Responding to the call of the NHS Nightingale, but at what cost? An auto-ethnography of a volunteer frontline mental health trainer's experiences during the COVID-19 pandemic

Healthcare workers, globally, volunteered time and skills to the COVID-19 pandemic frontline response. In March 2020, the predicted high demand for extra critical care beds led to the rapid construction of the UK National Health Service (NHS) Nightingale field hospital, London. I volunteered to develop and deliver psychological preparedness training - coined 'Psychological PPE' - to over 2300 frontline staff over an 8-week period. Existing research has identified broad themes of the impact working on the COVID-19 frontline has on healthcare workers but does not capture in-depth accounts of individuals' experiences. Using autoethnographic enquiry, this research explores my frontline experience at the NHS Nightingale during this time, and the personal impact this had on me. Reflexive thematic analysis explored themes of recognition and sacrifice, emotional lability and fragility, and the impact of transitions. Findings inform personal recovery, as well as future research and policy development pertaining to the sustainable recovery of our NHS people.

Five Coffin Nails to Informed Consent: An Autoethnography of Suffering Complications in Breastfeeding

This autoethnography describes an illness episode caused by breastfeeding complications. It focuses on informed consent processes accompanying this illness episode. Informed consent is a cornerstone of ethical medical practice and has to be obtained before a medical intervention can legally be implemented. It is therefore not trivial that in practice, informed consent processes often fail to achieve what they are set out to. With this autoethnography, I want to provide a review of how informed consent processes can fail in the context of breastfeeding, but also draw attention to what these situations can mean and feel like for those affected. I provide in-depth descriptions of five scenes from my illness episode each representing a different barrier to informed consent. The scenes were developed based on emotional recall and written to grant access to the emotional dimensions of my experience in the tradition of evocative autoethnography. As part of my story, I engage with various issues like practices of prescribing, communicative requirements in vulnerable situations to ensure understanding, the dual purpose of informed consent in the moral and legal realm, and the moralized breastfeeding discourse. Possible routes for change to abolish or reduce described barriers to informed consent are discussed.

Being fractal: Embodying antiracism values in course-based participatory action research

In the winter and spring of 2021, I-a White, female, graduate student-taught a six-month course surrounding the theme: Disrupting Systemic Racism at our University Through Action Research. I was challenged to lead a meaningful course in a two-dimensional virtual space, amidst rising death tolls of the COVID-19 pandemic and the rhythmic beat of calls for racial justice pulsing through our Zoom class periods. This experience opened my eyes as an educator, budding community psychologist, and an antiracist White accomplice. In this critical autoethnographic case study, I recount my experience adapting the community organizing principle of fractals into a pedagogical framework that guided my instructional practices in a community psychology course. In doing so, I echo the call for community psychologists to connect our work more tightly to Black, Indigenous, and people of Color social justice organizers and movements to fortify the field's relevance in the struggle for racial justice.

The time for patient partnership in medical education has arrived: Critical reflection through autoethnography from a physician turned patient

PURPOSE

This paper explores experiences of a physician who in one life-altering day awoke in intensive care and had to embark on a complex journey as full-time patient. It identifies the important literature, albeit limited, from a unique dual lens view of physician turned patient, and analyzes the potential for advancing medical education by recognizing the expertise that patients possess from lived experience.

METHODOLOGY

An autoethnography study was undertaken to unpack data obtained from lived patient experience during a two-and-a-half-year long hospitalization. Themes were captured in a series of eleven scenarios. Findings included critical reflection from the patient, medical educator, and research perspectives. Data was cross-referenced with relevant literature.

RESULTS

Seven themes emerged upon critical analysis of the eleven scenarios that described real-life healthcare encounters of the physician turned patient. These often-neglected themes from medical education include experiential learning, reflection, what counts as medical care, vulnerability, patient-centred care, agency, and patient expertise.

CONCLUSIONS

This study highlights differences between intellectual-experiential knowledge, and challenges medical education to harness the expertise that patients possess. It contributes to scholarly discourses by demonstrating the utility of autoethnography in medical education, critiques traditional medical education models, expands the breadth of what constitutes knowledge, and invites medical educators to actively involve patients as equal stakeholders in curricula.

The Ontology of Oncology: Navigating Cyborgs and Assemblages Through Cancer Treatment

Through narrative, the subjective experience of illness offers a corrective to biomedicine's interpretive grip. Narrative is both process and product and illness narratives, in particular, are examples of embodied research. This ecopathography - drawing upon embodied experiences of treatment and recovery from late stage Non-Hodgkin's lymphoma - enlists Haraway's cyborg and Lupton's digital assemblage in an effort to make broader claims about patient care in the United States, and specifically, the role of technology in healthcare and in the construction of patient identity. A surgically implanted port (facilitating blood draws and the delivery of chemotherapy) and the patient portal (representing the results of those blood draws as well as a medium for communication) provide a foundation for how cyborgian assemblages both assist and trouble the cancer experience. At stake is the fluidity and ambiguity of boundaries (human/machine, human/animal, and physical/virtual) and the management of those boundaries with regard to patient care.

Critical Reflexivity and Positionality on the Scholar-Practitioner Continuum: Researching Women's Embodied Subjectivities in Sport

The sports world has many prejudices that have been converted into common sense. Some relate to the idea of athletes being strong or pretty but endowed with little intelligence. There is another view, perhaps a little more accurate, around the reification of consciousness in the name of the automation and maximum outcome of the body. Both views are informed by Cartesian thinking, perpetuating the mind-body dichotomy. Such a dichotomy is spread in several other areas in our society, expressed as binaries. We meet a binary when conducting research as well, disembodying the researcher as someone who is neutral, objective, and highly rational, and someone who, in synthesis, performs good mental work, but who must not let feelings intrude. On the contrary, we argue that we are embodied beings who are often not able to (and maybe should not) become detached from previous experiences and knowledge when conducting research. Even though this can present itself as a challenge, we consider that a fluid non-binary positioning encompasses actions holistically and leads to tasks being performed on a continuum. The purpose of this paper is to explore the reflexive process embedded in carrying out a PhD project committed to studying the production of the embodied subjectivities of a group of women high-level athletes in karate. The researcher inserted in the researched environment was not a high-level athlete; however, she had several experiences competing at the amateur level in different countries and faced experiences that were, to some extent, similar to those of the elite athletes. She used her previous experiences as a karateka, researcher, and woman to inform her research-doing since the intersectional social issues faced by her and lived queer feelings motivated her research questions. She plunged into a process of self-reflection and counted on the guidance of the other authors to organise her learning in order to use it in her scholarship. That was, primarily, an experience of "practice" of subjectivity through examining others' production of subjectivity, besides strengthening a positionality that lacked self-confidence. Thus, we explore issues around the researcher-practitioner theoretical-practical continuum of research-doing, presenting a journey that became empowering.

