Academic Affairs, Association of American Medical Colleges, Washington, District of Columbia, USA.
Emergency Pediatric Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Med Educ. 2024 Feb;58(2):225-234. doi: 10.1111/medu.15164. Epub 2023 Jul 26.
The field of medical education is relatively new, and its boundaries are not firmly established. If we had a better understanding of the intricacies of the domain, we might be better equipped to navigate the ever-changing demands we must address. To that end, we explore medical education as a world wherein leaders harness agency, improvisation, discourse, positionality and power to act.
Using the constructivist theory of figured worlds (FW), we conducted a narrative analysis of the stories medical education senior leaders tell about their roles and experiences in the world of medical education (n = 9).
We identified four foundational premises about the world of medical education: (i) medical education stands at the intersection of three interrelated worlds of clinical medicine, hospital administration and university administration; (ii) medical education is shaped by and shapes the clinical learning environment at the local level; (iii) medical education experiences ubiquitous change which is a source of power; and (iv) medical education is energised by relationships between individuals.
Focusing on the FW theory's notions of agency, improvisation, discourse, positionality and power enabled us to describe the world of medical education as a complex domain existing in a space of conflicting power hierarchies, identities and discourses. Using FW allowed us to see the powerful affordances offered to medical education due to its position between worlds amid unceasing change.
医学教育领域相对较新，其边界尚未牢固确立。如果我们能更深入地了解该领域的复杂性，我们或许就能更好地应对不断变化的需求。为此，我们探讨了医学教育领域，领导者可以在此利用能动性、即兴创作、话语、定位和权力来采取行动。
我们使用 figured worlds（FW）的建构主义理论，对医学教育资深领导者讲述的关于他们在医学教育领域的角色和经历的故事（n=9）进行了叙事分析。
我们确定了医学教育领域的四个基本前提：（i）医学教育处于临床医学、医院管理和大学管理三个相互关联的世界的交汇处；（ii）医学教育由本地临床学习环境塑造，并塑造该环境；（iii）医学教育经历普遍变化，这是权力的源泉；（iv）医学教育由个体之间的关系推动。
关注 FW 理论的能动性、即兴创作、话语、定位和权力概念，使我们能够将医学教育领域描述为一个复杂的领域，存在于权力等级、身份和话语相互冲突的空间中。使用 FW 使我们能够看到由于医学教育处于世界之间并处于不断变化之中，因此为其提供了强大的功能。
