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语境与一切有何关系?一项针对医学领域代表性不足的医学生专业身份认同形成的研究。

What Does Context Have to Do With Anything? A Study of Professional Identity Formation in Physician-Trainees Considered Underrepresented in Medicine.

机构信息

T.R. Wyatt is associate professor, Educational Innovation Institute, Medical College of Georgia at Augusta University, Augusta, Georgia; ORCID: https://orcid.org/0000-0002-0071-5298.

N. Rockich-Winston is assistant professor of pharmacology, Medical College of Georgia at Augusta University, Augusta, Georgia; ORCID: https://orcid.org/0000-0002-2898-4393.

出版信息

Acad Med. 2020 Oct;95(10):1587-1593. doi: 10.1097/ACM.0000000000003192.

Abstract

PURPOSE

Research on professional identity formation has largely ignored how race, ethnicity, and the larger sociohistorical context work to shape medical students' professional identity. Researchers investigated how physician-trainees considered underrepresented in medicine (URM) negotiate their professional identity within the larger sociohistorical context that casts them in a negative light.

METHOD

In this qualitative study, 14 black/African American medical students were recruited from the Medical College of Georgia at Augusta University and Emory University College of Medicine between September 2018 and April 2019. Using constructive grounded theory and Swann's model of identity negotiation, the authors analyzed interview data for how students negotiate their racial and professional identities within medical education.

RESULTS

The results indicated that URM students were aware of the negative stereotypes ascribed to black individuals and the potential for the medical community to view them negatively. In response, students employed identity cues and strategies to bring the community's perceptions in line with how they perceived themselves-black and a physician. Specifically, students actively worked to integrate their racial and professional identities by "giving back" to the African American community. Community-initiated mentoring from non-URM physicians helped to reify students' hope that they could have a racialized professional identity.

CONCLUSIONS

Race, ethnicity, and the larger sociohistorical context is often overlooked in professional identity formation research, and this omission has resulted in an underappreciation of the challenges URM physicians' experience as they develop a professional identity. Within the context of this study, findings demonstrated that black/African American physicians negotiated the formation of professional identity within a challenging sociohistorical context, which should be given greater consideration in related research.

摘要

目的

专业身份形成的研究在很大程度上忽略了种族、族裔以及更广泛的社会历史背景如何塑造医学生的专业身份。研究人员调查了在将医生培训生描绘成负面形象的更广泛的社会历史背景下,医学领域代表性不足的医生培训生(URM)如何协商他们的专业身份。

方法

在这项定性研究中,作者从乔治亚州奥古斯塔大学的医学院和埃默里大学医学院招募了 14 名黑人和/或非裔美国医学生,时间为 2018 年 9 月至 2019 年 4 月。作者采用建构主义扎根理论和 Swann 的身份协商模型,分析了访谈数据,以了解学生在医学教育中如何协商他们的种族和专业身份。

结果

研究结果表明,URM 学生意识到与黑人相关的负面刻板印象,以及医疗社区可能对他们产生负面看法的可能性。作为回应,学生们采用身份线索和策略,使社区的看法与他们对自己的看法一致——黑人,也是医生。具体而言,学生们通过“回馈”非裔美国人社区,积极努力将他们的种族和专业身份融合在一起。非 URM 医生发起的社区辅导有助于使学生们更加相信,他们可以拥有一个种族化的专业身份。

结论

在专业身份形成研究中,种族、族裔和更广泛的社会历史背景往往被忽视,这导致对 URM 医生在发展专业身份时所面临的挑战认识不足。在本研究的背景下,研究结果表明,黑人/非裔美国医生在充满挑战的社会历史背景下协商专业身份的形成,这在相关研究中应给予更多考虑。

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