As if I was a spacecraft returning to Earth's atmosphere. Expanding insights into illness narratives and childhood cancer through evocative autoethnography

Today, a majority of children diagnosed with cancer are expected to grow up and live-hopefully until old age. Still, knowledge of the lived experience of childhood cancer survivors is sparse. In pursuit of knowledge expansion, by combining my intersecting roles as an academic, educational counselor, and childhood cancer survivor, I approach my personal illness narrative. By means of evocative autoethnography, I write intentionally vulnerably about my experiences and make them available for consideration. I explore my narrative through archives, artifacts, memories of the past, and conversations evoked in the present. I re-visit the cultural landscape of a southern Norwegian girl growing up in the 00s with cancer. Through this, my illness narrative presents as positioned, tangled, and interwoven with a developmental trajectory. Specific educational experiences seem to linger, and many are related to being absent from or re-entering school after the onset of illness. To grasp the intersecting and conflicting experiences of being very ill while also young, I suggest Erik Erikson's moratorium as a key concept. To complement Arthur Frank's illness narratives of restitution, chaos, and quest, I establish the moratorium narrative. As a fresh resource, the moratorium narrative underlines the need to make sensitive our academic community's gaze on illness trajectories unfolding in formative phases and illness narratives defined by growing up. By providing a point of recognition that prompts elaboration, this could also provide the young and very ill with a much-needed narrative space of opportunity, of which more narratives are invited and insisted upon.

An Individual's Lived Experiences of Taking Cannabis-Based Medicinal Products (CBMPs) to Treat Anxiety

This report documents the case of a patient (the author) participating in a clinical trial of medical cannabis (Cannabis sativa L.)-the Sapphire Access Scheme, run by the Sapphire Medical Clinic as part of the UK Medical Cannabis Registry-to explore the impacts of cannabis-based medicinal products (CBMPs) on anxiety. For most of my life, I have experienced often very serious bouts of poor mental health arising, in part, from childhood abuse, and have been diagnosed with several mental health conditions which constitute disabilities. I have received various conventional treatments and multiple alternative therapies. However, none of these have enabled me to consistently manage my conditions long-term, and I often suffer relapses. As part of the Sapphire Access Scheme, I complete regular quantitative questionnaires regarding the impacts of the CBMPs on my anxiety and have also obtained the clinic's permission to qualitatively document and write up the impacts of CBMPs on my mental health. Here, I present a preliminary autoethnographic exploration of my lived experiences of CBMP use over the first four months of the trial, which show that even within such a short space of time, CBMPs have had a positive impact on treating what had previously been treatment-refractive chronic anxiety.

An auto-ethnographic reflection on the nature of nursing in the UK during the Covid-19 pandemic

In this article I discuss the effects on the patient experience of isolation nursing during the CoronaVirus Disease (COVID)-19 pandemic. An unintended consequence of isolation nursing has been to distance patients from nurses and emphasise the technical side of nursing while at the same time reducing the relational or affective potential of nursing. Such distanced forms of nursing normalise the distal patient in hospital. I consider ways in which this new form of distanced nursing has unwittingly contributed to the continued commodification of nursing care in the British NHS. Autoethnography is used to describe and reflect on the illness experience, the experiences of caregivers and the sociocultural organisation of health care. The findings discuss three areas of the illness experience: intimate nursing care; communication; the 'distanced' patient experience.

Reflections of Adult Children of Mothers with Intellectual Disability

This multiple case study explores the phenomena of being raised by parents with intellectual disabilities from the adult child's perspective. Autoethnographic data was collected from the author and 4 non-disabled adults who were raised by mothers who had intellectual disabilities. The significance of the parent's disability, parent/child relationship and the social factors that either hindered or facilitated the family are discussed. This study found that the majority of the families were at risk of losing custody of their children and that extended family or support services protected the family unit and provided valuable support to the children. It was common for the participants to have additional responsibilities growing up. All of the adult children achieved typical adult outcomes. The adult children interviewed typically did not define their maternal relationships in terms of disability or limitations and all maintained a strong relationship with their mothers.

Unintended Consequences of "Breast Is Best" Messaging on Mothers: An Autoethnography

Purpose: To describe the breastfeeding experiences of a dietitian and mother so as to expose dominant discourses reinforcing expert-driven imperatives to breastfeed.Methods: Professional experiences and personal challenges related to breastfeeding promotion are described, analyzed, and interpreted using autoethnography. The social ecological model (SEM) is used as a sensitizing concept to guide the organization, presentation, and analysis of experiences.Results: Data were organized into two discussion themes: breastfeeding promotion practices and "failure" to breastfeed. Dominant discourses reinforcing expert-driven imperatives to breastfeed are revealed, including health as a duty, intensive motherhood, and mother blame. Discourses promoting or reinforcing breastfeeding simultaneously judge and denormalize formula-feeding.Conclusions: Contemporary breastfeeding promotion messages and strategies are quiet coercions used to influence infant-feeding decisions and do not support the principles of evidence-based practice, person-centred care, and informed choice.

