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Sivananthajothy P, Adel A, Afhami S, Castrogiovanni N, Osei-Tutu K, Brown A. Equity, diversity, and…exclusion? A national mixed methods study of "belonging" in Canadian undergraduate medical education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:611-639. [PMID: 37563338 DOI: 10.1007/s10459-023-10265-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/16/2023] [Indexed: 08/12/2023]
Abstract
Equity, diversity, and inclusion remain a prominent focus in medical schools, yet the phenomenon of "belonging" has arguably been overlooked. Little is known regarding how belonging is experienced by medical students from groups that face systemic oppression and exclusion. We employed a sequential explanatory mixed methods design to explore how students from equity-deserving groups (EDGs) experience belonging during medical school, including those who are women, racialized, Indigenous, disabled, and 2SLGBTQIA+. First, we conducted a national cross-sectional survey of medical students (N = 480) measuring four constructs: belonging, imposter syndrome, burnout, and depression. Belonging scores were overall lower for students from EDGs and, more specifically, significantly lowest amongst racialized students. Structural equation models show that poor sense of belonging precedes imposter syndrome and further exacerbates burnout and depression. Next, we sampled and interviewed students (N = 16) from the EDG whose belonging scores were significantly lowest. Participants described the essence of belonging as being able to exist as one's "true self" while emphasizing feelings of acceptance, comfort, and safety as well as being valued and seen as an equal - yet described how routine experiences of "othering" inhibited a sense of belonging, often due to differences in social identity and structural privilege. Poor sense of belonging negatively affected learners' well-being and career trajectory. We illuminate the range of psychological and professional consequences associated with diminished sense of belonging and highlight the need to expand traditional notions of equity, diversity, and inclusion to consider structural barriers to belonging.
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Affiliation(s)
| | - Adibba Adel
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Shima Afhami
- Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Nina Castrogiovanni
- Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Kannin Osei-Tutu
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Allison Brown
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
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Chen HC, Kuper A, Cleland J, O'Sullivan P. Should I do a synthesis (i.e. literature review)? ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:367-370. [PMID: 38634967 DOI: 10.1007/s10459-024-10335-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
This column is intended to address the kinds of knotty problems and dilemmas with which many scholars grapple in studying health professions education. In this article, the authors address the question of whether one should conduct a literature review or knowledge synthesis, considering the why, when, and how, as well as its potential pitfalls. The goal is to guide supervisors and students who are considering whether to embark on a literature review in education research.
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Affiliation(s)
- H Carrie Chen
- Georgetown University School of Medicine, Washington, DC, USA.
| | - Ayelet Kuper
- Wilson Centre for Research in Education, University Health Network, University of Toronto, Toronto, Canada
- Division of General Internal Medicine, Sunnybrook Health Sciences Center, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Jennifer Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Patricia O'Sullivan
- University of California San Francisco School of Medicine, San Francisco, CA, USA
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Onetto J, Sobczak M, Skapetis T, Kahler B, Tishkina O, Van Gorp G, O'Connell AC. Appraisal of the IADT fellowship - A member survey. Dent Traumatol 2024. [PMID: 38651791 DOI: 10.1111/edt.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/07/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND/AIM The International Association of Dental Traumatology (IADT) is considered the foremost authority in Dental Traumatology. Fellowship status was introduced in 2015 and is considered an international standard of excellence. The Fellowship Committee of the IADT believed it was essential to survey members seeking information on the benefits of the IADT Fellowship and potential considerations for future development. This survey aimed to explore the perceptions of members of IADT surrounding the fellowship process in terms of interest, accessibility, equality, perceived prestige, and value to the membership. MATERIAL AND METHODS The survey was sent to 546 IADT members, of whom 89 were fellows (as of 31 July 2022) from 74 countries via an email invitation. Answers were analysed using the Chi2 and Fisher's exact test (p < .05). RESULTS The response rate to the survey was 20.69% (n = 113), including 28 fellows (24.78%). Forty-six respondents (40.71%) were female, and 67 (59.30%) were male. Dentists identified as specialists were significantly more likely to be involved in teaching dental trauma (p = .000008). A majority of respondents (87.76%; 86/98) expressed interest in obtaining fellowship, with increased interest from more recent graduates. Learning opportunities, obtaining expertise, networking and a sense of community and prestige, were key factors in considering fellowship. There was interest in alternate pathways other than examination alone, with 60.2% of 98 respondents suggesting a combination of publications /service to IADT/ reviewer for Dental Traumatology, 57.14% suggesting the submission of case reports, and 42.86% suggesting Honorary Fellowship. Respondents (73%) were willing to participate in online discussion forums and other professional development opportunities. This preference was more notable among non-fellows (75.29%) than fellows (67.85%). CONCLUSIONS The survey indicates the diverse motivations and perceptions regarding the IADT Fellowship, despite the low participation of IADT members. Achieving fellowship status is desired by 87.7% of non-fellows. The majority of respondents were aware of the process, but main concerns were identified as eligibility criteria and examination difficulty. Options for alternate pathways and other initiatives promoting engagement were identified. Further exploration of these issues is required to be representative of the entire IADT membership. Addressing these obstacles could significantly enhance fellowship participation and overall member satisfaction within the IADT community.
