Transformative learning of medical trainees during the COVID-19 pandemic: A mixed methods study

Abstract

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has had a transformative effect on individuals across the world, including those in healthcare. Transformative learning is an educational theory in which an individual's worldview is fundamentally altered through conscious reflection (Cognitive Rational), insights (Extrarational), or social reform (Social Critique). We utilized transformative learning theory to characterize the experiences of medical trainees during the pandemic. MethodsWe used the Transformative Learning Survey in September and October 2020 to evaluate the processes and outcomes of transformative learning in health professions students and housestaff at an academic medical center during the pandemic. We analyzed survey scores for three process domains and four outcome subdomains. We inductively coded the survey's two open-ended questions and performed qualitative and mixed-methods analyses. ResultsThe most prominent TL outcome was Self-Awareness, Acting Differently was intermediate, and Openness and Worldview Shifts were lowest. Cognitive Rational and Social Critique processes were more prominent than Extrarational processes. Students were more likely than housestaff to undergo transformative learning through the Social Critique process (p = 0.025), in particular the sub-processes of Social Action (p = 0.023) and Ideology Critique (p = 0.010). Qualitative analysis via the aggregation of codes identified four responses to the pandemic: negative change, positive change, existential change, or no change. Negative changes (67.7%) were most common, with students reporting more of these changes than housestaff (74.8% vs 53.6%; p < 0.01). Only 8.4% of reported changes could be defined as transformative

Teaching (remotely) to communicate (remotely) with relatives of patients during lockdown due to the COVID-19 pandemic

“…The key elements are a disorienting dilemma that triggers critical reflection and rational discourse whose end result is a change in both the thinking and the acts of the professional [ 22 ]. Undoubtedly, the situation the health professionals went through was a challenge that acted as a disorienting dilemma, and more specifically the difficulties in communication between professionals and patients’ families in a highly complex scenario held a transformative power [ 23 , 24 ].…”

COVID-19 and Collective Transformation: Changes in Online Nursing Faculty Pedagogical Practices

“…Lira et al (2020) and Carolan et al (2020) argued that these disruptions have potential for transformation. Several studies have been published to understand changes caused by COVID-19 and how it impacted healthcare professionals, including those workers engaged in the academic environment (Robinson, 2020; Singaram & Sofika, 2022; Vipler et al, 2022). As faculty strove to continue providing high-quality education to students during the COVID-19 pandemic, they faced a radical and life-changing experience (Bartholomay, 2022).…”

“…TLT explains the process of transformation experienced by individuals due to a sudden shift in their lives as a result of a disorienting dilemma. These disorienting events could be death of a family member, sickness, or being the victim of a crime (Vipler et al, 2022). However, “COVID-19 is a disorienting event experienced by a large number of people.…”

When I say… transformative learning

“…5 Nevertheless, we have ample qualitative evidence demonstrating that transformative learning is occurring for our learners in clinical and extracurricular settings. 3,11,14,16,18 Many of these studies identify how the educator can tie learner experiences to various Transformative Learning Theory…”

“…Merriam and Baumgartner astutely point out that as of 2020, we do not have any empirical evidence comparing Transformative Learning Theory with other educational theories 5 . Nevertheless, we have ample qualitative evidence demonstrating that transformative learning is occurring for our learners in clinical and extracurricular settings 3,11,14,16,18 . Many of these studies identify how the educator can tie learner experiences to various Transformative Learning Theory steps, in order to move the learner to the next stage.…”