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      Narrative reflective practice in medical education for residents: composing shifting identities

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          Abstract

          As researchers note, medical educators need to create situations to work with physicians in training to help them attend to the development of their professional identities. While there is a call for such changes to be included in medical education, educational approaches that facilitate attention to the development of medical students’ professional identities, that is, who they are and who they are becoming as physicians, are still under development. One pedagogical strategy involves narrative reflective practice as a way to develop physician identity. Using this approach, medical residents first write narrative accounts of their experiences with patients in what are called “parallel charts”. They then engage in a collaborative narrative inquiry within a sustained inquiry group of other residents and two researcher/facilitators (one physician, one narrative researcher). Preliminary studies of this approach are underway. Drawing on the experiences of one medical resident in one such inquiry group, we show how this pedagogical strategy enables attending to physician identity making.

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          Most cited references18

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          The Body in the Mind: The Bodily Basis of Meaning in Imagination, and Reason

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            Creating pedagogical spaces for developing doctor professional identity.

            Working with doctors to develop their identities as technically skilled as well as caring, compassionate and ethical practitioners is a challenge in medical education. One way of resolving this derives from a narrative reflective practice approach to working with residents. We examine the use of such an approach. This paper draws on a 2006 study carried out with four family medicine residents into the potential of writing, sharing and inquiring into parallel charts in order to help develop doctor identity. Each resident wrote 10 parallel charts over 10 weeks. All residents met bi-weekly as a group with two researchers to narratively inquire into the stories told in their charts. One parallel chart and the ensuing group inquiry about the chart are described. In the narrative reflective practice process, one resident tells of working with a patient and, through writing, sharing and inquiry, integrates her practice and how she learned to be a doctor in one cultural setting into another cultural setting; another resident affirms her relational way of practising medicine, and a third resident begins to see the complexity of attending to patients' experiences. The process shows the importance of creating pedagogical spaces to allow doctors to tell and retell, through narrative inquiry, their stories of their experiences. This pedagogical approach creates spaces for doctors to individually develop their own stories by which to live as doctors through narrative reflection on their interwoven personal, professional and cultural stories as they are shaped by, and enacted within, their professional contexts.
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              Identity as an Analytic Lens for Research in Education

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                Author and article information

                Journal
                Adv Med Educ Pract
                Adv Med Educ Pract
                Advances in Medical Education and Practice
                Dove Medical Press
                1179-7258
                2011
                20 December 2010
                : 2
                : 1-7
                Affiliations
                [1 ]Center for Research for Teacher Education and Development, University of Alberta, Edmonton, Alberta, Canada
                [2 ]Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
                Author notes
                Correspondence: Jean Clandinin, Room 633, Education South, University of Alberta, Edmonton, Alberta T6G 2G5, Canada, Tel +1 780 492 7770, Fax +1 780 492 0113, Email jean.clandinin@ 123456ualberta.ca
                Article
                amep-2-001
                10.2147/AMEP.S13241
                3661238
                23745070
                44815e48-3c03-4d99-b23e-43de69a5a58d
                © 2011 Clandinin et al, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Original Research

                physician identity formation,residency
                physician identity formation, residency

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