ERIC Number: EJ984945
Record Type: Journal
Publication Date: 2012-Dec
Abstractor: As Provided
Reference Count: 67
"It's Just a Clash of Cultures": Emotional Talk within Medical Students' Narratives of Professionalism Dilemmas
Monrouxe, Lynn V.; Rees, Charlotte E.
Advances in Health Sciences Education, v17 n5 p671-701 Dec 2012
Recent investigations into the UK National Health Service revealed doctors' failures to act with compassion and professionalism towards patients. The British media asked questions about what happens to students during their learning that influences such behaviour as doctors. We listened to 200 medical students' narratives of professionalism dilemmas during workplace learning (n = 833) to understand the range of dilemmas experienced and emotional reactions to them. 32 group and 22 individual interviews were held across three medical schools (England, Wales, Australia). Data were analysed thematically (Framework Analysis), for negative emotional content (Linguistic Inquiry and Word Count) and a narrative analysis of one exemplar narrative was also conducted. While a wider range of professionalism dilemmas than previously identified were found, most were classified to five main sub-themes. Within these sub-themes, clinical students' narratives contained more negative emotion words than pre-clinical students' narratives (p = 0.046, r = -0.36). Narratives of "patient safety and dignity breaches by students" contained fewer anger words (p = 0.003, r = -0.51), "patient safety and dignity breaches by healthcare professionals" contained more anger words (p = 0.042, r = -0.37), "identity" narratives contained fewer anxiety words (p = 0.034, r = 0.38), and "abuse" narratives contained more sadness words (p = 0.013, r = -0.47). The narrative analysis revealed a complex interplay between identities, attribution of blame, narrated emotions and emotional residue. Analysing emotional talk within narratives suggests that medical students sometimes struggle with contradictory formal and informal learning experiences around professionalism arising from a cultural clash. We provide educational recommendations to facilitate students' coping with their emotional reactions to professionalism dilemmas and to facilitate cultural change.
Descriptors: Foreign Countries, Interviews, Discourse Analysis, Content Analysis, Medical Education, Physicians, Affective Behavior, Professional Identity, Negative Attitudes, Work Environment, Health Services, Safety, Workplace Learning, Psychological Patterns, Student Attitudes, Altruism, Patients, Medical Schools, Medical Care Evaluation, Medical Students, Clinical Teaching (Health Professions), Culture Conflict, Physician Patient Relationship
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Publication Type: Journal Articles; Reports - Research
Education Level: Higher Education; Postsecondary Education
Authoring Institution: N/A
Identifiers - Location: Australia; United Kingdom; United Kingdom (England); United Kingdom (Wales)