"Anxiety or enjoyment, I feel pleasant to welcome them both": thematic analysis of a Chinese PhD student's personal growth experiences

Engaging with research is an emotionally demanding experience and a trajectory full of difficulties, challenges, and stress. This autoethnographic study explored my personal experiences as a PhD student in a four-year program and conducted a qualitative thematic analysis by analyzing 550 research diary entries collected between September 2018 and June 2022, in which supervisor feedback and reviewer comments were part of the content. Three recurring, unique, and salient themes pertaining to my personal experiences were identified: being fraught with anxiety, gaining a sense of enjoyment, and achieving personal growth. Whereas anxiety was from publication and dissertation writing, foreign language writing, and individual stressors, enjoyment was gained from the support network and conducting research. My personal growth was reflected from sustained engagement and improved autonomy. In the process, I experienced some negative emotions, but found more enjoyment. The findings indicate that anxiety and enjoyment are fluctuating, co-occurring, and reciprocal. The findings call for more attention to the role of research diary writing in scaffolding PhD research, providing emotional support, and facilitating personal growth and well-being of PhD students.

The Role of Large Language Models in Medical Education: Applications and Implications

Large language models (LLMs) such as ChatGPT have sparked extensive discourse within the medical education community, spurring both excitement and apprehension. Written from the perspective of medical students, this editorial offers insights gleaned through immersive interactions with ChatGPT, contextualized by ongoing research into the imminent role of LLMs in health care. Three distinct positive use cases for ChatGPT were identified: facilitating differential diagnosis brainstorming, providing interactive practice cases, and aiding in multiple-choice question review. These use cases can effectively help students learn foundational medical knowledge during the preclinical curriculum while reinforcing the learning of core Entrustable Professional Activities. Simultaneously, we highlight key limitations of LLMs in medical education, including their insufficient ability to teach the integration of contextual and external information, comprehend sensory and nonverbal cues, cultivate rapport and interpersonal interaction, and align with overarching medical education and patient care goals. Through interacting with LLMs to augment learning during medical school, students can gain an understanding of their strengths and weaknesses. This understanding will be pivotal as we navigate a health care landscape increasingly intertwined with LLMs and artificial intelligence.

Tales from a Hospital Entrance Screener: An Autoethnography and Exploration of COVID-19, Risk, and Responsibility

This autoethnography explores my experiences as a hospital entrance screener during the first wave of the pandemic in a hospital in Ontario, Canada. In April 2020, I was redeployed from my research role to a hospital entrance screener. Focused on my lived experiences, the purpose of this research is to provide a glimpse into what it was like to work in a hospital early in the pandemic, to understand these experiences in relation to sociocultural meanings, and to try to make sense of my experiences with COVID-19. Through reflections, I offer a critical account of my experiences working as a screener and analyze personal reflections about my thoughts, feelings, and experiences from a post-structural lens. My analysis reveals several themes: responsibilization, risk, emotional labor, policing and securitization, and the hero discourse. My experiences as a screener demonstrate the complexities of the COVID-19 society and experience.

Reflections of a white healthcare professional researching ethnicized and racialized minorities: Autoethnographically explored emotions revealing implicit advantages and consequences

Health research is often embedded in biomedicine in which the goal is to remove all bias. However, this is problematic in research on social issues such as social and health inequities. Therefore, there is growing criticism of health researchers' positions as neutral and invisible. I explore research-based advantages and consequences following my positionings within whiteness, nursing and healthcare professionality. Drawing on two ethnographic studies conducted in Denmark, one among black Nigerian women working in the streets of Copenhagen, the other following patients, defined in Danish healthcare as 'ethnic minorities', in two hospitals in the greater Copenhagen area, I take the point of departure from autoethnographic emotions of 'doing good', 'discomfort' and 'denial'. As I analyse these emotions as a production in the contexts, I show the advantages and consequences of leaving my marked body unmarked. With an intersectional lens, I discuss how health researchers' risk (re)producing social inequalities in health based on for example, avoiding topics of skin colour and experiences of discrimination. Ultimately, what legitimized my access to the people in the field paradoxically also risked delegitimizing their experiences of racialized and ethnicized inequalities. This is not only consequential for the interlocutors but also for the knowledge production, since we as health researchers' risk implicitly avoiding important knowledge if we do not see our own research positionings as a racialized, ethnicized and culturalized matter. Therefore, the need for educational curriculum on racialization and anti-discrimination is imperative within the health professions and as health researchers regardless of profession or research area.

Strengths and limitations of the Inclusive Society research model: an autoethnography

Purpose: The Inclusive Society partnership research model aims to promote change in society for people with disabilities by supporting research teams composed of researchers and partner organizations. The objective of this article is to identify the strengths and limitations of this research model.Material and methods: An autoethnography approach was used. Thematic analysis of four methods was undertaken: semi-directed interviews with members of the research teams funded by Inclusive Society (researchers, partners), a focus group with the Inclusive Society's intersectoral collaboration agents, their logbooks, and Inclusive Society's annual reports.Results: Strengths and limitations of the Inclusive Society model were identified through their networking activities, the role and support of the intersectoral collaboration agents and the partnership research program.Conclusions: Networking activities are an essential element of Inclusive Society. They are indispensable for composing intersectoral research teams that will work on answering needs of people with disabilities. Intersectoral collaboration agents are also a strength of the model, but their role could be clarified to better frame what tasks are in their scope of practice and what the research teams could ask from them. Finally, the research program eligibility criteria could be improved to support, among others, the projects' appropriation phases.

"Breast is best"… until they say so

In this autoethnographic article, I discuss the consequences of being exposed to two competing breastfeeding discourses during my first mothering experience-the "self-regulated dyad" and the "externally regulated dyad" discourse. The former represents the ideal scenario and the evidence-based practices recommended by the World Health Organization (i.e., breastfeeding on demand, internally regulated by the dyad). The externally regulated discourse refers to the standardized health interventions that take over when difficulties arise (e.g., weight gain deviations and latching issues). Building on Kugelmann's critique about our blind reliance on "standardized health," existing evidence, and my breastfeeding journey, I argue that unqualified and unindividualized breastfeeding interventions are highly counterproductive. To illustrate these points, I discuss the implications of the polarized interpretation of pain and the limited dyadically focused support. I then move on to analyze how ambivalent social positioning around breastfeeding impacts our experience. In particular, I found that I was highly regarded as a "good, responsible mum" up till my baby was 6 months, and how breastfeeding became increasingly challenged by others when my daughter was approaching her first birthday. Here, I discuss how performing attachment mothering identity work allowed me to navigate these challenges. Against this backdrop, I reflect upon feminist ambivalent positionings on breastfeeding and the complexity of balancing the promotion of women's hard-earned rights while supporting them to engage in whatever baby-feeding choice they feel appropriate. I conclude that unless we acknowledge the physical and social complexities of the process, and our healthcare systems seriously invest in allocating human resources and training them appropriately, breastfeeding rates may continue to suffer and women continue to interiorize it as their own failure.

