Cupido Nathan, Diamond Laura, Kulasegaram Kulamakan, Martimianakis Maria Athina, Forte Milena
N. Cupido is a doctoral student, the Wilson Centre, University Health Network and Temerty Faculty of Medicine, and Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
L. Diamond is a medical student, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Acad Med. 2023 Nov 1;98(11S):S24-S31. doi: 10.1097/ACM.0000000000005359. Epub 2023 Jul 28.
The COVID-19 pandemic has resulted in numerous disruptions to health professions education training programs. Much attention has been given to the impact of these disruptions on formal learning opportunities in training; however, little attention has been given to the impact on professional socialization and professional identity formation. This study explored the impact of the pandemic and resultant curricular changes on the professional identity of family medicine residents.
23 family medicine residents at the University of Toronto were interviewed between September 2020 and September 2022. Using symbolic interactionism as a theoretical framework, thematic analysis explored the meanings residents attributed to both experiences that were disrupted due to the pandemic, and new experiences that resulted from these disruptions.
Participant responses reflected that disruptions in training did not always align with their expectations for family medicine and plans for future practice; however, these new experiences also reinforced their understanding of what it means to be a family physician. While participants felt the pandemic represented a loss of agency and negatively impacted relationships in their training program, it also provided a sense of belonging and membership in their profession. Finally, these new experiences continually blurred the line between professional and personal identities through the impact of the pandemic on participants' sense of well-being and safety.
The impact of the pandemic on training experiences extends beyond the loss of formal learning opportunities. Participant responses reflect the collective influence of the formal, informal, and hidden curriculum on the professional socialization and professional identity formation of residents-and how these different curricular influences were disrupted due to the pandemic. These training experiences have important implications for the future practice of residents who completed their training during the pandemic and highlight the role of training programs in supporting the professional identity formation of residents.
新冠疫情对卫生专业教育培训项目造成了诸多干扰。人们对这些干扰对培训中正规学习机会的影响给予了大量关注；然而，对其对职业社会化和职业身份形成的影响却鲜有关注。本研究探讨了疫情及由此产生的课程变化对家庭医学住院医师职业身份的影响。
2020年9月至2022年9月期间，对多伦多大学的23名家庭医学住院医师进行了访谈。以符号互动主义为理论框架，主题分析探讨了住院医师赋予因疫情而中断的经历以及这些中断所带来的新经历的意义。
参与者的回答反映出，培训中的干扰并不总是符合他们对家庭医学的期望以及未来执业计划；然而，这些新经历也强化了他们对成为一名家庭医生意义的理解。虽然参与者认为疫情意味着失去自主性，并对他们培训项目中的人际关系产生了负面影响，但它也赋予了他们一种职业归属感。最后，这些新经历通过疫情对参与者幸福感和安全感的影响，不断模糊了职业身份和个人身份之间的界限。
疫情对培训经历的影响不仅限于正规学习机会的丧失。参与者的回答反映了正规、非正规和隐性课程对住院医师职业社会化和职业身份形成的共同影响——以及这些不同的课程影响如何因疫情而受到干扰。这些培训经历对在疫情期间完成培训的住院医师未来的执业具有重要意义，并凸显了培训项目在支持住院医师职业身份形成方面的作用。
