University of Leeds, Leeds, UK.
Soc Sci Med. 2010 Dec;71(12):2195-203. doi: 10.1016/j.socscimed.2010.09.048. Epub 2010 Oct 21.
Our purpose is to examine the possibilities of Bakhtinian dialogical analysis for understanding students' experiences of medical training. Twenty-three interviews were conducted with eleven British medical students intercalating in psychology. Forty emotionally resonant key moments were identified for analysis. Our analysis illustrates students' use of the professional genre to present their training as emotionally neutral. However, we show how medical training can be framed in more unofficial and affective-laden ways in which threshold moments of crisis are presented as space-time breaches characteristic of the genres of adventure-wonder and adventure-ordeal. This affect was often depotentiated in the narratives through brief allusion to the professional genre. This cycling between genres suggests that the students were searching for an appropriate way in which to frame their experiences, a central dilemma being the extent to which medical training makes sense within an immediate and affect-laden, or future-orientated and affect-neutral, pedagogy. Finally, we identify how consultants are an important aspect of the affective experience of medical training who, at their best, offer inspiring exemplars of flexible movement between official and unofficial ways of being a doctor. In conclusion, we demonstrate the potential of genres to make sense, and to organize the experience, of medical training spatially in terms of moving between personal and impersonal contact, temporally in terms of moving between the extraordinary and routine, and affectively in terms of moving between potent and neutral affect. Learning to use the professional genre is part of enculturation as a doctor and can be helpful in providing a framework restoring coherence and composure through engaging with, and reformulating, difficult experiences. However, it is important to take seriously the resistance many of the students demonstrated to the professional genre as a possible barometer of its acceptability to the general public.
我们的目的是探讨巴赫金对话分析对于理解学生医学培训经历的可能性。对 11 名在心理学专业插班的英国医学生进行了 23 次访谈。确定了 40 个情感共鸣的关键时刻进行分析。我们的分析说明了学生使用专业体裁将他们的培训呈现为情感中立。然而，我们展示了医学培训如何以更非正式和情感化的方式呈现，其中危机的关键时刻被呈现为具有冒险-奇迹和冒险-磨难体裁特征的时空破裂。这种情感在叙述中经常通过简短地提到专业体裁而被削弱。这种体裁之间的循环表明，学生正在寻找一种合适的方式来构建他们的经验，其中一个核心困境是医学培训在多大程度上可以在即时和情感化、或未来导向和情感中立的教育学中获得意义。最后，我们确定顾问是医学培训情感体验的一个重要方面，他们在最好的情况下，提供了在官方和非官方行医方式之间灵活转换的鼓舞人心的范例。总之，我们展示了体裁在个人与非个人接触之间的空间、在非凡与常规之间的时间、以及在有力与中性情感之间的情感上，使医学培训的意义和经验得以组织的潜力。学习使用专业体裁是作为医生的文化适应的一部分，通过与困难经历接触并重新构建，可以提供恢复连贯性和镇定的框架，这很有帮助。然而，重要的是要认真对待许多学生对专业体裁的抵制，因为这可能是其对公众接受程度的一个指标。