Being and doing anorexia nervosa: An autoethnography of diagnostic identity and performance of illness

This autoethnography examines my experience of the diagnosis and treatment of anorexia nervosa. Drawing on memory and personal and medical documents relating to inpatient admissions in an adult specialist eating disorder unit, I narrate and analyse my experience in terms of my relationship to the diagnosis of anorexia and the constructions of it I encountered. I show how I came to value an identity based on anorexia and how I learned ways of 'doing' the diagnosis in treatment. This involved me valuing medical markers of illness, including signs of poor health, which became crucial to how I performed my diagnosis and retained the diagnostically-informed sense of self that I valued. I suggest that, ultimately, these diagnostic-dynamics, alongside other effects of long-term inpatient treatment such as detachment from 'normal life', prolonged my struggles with self-starvation. The insights from this autoethnography shed light on potential iatrogenic impacts of diagnosis and treatment for anorexia.

A Music Teacher's Blended Teaching and Learning Experience during COVID-19: Autoethnography of Resilience

The purpose of this co-autoethnographic qualitative case study was to chronicle the experiences of the first author as he taught general music in a blended, face-to-face, and online synchronous, environment during the COVID-19 pandemic. The co-autoethnography conveys a voice of a practicing teacher with advice and wisdom gained from living and working through the technological aspects of teaching and learning in a blended environment for practicing music teachers. His experiences chronicle how technology was used as a vehicle for amplifying the experiences of students and empowering them to creativities not possible before the pandemic. Implications for music education include exploring the stories of the lived experiences of teachers who taught through the pandemic with a focus on the possibilities and potentialities for profound change mediated by technology, learner-centered pedagogy, and creativities in practice.

Family Pictures: The Queer Relationalities of Multigenerational Queer Family

Combining queer theorizing, autoethnography, and relational dialectics theory (RDT), this essay examines how my lesbian mothers and donor struggle to define family, queer family, and their emerging familial identities as grandparents to my own donor-conceived daughter through the competing discourses of biology and history. I further explore how my parents engage their relational history as queer parents as salient models for understanding their emergent familial identities as queer grandparents, as well as how they talk about an anticipated queer grandparent relationship with my daughter in the future. Ultimately, this essay works to articulate a queer(spawn) relationality-one that possibly exists at the (non-)intersection of multiple liminalities-as a means of building on earlier mappings of queer relationality.

Becoming a cancer survivor: An experiment in dialogical health research

The article makes cancer survivorship the topic of an experiment in a form of writing we call dialogical response. First, in the style of autoethnography, each author presents an account of her or his long-term survivorship of cancer and the issues that involves. Less conventionally, we then respond each to the other's story. The article seeks to contribute to an in-depth understanding of long-term cancer survivorship. More important, we offer it as an example of a form of writing rarely practiced in health research: speaking to those who participate in research, rather than speaking about those people. Among the multiple theoretical implications that could be explored, we consider Foucault's concept of subjectification. Our argument is that recognising the discursive formulation of the subject can and should be complemented by recognition of the local, immediate dialogical formulation of subjects. Rather than presenting research findings about cancer survivors, we offer a performative enactment of survivorship as an ongoing process of dialogical exchange. We show ourselves, responding to each other, in the process of becoming the cancer survivors we are as a result of those responses.

Domesticating the condition: Design lessons gained from a marathon on how to cope with barriers imposed by type 1 diabetes

Through analytical autoethnographic analysis of marathon preparation, this study examines challenges faced by people with Type 1 Diabetes (T1D) who engage in high-performance sports. Autoethnographer and second-person perspectives (T1D runners, family members, and health providers) were collected through introspective activities (autoethnographic diary and in-depth interviews) to understand the T1D runner's coping experience. Six insights involved in T1D self-management were identified and analyzed with reference to related design tools (prototyping, archetyping and journey mapping). Finally, we conclude with a discussion of how endurance physical activity (PA) such as running helps to "domesticate" T1D, a term coined to reflect the difficulties that T1D presents for PA accomplishment and how T1D runners' experiences give them an opportunity to overcome PA barriers promoting physical culture and enriching further health psychology studies.

The Sonic Meanings of the Life and Death of My Disabled Brother: Listening as a Method for Qualitative Research

Long neglected listening is an underdeveloped element in western epistemology in general and in qualitative research in particular. However, recent developments in philosophy, sound art, anthropology, and qualitative research open promising pathways for mastering listening as a method and metaphor of inquiry also in health research, where understanding multiple layers of emotionally challenging experiences is crucial, yet often elusive. Through a sonic analysis of autobiographical data about life, death, and my disabled brother, I will try to demonstrate how paying attention to listening and sounds in research can add evolving layers of meaning to the data gathering and analyzing processes. Ultimately, such an analysis provides insights into a sibling's role as a caregiver by revealing mechanisms of nonconscious emotional coping and also into the acts of a disabled sibling as a teacher of subtle ways of listening.

Cutting our own keys: New possibilities of neurodivergent storying in research

LAY ABSTRACT

A lot of people who do research are also neurodivergent (such as being autistic or attention deficit hyperactivity disorder), but neurodivergent people do not always feel welcome in research spaces which are often shaped around neurotypical people. Some neurotypical researchers lack confidence in talking to neurodivergent people, and others feel like neurodivergent people might not be able to do good research about other people who are like them without being biased. We think it is important that all researchers are able to work well together, regardless of whether they are neurotypical, autistic, or attention deficit hyperactivity disorder (or any other neurotype) - in truly 'neurodiverse' teams. In this article we talk about how to create better spaces for all researchers, where we feel valued for who we are and take each others' needs into account. We do this using some approaches from other areas of research and talking about how they relate to our personal experiences of being neurodivergent researchers with our own personal stories. This article adds to a growing work on how we can work with people who are different from us, in more respectful and kind ways.

