Transition theory and the emotional journey to medical educator identity: A qualitative interview study.

BACKGROUND: Medical academia is in crisis, with fewer people entering and growing concern at numbers leaving. While faculty development is often seen as part of the solution, there are significant issues with faculty not engaging with and resisting development opportunities. Lack of motivation may be linked to what might be called a 'weak' educator identity. We studied medical educators' experiences of career development to gain further insights into: how professional identity may develop; individuals' accompanying emotional responses to perceived identity change; and consideration of the accompanying temporal dimensions. Drawing on new materialist sociology, we explore medical educator identity formation in terms of an affective flow that places the individual within a constantly shifting assemblage of psychological, emotional and social relations. METHOD: We interviewed 20 medical educators at various career stages, with differing strengths of medical educator self-identity. Using an adapted transition model as a basis for understanding the emotions experienced by those undergoing identity transitions, we explore the process that, for some medical educators, appears to lead to decreased motivation, ambiguous identity and disengagement, but for others results in renewed energy, a stronger and more stable professional identity and increased interest and engagement. RESULTS: By more effectively illustrating the emotional impact of the transition process leading to a more stable educator identity, we show that some individuals, especially where the change was not sought or welcomed, express their uncertainty and distress through low mood, resistance and an attempt to minimise the significance of undertaking or increasing teaching duties. DISCUSSION: Understanding the emotional and developmental phases of the transition to medical educator identity has several key implications for faculty development. Faculty development approaches should be alert to the individual educator's stage of transition since this will affect that individual's readiness to accept and respond to guidance, information and support. A renewed emphasis on early educational approaches that will support the transformational and reflective learning of the individual is needed, while traditional approaches emphasising skills and knowledge may be more useful in the later stages. Further testing of the transition model and its applicability to identity development in medical education is indicated.

'I felt forced to find an alternative': a qualitative analysis of women medical educators' narratives of career transitions.

OBJECTIVES: While institutional and systemic attempts to increase women's participation in medical education have enabled increasing numbers to enter the field and achieve more senior positions, little is known about lived experiences of female clinical educators. Women clinicians are more likely to change careers and work less than full time. This study focuses on women medical educators' narratives of career change, with the aim of exploring the interplay between factors affecting career decision-making, career trajectory and professional development.  METHODS: We employed narrative enquiry approaches to two data sources (55 written accounts of turning points; 9 semistructured interviews reflecting on periods of career transition). Through analysing themes within each dataset before comparing and contrasting datasets simultaneously, we identified three areas of inconsistency and tension. RESULTS: Participants reported feeling both drawn and pushed into medical education. Some respondents reported that they were compelled by circumstances to enter medical education. Participants' narratives were ambiguous regarding personal and professional identities. Additionally, participants asserted their position as autonomous agents while acknowledging their powerlessness when encountering organisational, social and cultural expectations limiting the ability to make independent choices. Even where primary decisions to pursue medical education were positive and motivated by interest, subsequent disappointments and challenges led some participants to doubt their choices. CONCLUSIONS: Career advancement in medical education may involve women taking significant personal or career sacrifices, partly due to the continued existence of a medical culture allowing men to dominate senior ranks. Women medical educators achieving satisfying senior roles in the field may harbour lingering regret and resentment at the personal and career costs.

Recent research into healthcare professions regulation: a rapid evidence assessment.

BACKGROUND AND AIMS: Over the last decade, regulators have taken significant steps towards tackling perceptions that regulatory systems are burdensome. There has been much international research activity in the regulation of health and care professionals. This article reports a review of studies on health professions regulation between January 2011 and March 2020. Its chief object was to provide robust and up-to-date evidence to assist regulators in policy development and implementation. The main objectives of this study were to: 1. Identify and retrieve research in the field of health and care professions regulation in English since 2011; 2. Evaluate the published research, exploring its utility to regulators and practitioners, and drawing out any key messages; 3. Draw conclusions concerning the scope and limitations of the research literature and identify areas for further research. METHODS: We undertook a rapid evidence assessment (REA) of the international literature on health and care professions regulation, including reviewing ten UK regulators' websites to identify issues of concern and strategic priorities. We retrieved 3833 references, using a four-stage screening process to select the 81 most relevant. RESULTS: Results are reported within six key themes: harm prevention and patient safety; fitness to practise; quality assurance of education and training; registration including maintenance of registers; guidelines and standards and relations with regulatory bodies. CONCLUSIONS: Regulation of professionals in health and care is comparatively undeveloped as a field of academic study. Consequently, the published evidence is diffuse and small-scale. Most work presents relatively weak data of low relevance to regulators, mainly reporting or describing the current position. Few studies are able to show the impact of regulation or demonstrate a causal link between regulation and its effects. To inform their research and policy agendas health and social care regulators need to commission, interpret and apply the scholarly literature more effectively; academics need to engage with regulators to ensure that their research provides high-quality evidence with practical relevance to the regulators' agendas. Further study is needed to explore how effective academic collaborations between regulators and researchers may be created and sustained.

