Dermatology residents as educators: a qualitative study of identity ... - BMC Medical Education

The data revealed rich insights into educator identity formation amongst dermatology residents. Overall, 20 participants took part in the study in years 2, 3, 4 of the 4-year residency program. Seventeen participants were female and 3 were male. Based on the 60 written reflections and 20 interviews, themes were broadly categorized according to research question. The first research question comprised of participants' views and experiences of education and educational practice in medicine. These themes include definitions of education, the process of education, and the various identities formed by residents. For the second research question regarding professional development programs one theme is highlighted. Appendix C: Analysis Framework includes the cascade of research questions, themes, sub-themes, their definitions, and number of found quotes in each sub-theme. In what follows, the themes are organized according to our research questions.

How do dermatology residents form identities as educators?

Defining education

In response to the question 'Who am I as an educator?' participants wrote in their personal professional portfolios and shared during the interviews: definitions of education, attributes of a good educator, and their aspirations of becoming a better educator. Some residents defined education within the confines of the residency program:

"So as part of our residency program we're kind of obligated to give lectures that are carried out as part of the training. Those lectures are either joint or within the hospital that we rotate in. This is one of our roles as educators." (Resident 5_Interview)

Another participant defined education more holistically, drawing attention to the environment:

"I mean, to me, it's the cultivating, supportive, and professional relationship you have. The encouragement of self-inquiry and research and reflective activity is going to culminate into allowing you to be part of this educator establishment or educational establishment. In my career, I don't think I– it's not the process of teaching itself. It's the entire environment you're in" (Resident 8_Interview)

Another participant defined education beyond residency:

"I'm the eldest of the family among my brothers and sisters. So I always try to share my experiences with my brothers and sisters…give advice. I'm always willing to help out with their studies if someone has difficulty understanding a certain topic. My younger sister was enrolled in medical school for a while, so I was helping her out with that" (Resident 9_Interview)

Some participants described attributes of being a successful educator, suggesting that being a good educator, required committing to lifelong learning, having an ability to design and communicate:

"In my opinion, to be a successful educator, a person needs to be a lifelong learner in the first place, a designer who's able to simplify and deliver information using creative teaching methods and lastly a good communicator who can discuss and view knowledge from different perspectives" (Resident 13_Written reflection)

Participants reflected on their aspirations of becoming better educators by engaging in informal activities with juniors. These authentic personal experiences, as reported by participants, helped them become better learners:

"Yes. So I do group studies, and most of the time, I've been teaching more junior residents, and I found it really helpful for me, more than the residents themselves…I'll never forget it if I give it to someone or if I explain it." (Resident 15_Interview)

The process of education

Participants reflected on how they went about educating others. One participant conceptualized education as prioritizing and guiding learners to appropriate learning resources:

"Sharing important resources and highlighting important topics is more important than offering a piece of information that might be forgotten at the end of the day." (Resident 17_Written reflection)

Some participants spoke of education as an act of paying it forward, as a resident shared:

"because if you get benefits from those sessions from the people who are senior to you at that time, it's like a mandate in a way to give it to the juniors." (Resident 12_Interview).

The process of education was also viewed as context-based: in the clinical setting or in the lecture hall.

"Being an R3 resident we're also sharing information during clinics with our colleague residents…This is my role as an educator." (Resident 20_Interview)

Educator identity formation

In written reflections and in some of the early interviews, participants struggled with their identity as an educator as one participant shared:

"Okay. Actually, I don't find myself that much as an educator. But I have things I did in my med school, also during residency. We did summaries, we did lectures, we did seminars, we did also some lectures during our residency. Those are the things that I did, and I don't find them that much for a purpose as education. I think I have to fulfill all the things that I need, then I can be educator. Uh-huh. So– Yeah, I have to gain all the knowledge I need, then, I can deliver it to people" (Resident 15_Interview)

While overtime and during interviews conducted months after the program, other residents began to form educator identities in several multifaceted ways:

Educator as leader

"After the program, I have ambitions of creating more dermatology programs. I can do it, now that I know about the need. We don't have many (programs) in Saudi Arabia" (Resident 13_Interview)

Educator as simplifier

"Some people tell me that I'm good at teaching. I try to simplify ideas as much as I can. I've had the sort of feedback before that I simplify what people find difficult. And people usually tend to come to me to explain certain things that they find difficult. However, I don't think I'm an excellent educator. I'm still working on that aspect, but I'm always willing to help." (Resident 13_Interview).

Educator as knowledge curator

In the following quote, the participant forms their identity as an educator, and speaks using plural pronouns:

"We do a formal topic review, which is our Tuesday activity. So you've been assigned to a certain topic, and you're going to read through this topic from different resources, and then you're going to approach it in a way where it's presentable and simplified for your colleagues to learn about and to know. This is the formal aspect of it. But then you have the broader part of this process which is the journal club reviews, for example, or the grand rounds. This is the time to challenge and to explore. So if it's the journal club, you're going to decide which, for– you're going to be given options to read, for example, from different journals out there, and then you're going to choose a topic of interest, and you're going to explore that. So you're going to learn how to– this is your own learning experience. Then you're going to relay it to the rest." (Resident 19_Interview).

Educator as community advocate

In the following quote, one resident shares the positive influence of being a part of a community:

"As an educator, I love doing teaching sessions because it gives me a positive feeling. It gives me motivation. It gives me a feeling that I helped my community; I helped my colleague. And it's like retaining the feeling" (Resident 6_Written reflection).

Educator as self-motivated

One resident explained how he self-motivated:

"Of course self-motivation is one of the cards as a teacher that helped me encourage myself before giving any session to any group, I motivate myself saying that: you can do it! This is a small group." (Resident 16_Interview).

Educator as learner

In the following quote, a participant shared the need to recognize being a learner in order to be a good educator:

"You need to have an open-minded approach to learning. As a learner to be able to educate from anything that is surrounding you. So it is a process. It's not something that you can take. It's not a certificate that you can just work for. It's a lifelong process of learning." (Resident 17_interview).

Educator as collaborator

In the following quote the participants highlight the role of reciprocity in education:

"It's always a two-way street. You need the other person, the recipients to want to learn or to want to be good teachers. If you teach a person who doesn't want to be taught, you're going to waste your time. It's going to have to be a two-way street." (resident 9_Interview).

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