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Affiliation(s)
- Juan Onetto
- Pediatric Dentistry, Faculty of Dentistry, Research Center in Dental and Medical Sciuences (CICOM), Universidad de Valparaíso, Valparaiso, Chile
| | | | - Tony Skapetis
- Western Sydney Local Health District, NSW Health, Westmead, New South Wales, Australia
| | - Bill Kahler
- Faculty of Medicine and Health, Sydney Dental School, The University of Sydney, Surry Hills, New South Wales, Australia
| | - Olga Tishkina
- Private Practice, Dental Trauma Center Iceberg, Moscow, Russia
| | - Geertje Van Gorp
- Department of Oral Health Sciences-Population Studies in Oral Health, KU Leuven, Leuven, Belgium
- Pediatric Dentistry and Special Care, University Hospitals Leuven, Leuven, Belgium
| | - Anne C O'Connell
- School of Dental Science, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
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Samaraweera BP, Pillay M, Muttiah N, Moodley L. Exploring clinical reasoning in child language assessment through decoloniality. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-16. [PMID: 38425227 DOI: 10.1080/17549507.2023.2296864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
PURPOSE Clinical reasoning has been taught, practised, and researched under Western epistemologies, which have been fallible in addressing the complexity of clinical reasoning within Indigenous cultures and societies. We explored how speech-language pathologists in Sri Lanka negotiate and value Indigenous and Western perspectives in clinical reasoning within a decolonial framework. METHOD This study used participatory research methodology within the decolonised qualitative research paradigm to produce data collaboratively with eight Sri Lankan speech-language pathologists. Oral history narratives and object-based textual reflections generated the necessary data for the study. Systematic visual-textual analysis and reflexive thematic analysis were carried out iteratively, and the data analysis and interpretation were undertaken collaboratively with the participants. RESULT We generated four key themes about professional education, individuality in practice, holistic thinking, and balancing interests and priorities. The results demonstrate that social, political, and economic forces impact practitioners' clinical reasoning. CONCLUSION Practising science in its original form within Indigenous contexts is challenging. Colonial roots and imperialism impact the delivery of appropriate services in socially and politically marginalised communities. Practitioners' self-awareness about authentic identities and practical wisdom can develop culturally relevant knowledge for equitable practice.
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Affiliation(s)
- Buddhima P Samaraweera
- Discipline of Speech-Language Therapy, University of KwaZulu-Natal, Durban, South Africa
| | - Mershen Pillay
- Discipline of Speech-Language Therapy, University of KwaZulu-Natal, Durban, South Africa
- Speech-Language Therapy, Massey University, New Zealand
| | - Nimisha Muttiah
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Sri Lanka
- Communication Disorders and Sciences, State University of New York, Cortland, NY, USA
| | - Legini Moodley
- Discipline of Speech-Language Therapy, University of KwaZulu-Natal, Durban, South Africa
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Acharya A, Black RC, Smithies A, Darzi A. Evaluating the Impact of the National Health Service Digital Academy on Participants' Perceptions of Their Identity as Leaders of Digital Health Change: Mixed Methods Study. JMIR MEDICAL EDUCATION 2024; 10:e46740. [PMID: 38381477 PMCID: PMC10918534 DOI: 10.2196/46740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 10/14/2023] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND The key to the digital leveling-up strategy of the National Health Service is the development of a digitally proficient leadership. The National Health Service Digital Academy (NHSDA) Digital Health Leadership program was designed to support emerging digital leaders to acquire the necessary skills to facilitate transformation. This study examined the influence of the program on professional identity formation as a means of creating a more proficient digital health leadership. OBJECTIVE This study aims to examine the impact of the NHSDA program on participants' perceptions of themselves as digital health leaders. METHODS We recruited 41 participants from 2 cohorts of the 2-year NHSDA program in this mixed methods study, all of whom had completed it >6 months before the study. The participants were initially invited to complete a web-based scoping questionnaire. This involved both quantitative and qualitative responses to prompts. Frequencies of responses were aggregated, while free-text comments from the questionnaire were analyzed inductively. The content of the 30 highest-scoring dissertations was also reviewed by 2 independent authors. A total of 14 semistructured interviews were then conducted with a subset of