Making the leap to medical education: a qualitative study of medical educators' experiences.

CONTEXT: Medical educators often have prior and primary experience in other academic and clinical disciplines. Individuals seeking successful careers in the education of medical students and doctors must, at some point in their development, make a conscious transition into a new identity as a medical educator. This is a necessary move if individuals are to commit to acquiring and maintaining specialist expertise in medical education. Some achieve this transition successfully, whereas others struggle and may even lose interest and abandon the endeavour. We explored senior educators' experiences of achieving the transition into medical education and their views on what helps and what hinders the process. METHODS: In 2015 we conducted three focus groups with 15 senior medical educators. All focus group discussions were audiorecorded and transcribed verbatim. We applied transition theory to guide our deductive analysis, using Schlossberg's Four S (4S) framework to code and report participants' self-reported perceptions of those factors relating to Self, Situation, Support and Strategy that had assisted them to make a successful transition to a fully acknowledged medical educator identity. Through inductive analysis, we then identified 17 explanatory sub-themes common to all three focus groups. RESULTS: Background and circumstances, individual motivation, a sense of control, organisational support, and effective networking and information-seeking behaviour were factors identified as contributing to successful transition into, and maintenance of, a strong self-identity as a medical educator. CONCLUSIONS: The experiences of established medical educators and, in particular, an exploration of the factors that have facilitated their transition to an acknowledged self-identity as a medical educator could assist in supporting new educators to cope with the changes involved in developing as a medical educator.

Closing Editorial: Peer teaching and learning; the key to scholarship.

This article was migrated. The article was marked as recommended. In our opening editorial we discussed our desire to receive a diverse range of submissions regarding peer teaching and learning. We are delighed to have received such a range of different submissions from healthcare education teams across the globe, focussing on peer education in very different settings. In this, our closing editorial, we discuss the key findings from the submissions that we have received, provide our own reflections on what authors have submitted and discuss our experiences of co-editing this themed edition of MedEdPublish.

Editorial: Medical Students and Postgraduate Trainees as Medical Educators: peer learning is everywhere.

This article was migrated. The article was marked as recommended. In this special issue we would like to encourage authors to contribute as many diverse understandings as possible of how learning occurs in situations where the teacher is, as Osler so memorably put it, a senior student anxious to help his or her juniors. So although we expect to see plenty of work on peer assisted learning programmes within clinical skills units or hospitals we would like to invite authors to be creative in their interpretation of what Medical Students and Postgraduate Trainees as Medical Educators means. In particular we'd like to advance the definition to include "teaching and learning with flat hierarchies" - that is to say, teaching and learning that takes place between people who are fairly close in age, experience or stage of learning, as well as teaching and learning that occurs in the 'opposite direction' - such as when seniors are able to learn from juniors. We will be celebrating the remarkable potential of peer teaching and learning with flat hierarchies and look forward to the publication of a variety of articles, including those that would not normally find an outlet elsewhere, such as replication studies, negative findings, pilots and protocols, case reports, narrative studies and reflections.

Cation Complexation by Chemically Modified Calixarenes. 11. Complexation and Extraction of Alkali Cations by Calix[5]- and -[6]arene Ketones. Crystal and Molecular Structures of Calix[5]arene Ketones and Na(+) and Rb(+) Complexes.

A series of four calix[5]arenes and three calix[6]arenes (R-calixarene-OCH(2)COR(1)) (R = H or Bu(t)) with alkyl ketone residues (R(1) = Me or Bu(t)) on the lower rim have been synthesized, and their affinity for complexation of alkali cations has been assessed through phase-transfer experiments and stability constant measurements. The conformations of these ketones have been probed by (1)H NMR and X-ray diffraction analysis, and by molecular mechanics calculations. Pentamer 3 (R = R(1) = Bu(t)) possesses a symmetrical cone conformation in solution and a very distorted cone conformation in the solid state. Pentamer 5 (R = H, R(1) = Bu(t)) exists in a distorted 1,2-alternate conformation in the solid state, but in solution two slowly interconverting conformations, one a cone and the other presumed to be 1,2-alternate, can be detected. X-ray structure analysis of the sodium and rubidium perchlorate complexes of 3 reveal the cations deeply encapsulated by the ethereal and carbonyl oxygen atoms in distorted cone conformations which can be accurately reproduced by molecular mechanics calculations. The phase-transfer and stability constant data reveal that the extent of complexation depends on calixarene size and the nature of the alkyl residues adjacent to the ketonic carbonyls with tert-butyl much more efficacious than methyl.