Transformative learning and professional identity formation during international health electives: A qualitative study using grounded theory

Academic Medicine

Volumn 93, Issue 9, 2018, Pages 1381-1390

  Sawatsky, Adam P ^a   Nordhues, Hannah C ^a   Merry, Stephen P ^a   Bashir, M Usmaan ^a   Hafferty, Frederic W ^a  

^a MAYO CLINIC   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CLINICAL COMPETENCE; DOCTOR PATIENT RELATIONSHIP; FEMALE; GLOBAL HEALTH; GROUNDED THEORY; HUMAN; MALE; MEDICAL EDUCATION; PROCEDURES; QUALITATIVE RESEARCH; SOCIAL BEHAVIOR;

CLINICAL COMPETENCE; EDUCATION, MEDICAL; FEMALE; GLOBAL HEALTH; GROUNDED THEORY; HUMANS; MALE; PHYSICIAN-PATIENT RELATIONS; QUALITATIVE RESEARCH; SOCIAL IDENTIFICATION;

EID: 85056446764     PISSN: 10402446     EISSN: 1938808X     Source Type: Journal    
DOI: 10.1097/ACM.0000000000002230     Document Type: Article

References (46)

1. Association of American Medical Colleges. Medical School Graduation Questionnaire: 2015 All Schools Summary Report. Washington, DC: Association of American Medical Colleges; 2015.
2. Drain PK, Holmes KK, Skeff KM, Hall TL, Gardner P. Global health training and international clinical rotations during residency: Current status, needs, and opportunities. Acad Med. 2009;84:320-325.
3. Anspacher M, Frintner MP, Denno D, et al. Global health education for pediatric residents: A national survey. Pediatrics. 2011;128:e959-e965.
4. Tupesis JP, Babcock C, Char D, Alagappan K, Hexom B, Kapur GB. Optimizing global health experiences in emergency medicine residency programs: A consensus statement from the Council of Emergency Medicine Residency Directors 2011 Academic Assembly global health specialty track. Int J Emerg Med. 2012;5:43.
5. Sawatsky AP, Rosenman DJ, Merry SP, McDonald FS. Eight years of the Mayo International Health Program: What an international elective adds to resident education. Mayo Clin Proc. 2010;85: 734-741.
6. Nordhues HC, Bashir MU, Merry SP, Sawatsky AP. Graduate medical education competencies for international health electives: A qualitative study. Med Teach. 2017;39:1128-1137.
7. Thompson MJ, Huntington MK, Hunt DD, Pinsky LE, Brodie JJ. Educational effects of international health electives on U.S. and Canadian medical students and residents: A literature review. Acad Med. 2003;78: 342-347.
8. Grudzen CR, Legome E. Loss of international medical experiences: Knowledge, attitudes and skills at risk. BMC Med Ed. 2007;7:47.
9. Gladding S, Zink T, Howard C, Campagna A, Slusher T, John C. International electives at the University of Minnesota global pediatric residency program: Opportunities for education in all Accreditation Council for Graduate Medical Education competencies. Acad Pediatr. 2012;12:245-250.
10. Battat R, Seidman G, Chadi N, et al. Global health competencies and approaches in medical education: A literature review. BMC Med Educ. 2010;10:94.
11. Gruppen LD, Mangrulkar RS, Kolars JC. The promise of competency-based education in the health professions for improving global health. Hum Resour Health. 2012;10:43.
12. Bazemore AW, Goldenhar LM, Lindsell CJ, Diller PM, Huntington MK. An international health track is associated with care for underserved US populations in subsequent clinical practice. J Grad Med Educ. 2011;3:130-137.
13. Umoren RA, Gardner A, Stone GS, et al. Career choices and global health engagement: 24-year follow-up of U.S. participants in the Indiana University-Moi University elective. Healthc (Amst). 2015;3:185-189.
14. Cooke M, Irby DM, O'Brien BC. Educating Physicians: A Call for Reform of Medical School and Residency. San Francisco, CA: Jossey-Bass; 2010.
15. Cruess RL, Cruess SR, Steinert Y. Amending Miller's pyramid to include professional identity formation. Acad Med. 2016;91:180-185.
16. Merton RK. Some preliminaries to a sociology of medical education. In: Merton RK, Reader LG, Kendall PL, eds. The Student Physician: Introductory Studies in the Sociology of Medical Education. Cambridge, MA: Harvard University Press; 1957:3-79.
17. Jarvis-Selinger S, Pratt DD, Regehr G. Competency is not enough: Integrating identity formation into the medical education discourse. Acad Med. 2012;87:1185-1190.
18. Kegan R. The Evolving Self: Problem and Process in Human Development. Cambridge, MA: Harvard University Press; 1982.
19. Wenger E. Communities of Practice: Learning, Meaning and Identity. Cambridge, UK: Cambridge University Press; 1998.
