R. Sternszus is assistant professor, Department of Pediatrics and Institute of Health Sciences Education, McGill University, Montreal, Quebec, Canada; ORCID: https://orcid.org/0000-0001-8115-5490.
J.D. Boudreau is associate professor, Department of Medicine and Institute of Health Sciences Education, McGill University, Montreal, Quebec, Canada.
Acad Med. 2020 Oct;95(10):1594-1599. doi: 10.1097/ACM.0000000000003369.
A fundamental goal of medical education is supporting learners in forming a professional identity. While it is known that learners perceive clinical teachers to be critically important in this process, the latter's perspective is unknown. This study sought to understand how clinical teachers perceive their influence on the professional identity formation of learners.
In 2017, a research assistant conducted 16 semistructured interviews of clinical teachers from 8 specialties at McGill University. The research assistant audiorecorded and subsequently transcribed interviews for analysis. Following principles of qualitative description, the research team developed a coding scheme using both inductive codes (from the words of the participants) and deductive codes (based on the literature and the theory of communities of practice). Through a cross-case analysis, the team then identified salient themes.
Participants struggled to describe their influence on learners' professional identity without first being prompted to focus on their own identity and its formation. Once prompted, clinical teachers reported viewing their personal and professional identities as integrated and believed that caring for patients was integral to forming their professional identity. They identified explicit role modeling, engaging in difficult conversations, and providing graded autonomy as ways in which they could influence the identity development of learners. However, they had difficulty discerning the magnitude of their influence.
This study was the first to explore professional identity formation from the perspective of clinical teachers. The 2010 Carnegie Foundation report called for an increased focus on professional identity formation. Giving clinical teachers the space and guidance to reflect on this process, helping them make the implicit explicit, and supporting them in using their own experiences as learners to inform their teaching appear to be critical steps in achieving this goal.
医学教育的一个基本目标是支持学习者形成专业身份。虽然学习者认为临床教师在这个过程中至关重要,但后者的观点尚不清楚。本研究旨在了解临床教师如何看待自己对学习者专业身份形成的影响。
2017 年,一名研究助理对麦吉尔大学 8 个专业的临床教师进行了 16 次半结构化访谈。研究助理对访谈进行了录音,并随后将访谈转录进行分析。研究团队遵循定性描述的原则,使用归纳编码(来自参与者的话语)和演绎编码(基于文献和实践共同体理论)开发了一个编码方案。通过跨案例分析,团队确定了突出的主题。
参与者在没有首先被提示关注自己的身份及其形成的情况下,难以描述他们对学习者专业身份的影响。一旦被提示,临床教师报告说将个人和职业身份视为一体,并认为照顾患者是形成职业身份的重要组成部分。他们确定了明确的榜样作用、参与艰难的对话以及提供分级自主权,作为他们可以影响学习者身份发展的方式。然而,他们很难辨别自己的影响程度。
这项研究首次从临床教师的角度探讨了专业身份的形成。2010 年卡内基基金会的报告呼吁更加关注专业身份的形成。为临床教师提供反思这一过程的空间和指导,帮助他们将隐含的变得明确,并支持他们利用自己作为学习者的经验来指导教学,这似乎是实现这一目标的关键步骤。