Precarious privilege in the time of pandemic: A hybrid (auto)ethnographic perspective on COVID-19 and international schooling in China

Although the impact of the global COVID-19 pandemic in terms of school closure and the sudden shift to online learning has started to be explored, little has so far been written about the impact on teachers. This paper addresses this gap by drawing on the first author's autoethnographic experiences of working in the growing body of 'non-traditional' international schooling in Shanghai, China, during the first wave of the pandemic in early 2020. These experiences are complemented by insights from other teachers from the author's school site, leading to a hybrid (auto)ethnographic perspective. By utilising and developing the emergent concept of 'precarious privilege', we can see that whilst the pandemic has restricted teachers' movements and agency in a physical sense through lockdowns and travel restrictions, this immobility also fosters new symbolic and physical spaces, which in turn give rise to new forms of privilege. The privilege in this context is not financial, as is often the case, but rather existential (reclaiming a more authentic self) and spatial (the school offers teachers security) in nature. This fresh, nuanced approach to discussing precarity is timely and necessary. Given the novelty of the situation we now find ourselves in, new positionings are required to orient the individual and the researcher to a post-pandemic world. This paper offers one such positioning in the form of autoethnography for (re)imagining precarity and privilege in international schooling within the context of an emerging new world.

Exploring the translation process for multilingual implementation research studies: a collaborative autoethnography

Introduction

In an increasingly globalised and interconnected world, evidence to evaluate complex interventions may be generated in multiple languages. However, despite its influence in shaping the evidence base, there is little literature explicitly connecting the translation process to the goals and processes of implementation research. This study aims to explore the processes and experience of an international implementation research team conducting a process evaluation of a complex intervention in Tibet Autonomous Region, China.

Methods

This study uses a collaborative autoethnographic approach to explore the translation process from Chinese or Tibetan to English of key stakeholder interview transcripts. In this approach, multiple researchers and translators contributed their reflections, and conducted joint analysis through dialogue, reflection and with consideration of multiple perspectives. Seven researchers involved with the translation process contributed their perspectives through in-depth interviews or written reflections and jointly analysed the resulting data.

Results

We describe the translation process, synthesise key challenges including developing a ‘voice’ and tone as a translator, conveying the depth of idioms across languages, and distance from the study context. We further offer lessons learnt including the importance of word banks with unified translations of words and phrases created iteratively during the translation process, the need to collaborate between translators and the introspective work necessary for translators to explore their positionality and reflexivity during the work. We then offer a summary of these learnings for other implementation research teams.

Conclusion

Our findings emphasise that in order to ensure rigour in their work, implementation research teams using qualitative data should make concerted effort to consider both the translation process as well as its outcomes. Given the numerous multinational or multilingual implementation research studies using qualitative methods, there is a need for further consideration and reflection on the translation process.

Remote schooling during a pandemic: Visibly Muslim mothering and the entanglement of personal and political

This experimental double-conscious autoethnography narrates my navigation of remote learning after the COVID-19 outbreak between mid-March and early June 2020 as an apparent Muslim mother at a public school in upstate New York. To this end, using handwritten notes in a daily journal, I first delineated the process of becoming a visibly Muslim mother, which started earlier and reached a head after moving to the United States in 2018. In this way, using an autoethnographic style based on my experience of remote learning as a Muslim mother, I will present a dialog with feminist insights to reiterate that personal experience and cultural experience are incapable of being disentangled, that personal experience matters, and that all experience, however personal or private, is structured in a broader political and historical context.

Expanding collaborative autoethnography into the world of natural science for transdisciplinary teams

Wicked problems such as climate change and the COVID-19 pandemic require authentically transdisciplinary approaches to achieving effective collaboration. There exist several research approaches for identifying the components and interactions of complex problems; however, collaborative autoethnography provides an empirical way to collect and analyze self-reflection that leads to transformative change. Here, we present a case study of collaborative autoethnography, applied as a tool to transform research practice among a group of natural and social scientists, by constructively revealing and resolving deep, often unseen, disciplinary divides. We ask, "How can natural and social scientists genuinely accept, respect, and share one another's approaches to work on the wicked problems that need to be solved?" This study demonstrates how disciplinary divisions can be successfully bridged by open-minded and committed collaborators who are prepared to recognize the academic bias they bring to their research and use this as a platform of strength.

Experiences of Being Cared-For: The Perspective of an Expert-by-Experience in Mental Health

It is difficult to understand what it feels like for people with mental ill-health to be cared-for and supported by family members; this experience is often little-explored. Narratives about caring have been increasingly written alongside first-person accounts of recovery, however, there is a dearth of literature written to gain the perspective of being cared-for because of mental distress. Thus, using autoethnography, I present three critical incidents occurring at different points in my recovery to enable exploration of experiences of being cared-for. Firstly, a critical incident at the point of acute unwellness is introduced, secondly an incident during a consultation with a health professional is highlighted, and finally a moment of transition when embarking on an independent life with my husband-to-be is described. I use autoethnography to connect "the autobiographical and personal to the cultural, social, and political". I consider how the identity of a carer is continually negotiated in a relationship with the service user in both the "private" and the "public" worlds during recovery. I reflect on how professionals can support both service users and carers in a triangle of care, by providing information and support, alongside promoting the development of independence and agency for the service user whilst in the caring relationship. Finally, I introduce a service model which promotes a family network approach to empower the service user, and highlight training programs on recovery that enable carers. I conclude by suggesting the potential of both approaches to support carers to promote the recovery of the service user.

Accessing Active Inference Theory through Its Implicit and Deliberative Practice in Human Organizations

Active inference theory (AIT) is a corollary of the free-energy principle, which formalizes cognition of living system’s autopoietic organization. AIT comprises specialist terminology and mathematics used in theoretical neurobiology. Yet, active inference is common practice in human organizations, such as private companies, public institutions, and not-for-profits. Active inference encompasses three interrelated types of actions, which are carried out to minimize uncertainty about how organizations will survive. The three types of action are updating work beliefs, shifting work attention, and/or changing how work is performed. Accordingly, an alternative starting point for grasping active inference, rather than trying to understand AIT specialist terminology and mathematics, is to reflect upon lived experience. In other words, grasping active inference through autoethnographic research. In this short communication paper, accessing AIT through autoethnography is explained in terms of active inference in existing organizational practice (implicit active inference), new organizational methodologies that are informed by AIT (deliberative active inference), and combining implicit and deliberative active inference. In addition, these autoethnographic options for grasping AIT are related to generative learning.