20. Gonzalo JD, Thompson BM, Haidet P, Mann K, Wolpaw DR. A constructive reframing of student roles and systems learning in medical education using a communities of practice lens. Acad Med. 2017;92:1687-1694.
21. Cruess RL, Cruess SR, Boudreau JD, Snell L, Steinert Y. A schematic representation of the professional identity formation and socialization of medical students and residents: A guide for medical educators. Acad Med. 2015;90:718-725.
22. Mezirow J. Transformative learning: Theory to practice. New Dir Adult Contin Educ. 1997;74:5-12.
23. Mezirow J. Transformative learning theory. In: Mezirow J, Taylor EW, eds. Transformative Learning in Practice: Insights From Community, Workplace and Higher Education. San Francisco, CA: Jossey-Bass; 2009:18-31.
24. Taylor EW. Fostering transformative learning. In: Mezirow J, Taylor EW, eds. Transformative Learning in Practice: Insights From Community, Workplace and Higher Education. San Francisco, CA: Jossey-Bass; 2009:3-17.
25. Taylor EW. An update of transformative learning theory: A critical review of the empirical research (1999-2005). Int J Lifelong Educ. 2007;26:173-191.
26. Irby DM, Cooke M, O'Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med. 2010;85:220-227.
27. Holden MD, Buck E, Luk J, et al. Professional identity formation: Creating a longitudinal framework through TIME (Transformation in Medical Education). Acad Med. 2015;90:761-767.
28. Charmaz K. Constructing Grounded Theory. 2nd ed. Thousand Oaks, CA: Sage Publications; 2014.
29. Petrosoniak A, McCarthy A, Varpio L. International health electives: Thematic results of student and professional interviews. Med Educ. 2010;44:683-689.
30. Elit L, Hunt M, Redwood-Campbell L, Ranford J, Adelson N, Schwartz L. Ethical issues encountered by medical students during international health electives. Med Educ. 2011;45:704-711.
31. Kumwenda B, Royan D, Ringsell P, Dowell J. Western medical students' experiences on clinical electives in sub-Saharan Africa. Med Educ. 2014;48:593-603.
32. Button L, Green B, Tengnah C, Johansson I, Baker C. The impact of international placements on nurses' personal and professional lives: Literature review. J Adv Nurs. 2005;50:315-324.
33. van den Heuvel M, Au H, Levin L, Bernstein S, Ford-Jones E, Martimianakis MA. Evaluation of a social pediatrics elective: Transforming students' perspective through reflection. Clin Pediatr (Phila). 2014;53: 549-555.
34. Crump JA, Sugarman J; Working Group on Ethics Guidelines for Global Health Training (WEIGHT). Ethics and best practice guidelines for training experiences in global health. Am J Trop Med Hyg. 2010;83:1178-1182.
35. Wilson JW, Merry SP, Franz WB. Rules of engagement: The principles of underserved global health volunteerism. Am J Med. 2012;125:612-617.
36. Taylor EW. Transformative learning theory: A neurobiological perspective of the role of motions and unconscious ways of knowing. Int J Lifelong Educ. 2001;20:218-236.
37. Dirkx JM. Engaging emotions in adult learning: A Jungian perspective on emotion and transformative learning. New Dir Adult Contin Educ. 2006;109:15-26.
38. Cruess RL, Cruess SR. Professionalism and professional identity formation: The cognitive base. In: Cruess RL, Cruess SR, Steinert Y, eds. Teaching Medical Professionalism: Supporting the Development of a Professional Identity. 2nd ed. Cambridge, UK: Cambridge University Press; 2016.
39. Sandars J. The use of reflection in medical education: AMEE guide no. 44. Med Teach. 2009;31:685-695.
40. Lange EA. Transformative and restorative learning: A vital dialectic for sustainable societies. Adult Educ Q. 2004;54:121-139.
41. Aronson L. Twelve tips for teaching reflection at all levels of medical education. Med Teach. 2011;33:200-205.
42. Krug E, Kavanagh M. Ethical challenges faced by medical students. MedEdPORTAL. 2014;10:9679.
43. Rhodes-Kropf J, Carmody SS, Seltzer D, et al. "This is just too awful; I just can't believe I experienced that ": Medical students' reactions to their "most memorable" patient death. Acad Med. 2005;80:634-640.
44. Timmermans S, Angell A. Evidence-based medicine, clinical uncertainty, and learning to doctor. J Health Soc Behav. 2001;42: 342-359.
45. Engel KG, Rosenthal M, Sutcliffe KM. Residents' responses to medical error: Coping, learning, and change. Acad Med. 2006;81:86-93.
46. Wittich CM, Reed DA, McDonald FS, Varkey P, Beckman TJ. Perspective: Transformative learning: A framework using critical reflection to link the improvement competencies in graduate medical education. Acad Med. 2010;85:1790-1793.