the cohort. These focused on individuals' perceptions of digital leadership and the influence of the course on the attainment of skills. In total, 3 in-depth focus groups were then conducted with participants to examine shared perceptions of professional identity as digital health leaders. The transcripts from the interviews and focus groups were aligned with a previously published examination of leadership as a framework. RESULTS Of the 41 participants, 42% (17/41) were in clinical roles, 34% (14/41) were in program delivery or management roles, 20% (8/41) were in data science roles, and 5% (2/41) were in "other" roles. Interviews and focus groups highlighted that the course influenced 8 domains of professional identity: commitment to the profession, critical thinking, goal orientation, mentoring, perception of the profession, socialization, reflection, and self-efficacy. The dissertation of the practice model, in which candidates undertake digital projects within their organizations supported by faculty, largely impacted metacognitive skill acquisition and goal orientation. However, the program also affected participants' values and direction within the wider digital health community. According to the questionnaire, after graduation, 59% (24/41) of the participants changed roles in search of more prominence within digital leadership, with 46% (11/24) reporting that the course was a strong determinant of this change. CONCLUSIONS A digital leadership course aimed at providing attendees with the necessary attributes to guide transformation can have a significant impact on professional identity formation. This can create a sense of belonging to a wider health leadership structure and facilitate the attainment of organizational and national digital targets. This effect is diminished by a lack of locoregional support for professional development.
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Affiliation(s)
- Amish Acharya
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Ruth Claire Black
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Alisdair Smithies
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Ara Darzi
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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Dahri K, Luo C, Kent B, Lai M, Driver A, Haag H. Exploring the Professional Identity of Hospital Pharmacists in British Columbia. Can J Hosp Pharm 2024; 77:e3419. [PMID: 38204498 PMCID: PMC10754406 DOI: 10.4212/cjhp.3419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/11/2023] [Indexed: 01/12/2024]
Abstract
Background Pharmacists lack a cohesive professional identity, with only limited previous research on the formation of a professional identity for pharmacy. In particular, there is sparse information on the professional identity of pharmacists who practise in hospital settings. Objectives To determine hospital pharmacists' professional identity and the characteristics of an ideal pharmacist and ideal practice setting. Methods This qualitative study used key informant interviews with semistructured questions. A maximum variation sampling strategy was used to recruit a cross-section of pharmacists from different geographic areas of British Columbia who were practising in a variety of roles. The interviews were transcribed and then analyzed thematically. Results Nineteen pharmacists participated in the study. Seven themes pertaining to hospital pharmacists' professional identity were generated, specifically medication expert, therapy optimizer, collaborator, educator, researcher, patient advocate, and unknown professional. Similarities were found with personas previously identified in a population of primarily community pharmacists. The ideal pharmacist was described as being a medication expert, a collaborator, and a leader. The ideal practice setting was characterized as being adequately funded and allowing pharmacists to practise to their full scope. Conclusions Hospital pharmacists' professional identity is based on being a medication expert who is seen as an essential member of a collaborative team.
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Affiliation(s)
- Karen Dahri
- , BSc, BScPharm, PharmD, ACPR, FCSHP, is with the Faculty of Pharmaceutical Sciences, The University of British Columbia, and Vancouver General Hospital, Lower Mainland Pharmacy Services, Vancouver, British Columbia
| | - Cindy Luo
- , BScPharm, PharmD, ACPR, is with Vancouver General Hospital, Lower Mainland Pharmacy Services, Vancouver, British Columbia
| | - Brandy Kent
- , PharmD, is with the Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia
| | - Madison Lai
- , BSc, PharmD, is with the Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia
| | - Amanda Driver
- , BScPharm, ACPR, is with Vancouver General Hospital, Lower Mainland Pharmacy Services, Vancouver, British Columbia
| | - Hans Haag
- , BSc, BScPharm, ACPR, is with Vancouver General Hospital, Lower Mainland Pharmacy Services, Vancouver, British Columbia
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