"Communitas in Crisis": An Autoethnography of Psychosis Under Lockdown

In this article, I use autoethnography to examine time spent on an acute psychiatric ward during the COVID-19 lockdown. I employ the device of "communitas in crisis" to emphasize the precarious nature of this experience and the extent to which, for myself at least, informal social interactions with fellow patients and "communitas" were significant features of my hospital experience and subsequent discharge. I suggest that a lack of emphasis on inpatient to inpatient relationships in the recovery literature is an omission and a reflection of psychiatry's authority struggles with both service users and professionals, along with a general perception of psychosis as individual rather than as a socially constructed phenomenon. I also suggest that, especially in the wake of greater social distancing, mental health and social services should safeguard against psychological and social isolation by creating more spaces for struggling people to interact without fear or prejudice.

Pattern Recognition: Using Rocks, Wind, Water, Anxiety, and Doom Scrolling in a Slow Apocalypse (to Learn More About Methods for Changing the World)

In 5 months of COVID isolation, living out of a suitcase in temporary housing, countless fractal patterns emerged. I can't say if I created these patterns by looking for them, or that I know the whole world by looking at a grain of sand. The truth of the matter is that it feels like the key for massive scale change is just in front of us, but slipping from our grasp. As we move through these days, weeks, and months, we have very little time before the difference recedes again. I address this matter of concern as a matter of method in performative grounded theory piece.

Time Across the Lines: Collaborative Wonderings Under COVID-19

In this article, we "write-to" time from an autoethnographic perspective. Working intra-actively via a dialogic play script form, we collaboratively wonder about time during our experiences of COVID-19 as it relates to a compression of offline into online spaces. Presenting conversations we've had together over email, WhatsApp, and Google docs, with the reviewers of this Special Issue, and with scholarship, we foreground three main questions: What does time mean? How has our sense of time changed? And what is the link between these meanings and changes and the relationship between online and offline spaces?

Logged in While Locked Down: Exploring the Influence of Digital Technologies in the Time of Corona

Based on a collaborative endeavor, we present an autoethnographic textual collage of three fictionalized narrative accounts produced as a result of an amalgam of personal experiences encountered during the corona pandemic. The narrative accounts serve as illustrating examples of and critical reflections on how the pandemic and the increased use of digital technologies during the pandemic have affected the experience of reality and (trans)formed thinking and social relations alike. The crisis invites us to reflect on how the current confinement saturated with the ubiquitous presence and influence of digital technologies can be used as an occasion for large-scale reflections.

Grief in Times of Corona (Envoi)

This autoethnographic poem tells of personal grief happening in a time of lockdown. It draws on the concept of chronotope, a discrete time and space unit, a parenthesis of sorts, which I have chosen to illustrate as a bubble. In our daily speech, we see bubbles as related to both time and space, now with the added meaning of close relationship of people, those who belong to the same COVID bubble. In this autoethnographic piece, relationships are mediated by technology which anchors our bubbles together, with multimodal links carrying affect and emotion.

Of Late Alarms, Long Queues, and Online Attendances: My Experiences of COVID Time

This essay has three autoethnographic, interconnected, temporal vignettes that narrate my lived pandemic experiences of mothering a teenage daughter, performing socially isolated housework, and teaching online classes. These personal experiences are located in specific Indian contexts through thick descriptions that accommodate more massive perspectives. Adapting Sarah Sharma's concepts of power-chronography and temporal politics, I problematize my COVID-enforced slow time, and explore more deeply how my fraught COVID time experiences intersect with the multiple COVID times of others. I use this methodological format-autoethnography, thick description, and theorization-to make sense of my pandemic experiences at both microscopic and massive levels.

From iatrogenic harm to iatrogenic violence: corruption and the end of medicine

This paper seizes Ivan Illich's recurring notion of corruption to reflect on medicine's immanent spiral of maleficence. For Illich, the institutionalization of any 'good' necessarily corrupts it, and the institutionalization of health and care under the tutoring hand of medicine has produced counterproductive consequences on every plane. The paper explores the nemetic character of contemporary biomedicine - whose growth in technique has meant a corresponding growth in its capacity for corruption and harm - in an autoethnographic project that apprises and names the escalation from iatrogenic harm to iatrogenic violence that the author discovered at two UK hospitals in 2014. In January, she went to the hospital for a colonoscopy; in November, she finally left, disabled and unmade. In the interim, she suffered infection, sepsis, pneumonia, cardiac arrest, and - worst of all - a factitious psychiatrizing diagnosis embedded in spiralling loops of iatrogenic harm. By reflecting critically on this experience, interlocuting personal memory and writings with doctors' inscribed notes and insights from medical anthropology, the paper elucidates an iatrogenic spiral, showing how unknowable bodies pose an insurmountable epistemic and existential challenge to medicine's technic mandate, how medicine locates and uses an 'epistemic escape valve' in the face of such challenges, and how snowballing nosocomial harm escalates into brutality and vice. The argument, in short, is that iatrogenic violence (destructive, subjective or agentic, and intentional) is the natural endpoint of iatrogenic harm (destructive but objective or systemic, and unintentional).

An autoethnography of pregnancy and birth during Covid times: Transcending the illusio of overwork in academia?

Under the pressure of always increasing demands of publication, excessive working hours are widespread in academia. Based on an autoethnography of myself as a pregnant woman under Covid, I explore the extent of my being caught by the illusio–“being taken in and by the game” (Bourdieu & Wacquant, 1992), that prompted me to remain absorbed by the publishing game and to overwork until the very last day before giving birth to my son. I also explore how the forced deceleration induced by the maternity leave as well as the Covid confinement contributed to increased awareness and reflection thus helping me to transcend the illusio that prompted me to overwork. I also reflect to the extent of this conversion being reversible given the continued pressures of the academic context.

