage of the tension between the discourses of standardization and diversity.

Cited by 184 publications

References 64 publications

We lived and breathed medicine - then life catches up: Medical students’ reflections

We lived and breathed medicine - then life catches up: Medical students’ reflections

Medical professionalism: what the study of literature can contribute to the conversation

A model of professional self-identity formation in student doctors and dentists: a mixed method study

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