We have never been so bounded: Pandemic, territoriality, and mobility

In this intervention, I examine the bordering dynamics in the nomosphere configured by the global pandemic crisis and their territorial consequences, drawing on an autoethnography of the impact of bordering on everyday life and academic practices. On the one hand, I rely on my observation of Switzerland, and Europe in general, to discuss the bodily and everyday experiences with borders at different scales; on the other, as a British National (Overseas) passport holder in an attempt to get access to Taiwan for doing fieldwork, I document the difficulties in dealing with the border control, showing how the influence of geopolitics and contested identities on the research praxis is complicated by bordering during the pandemic. These legal geographies of territoriality demonstrate that borders are not only constantly becoming and fluid, but also more discursively present and materially visible during the pandemic than other times. The work of bordering, I argue, produces an uneven geography which deserves our attention.

Journaling the COVID‐19 pandemic: Locality, scale, and spatialised bodies

COVID‐19 has reconfigured, reaffirmed, and revealed socio‐material geographies in Australia and around the world. The pandemic is international but experiences of it exist in situated contexts. From strategies organising the human body by placing tape on supermarket floors to those using helicopter surveillance to identify illegal Easter barbecues, the impacts of COVID‐19 are mediated across different scales and are not experienced equally. In this article, I show how the COVID‐19 pandemic has revealed and compounded injustices and presented an opportunity to confront them. COVID‐19 is expressed via the production and circulation of meaning and diverse practices involving or implicating bodies, localities, and scales; among them one might include the advent of social distancing, the invention of “Fortress Tasmania,” from whence this work is written, and the constitution of bodies as dangerous yet vulnerable. I use autoethnography as an early career researcher and student trying to make sense of the COVID‐19 pandemic. This situated experience offers empirical diversity, context, and evocative narratives to enrich understandings of COVID‐19. The autoethnography is both a therapeutic outlet for a journaling, isolating honours student in suburban Tasmania and an attempt to make sense of body, locality, and scale in the geographies of pandemic.

Public health crises compounded: A high school equivalency context in the time of a pandemic

High school equivalency (HSE) is a recognised alternative to a high school diploma in the United States. It offers an opportunity to a range of disadvantaged adult learners such as school dropouts, refugees etc. to attain an educational certificate enabling them to move on in their life. This article presents an autoethnographic case study of a non-profit HSE programme in Philadelphia during the COVID-19 pandemic. The four authors of this article, all of them instructors on the front line of the youth crisis in adult education, explore the broader context of non-governmental organisation (NGO) management and privatised HSE exams. In their research and their reflections, they found that the pandemic exacerbated existing economic and social inequalities, with both pre-pandemic and current delivery of their HSE programme failing to address the survival needs of a population which has long been living in crisis. Juxtaposing relevant youth-in-crisis literature with narratives both from before the pandemic and whilst living through it, the authors of this article discuss the funding and institutional constraints around the environment in which they teach. Their case study sheds light on competing priorities within the non-profit education landscape, highlighting both pitfalls and successes in HSE curriculum and administration. The authors conclude that rapid adaptation to online teaching tools, platforms and products is not the panacea that many outcomes generators would like it to be.

Thematic Analysis of My "Coming Out" Experiences Through an Intersectional Lens: An Autoethnographic Study

For lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, identity development is one of the most critical developmental task. LGBTQ youth are shown to be at risk for a variety of risk factors including depression and suicidal ideation and attempts due to how their identities are appraised in heteronormative societies. However, most LGBTQ educational psychology research have highlighted protective factors that are primarily relevant to support LGBTQ white-youth. One of the major developmental theories, Erikson’s stages of psychosocial development, has identified adolescence as the period where identity development occurs. However, through an intersectional lens, identity development appears to encompass more than adolescence but also emerging adulthood, a developmental stage not accounted for by Erikson’s stages of psychosocial development. The primary goal of this study is to seek to understand and question Erikson’s stages of psychosocial development through an intersectional lens of an autoethnography of my LGBTQ experiences. An autoethnographic approach [diary entries (N = 9), conversations (N = 12), interview (N = 1), social media websites and blogs (N = 2), and drawing (N = 1)] is used to understand my LGBTQ-person of color (POC) experiences of “coming out” or self-disclosure during my adolescence through emerging adulthood. Data was collected on April 2020 and spanned from 2006 through 2020 to account for the developmental period of adolescence and emerging adulthood (ages 13 through 27). Thematic analysis revealed four themes across the two developmental periods: (1) confusion and conflict between my gay and ethnic identity as a closeted adolescent, (2) my first “coming out” as a gay adolescent and “it got better,” (3) frustration arising from the internal conflict between my gay and POC identity as an emerging adult, and (4) frustration arising from external experiences with the flaws of LGBTQ community inclusivity. Results reflected a continuous theme of identity exploration and struggle through both adolescence and emerging adulthood, highlighting the need for future research to replicate similar experiences from other intersectional individuals during emerging adulthood stage, a developmental stage that is considered in between Erikson’s adolescent and young adulthood developmental stage.

'Satan is holding your tongue back': Stuttering as moral failure

Background

The last decade has seen researchers and speech–language pathologists employ and advocate for a disability studies approach in the study of the lived experiences of people who stutter and in the design of interventions and treatment approaches for such individuals. Joshua St. Pierre, one of the few theorists to explore stuttering as a disability, mentions as a key issue the liminal nature of people who stutter when describing their disabling experiences.

Objectives

This article aimed to build on the work of St. Pierre, exploring the liminal nature of people who stutter.

Method

Drawing on my personal experiences of stuttering as a coloured South African man, I illuminated the liminal nature of stuttering.

Results

This analytic autoethnography demonstrates how the interpretation of stuttering as the outcome of moral failure leads to the discrimination and oppression of people who stutter by able-bodied individuals as well as individuals who stutter.

Conclusion

As long as stuttering is interpreted as the outcome of moral failure, the stigma and oppression, as well as the disablism experience by people who stutter, will continue to be concealed and left unaddressed.

The Covid-Shock Doctrine: Under the Tutorship of CoV-2, the Voice(s) From Poland

These are two autoethnographic voices. We speak in a strange time: democracy dies, social justice dies. A lot of people have died of the virus, many die of fear. We write to protest against new neoliberal and neoconservative "shock doctrine." We write together to protest against destructive self-absorption, isolation, and fear. It is protest-text. But we are not sure what we can do now.

Autoethnography of a Novice Teacher's Assessment Literacy in Elementary Physical Education

Purpose: The purpose of this study was to examine how a novice teacher (researcher) has developed his assessment literacy in elementary physical education (PE), and thereby investigating what cultural, micropolitical and sociological factors have impacted on his enactment of assessment literacy.

Method: Adopting autoethnography, this study investigated   theresearcher as a subject and an object of research in the pursuit of extending the personal to the social. The 4 years of narrative data collected from the researcher’s reflective journals, self-recalling, and artefacts on PE assessment were analysed using structural narrative analysis and reiterative process.

Findings and discussion: The findings revealed that thenovice teacher developed his assessment literacy in a chronological order: (a) assessment illiterate, (b) assessment literate, and (c) assessment aliterate. The cultural, micropolitical and sociological factors that have impacted on the teachers’ enactment of assessment literacy were discussed: (a) rampant complacency in elementary teaching culture: a bad judge or a good bystander?, (b) uniform culture of grade-level teams, and (c) distorted PE professionalism focusing on “hows”, not “whys”.

Conclusion: The novice teacher’s enactment of assessment literacy in elementary PE was not only related to himself but also to the school culture, grade level team, and PE professionalism where he belonged.

Shared Decision-Making: An Autoethnography About Service User Perspectives in Making Choices About Mental Health Care and Treatment

Shared decision-making (SDM) between mental health medication prescribers and service users is a central pillar in the recovery approach, because it supports people experiencing mental ill-health to explore their care and treatment options to promote their well-being and to enable clinicians to gain knowledge of the choices the service user prefers. SDM is receiving increasing recognition both in the delivery of physical and mental health services; and as such, is of significance to current practice. As an expert-by-experience with over 30 years of receiving mental health treatment, I have made many choices about taking medication and accessing other forms of support. The experiences of SDM have been variable over my career as a service user: both encounters when I have felt utterly disempowered and interactions when I have led decision-making process based on my expertise-by-experience. In this article, I recount two experiences of exploring care and treatment options: firstly, a discharge planning meeting; and secondly, the choice to take medication over the long-term, despite the side effects. The article will explore both opportunities and barriers to effective shared decision-making, as well as skills and processes to facilitate this approach. The need to balance power between service users and professionals in this interaction is highlighted, including the need to respect expertise built on lived experience, alongside that of clinical expertise. This narrative is framed within an autoethnographic approach which allows me to contextualize my personal experiences in the wider environment of mental health care and support.

Potential Space in Hospitals: Insight From a Health Psychologist

OBJECTIVE

Humanization is a challenge for the future of healthcare. Architecture may play a major role in designing spaces that enhance communication and help the patient to maintain mental health during physical illness. Health psychologists struggle to find adequate space for taking care of their patients. There is an urgent need to better define how relational space, defined here as potential, can be guaranteed in everyday hospital psychological consultations.

BACKGROUND

The author relates to his work as a health psychologist and psychotherapist in a consultation-liaison psychiatry (CLP) service operating in a general hospital in Lugano (Switzerland).

METHODS

An autoethnographic method is applied through calling on childhood memories on architecture and analyzing insights regarding the healthcare space in everyday work as a psychologist. Photographs and drawings are employed as evocative material.

RESULTS

Autoethnographical data show that building interiors can be a metaphor for an inner dimension. Spaces can be perceived as depersonalized in hospital. Through psychoanalytical theory, it is argued that space becomes ideal for CLP if it can ensure the continuity of the patient's self during hospitalization. Proximity, confidentiality, and privacy are healthcare design requirements to be considered for favoring potential space and psychological intervention.

CONCLUSION

Fostering potential space represents an outstanding challenge for the hospital of tomorrow in order to humanize healthcare spaces and promote a person-centered approach.

Autoethnography as a Strategy for Engaging in Reflexivity

Reflexivity is a key feature in qualitative research, essential for ensuring rigor. As a nurse practitioner with decades of experience with individuals who have chronic diseases, now embarking on a PhD, I am confronted with the question “how will my clinical experiences shape my research?” Since there are few guidelines to help researchers engage in reflexivity in a robust way, deeply buried aspects that may affect the research may be overlooked. The purpose of this paper is to consider the affordances of combining autoethnography (AE) with visual methods to facilitate richer reflexivity. Reflexive activities such as free writing of an autobiographical narrative, drawings of clinical vignettes, and interviews conducted by an experienced qualitative researcher were analyzed to probe and make visible perspectives that may impact knowledge production. Two key themes reflecting my values—fostering advocacy and favoring independence and autonomy were uncovered with this strategy.

Mental health nursing in bushfire-affected communities: An autoethnographic insight

There is no literature to guide mental health nursing in bushfire-affected communities. Using autoethnographic methods, the author reflects on his experience of mental health nursing during the Australian bushfires of 2019-20 and the challenges of identifying existing practice guidance. Applying an existing nursing model and insights from gestalt, he analyses his field notes to identify and describe practices which he found important and useful for working with bushfire-affected persons and communities. Eight suggestions are provided to assist mental health nurses to practise in an informed way and promote recovery. This paper makes a contribution to a small body of existing mental health nursing research using autoethnographic methods, and it is the first contribution to the mental health nursing literature about working with bushfire-affected persons and communities.

Experiences of a Teacher in Relation to the Student's Feelings of Learned Helplessness

This paper is based on the concern of a novice physical education teacher to reinforce the self-esteem and motor competence sensations of students during lessons. This concern arises from the experiences gained as a student. I draw on autobiographical narratives to delve into how these experiences led me to develop a feeling of learned incompetence, a sense of failure within the educational system and, consequently, an obvious difficulty to shape my personal and professional identity. However, it is these same experiences that condition professional development and teaching practice. Thus, I attempt to break from pedagogical models and to offer a dignified and democratic education to students. I attempt to engage the reader by communicating the subjectivity of different moments in a provocative, fragmented, physical, and emotional manner. Thus, I share the concerns, reflections, and manner of working, as a teacher, in the form of autobiographical reports and class journals. The intention is to understand how this manner of working responds to the feelings of incompetence learned by school children.