#57 – Who are you? 

Episode host: Lara Varpio

Dr. Lara Varpio, portrait.
Photo: Erik Cronberg.

In this episode, we talk about curriculum renewal from a different angle: What happens to the educator’s identity when major reform is undertaken? What happens to that identity when content expertise is only part of what is now required? 

Episode article

Volschenk, M., & Hansen, A. (2024). Medical teachers’ identity learning during major curriculum renewal: A landscapes of practice perspective. Medical Teacher, 1–7.

Notes

Background 

This paper offers us the opportunity to think about a relatively standard medical education topic—i.e., curriculum renewal—from a different angle—i.e., when we change curriculum in a fundamental way (e.g., traditional biomedical focus changes to incorporate / highlight critical consciousness) what happens to the identity of the teachers?  When we change curricula in such a fundamental way, we are also simultaneously and fundamentally changing the role of the educators who delivers the curriculum. We are shifting their role from conveyor of knowledge to one that is also simultaneously a socially conscious agent (at minimum: someone who can teach individuals how to navigate social contexts; more commonly: the teacher is also a social activist who should advocate for equality and justice). As the authors of this paper write, this kind of change can have a real impact on individual teachers and their professional identity. The authors write, “should medical teachers perceive the requisite changes as incongruent with their existing professional identities, they may experience conflicting feelings about the advantages of incorporating a critical agenda and the implications thereof for their teaching role.” This could create identity dissonance if it challenges their sense of expertise. This impacts the curriculum renewal process too. We know that teacher identities shape the decisions they make about curricula. Teacher identities shape what they think should be taught, and how.  

Purpose

This paper asks an important question: How do medical teachers in an undergraduate medical education program navigate their professional identities when involved in major curriculum renewal.” 

Methods 

The data are from a four-year longitudinal multi-institution study carried out in South Africa that is studying the range of understandings that educators bring to teaching as they interpret the alternative philosophies and practices that are part of integrating critical consciousness alongside clinical competence in undergraduate medical curricula. They had 26 participants in the study, who were bio-medical scientists and clinicians involved in the classroom or clinical teaching in the program. They held 9 focus groups. During which participants indicated that there were important voices that were unable to be at the focus group but who should contribute to the study. So the authors also conducted 3 interviews with participants who represented those perspectives. They conducted the study using Braun and Clarke’s thematic analysis. And they brought theory into the process after inductive analysis was completed. So theory informed interpretations of those analyses. 

Results/Findings 

To understand the results, we need have a brief review of the theories they use in the study. We will do a SHORT and HIGH LEVEL review of two theories—i.e., the bare bones of what you need to know to understand the results of the study. 

First, the authors draw on concepts from Landscapes of Practice from Wenger-Trayner and Wenger-Trayner. Landscapes of practices builds on the theory of communities of practice. If a community of practice is a group of people who regularly work and learn together and from each other because they care about the same real life problems, the landscapes of practice focuses on how different communities of practice can interact, depend on each other and might even be accountable to each other in local situated practices. Knowledgeability is an outcome of learning at the level of the landscape, it is about understanding the landscape and the communities therein, about understanding the practices across the landscape, and about understanding how all of that is relevant to you and how you fit in the landscape and the practices across the landscape. Knowledgeability is supported by three modes of identification:  

  • Engagement encourages participation in the practices and discourses of various communities in the landscape to gain experience of the expectations of these communities.  
  • Alignment requires professionals to coordinate their activities and perspectives with the various communities of practice’s expectations of competence, thereby connecting to the broader systems and discourses of the landscape.  
  • Imagination involves constructing an image of one’s professional self in the landscape and exploring possibilities for the future self 

The authors also rely on 3 concepts from Teacher Identity theory. This theory looks at how teachers continuously construct, negotiate, and transform their professional identities in response to changing educational contexts, From this theory’s perspective, a major curriculum change is a boundary experience where teachers need to figure out how to function adequately and competently in this new set of expectations. This theory focuses on this sense making and says that there are four possible outcomes.  

  • Assimilation is when the teacher is able to fit new expectations into their existing frame of reference. They assimilate. 
  • Accommodation is when the teacher is able to transform current knowledge and belief to adapt to the new. So they can accommodate to the new situation. 
  • Tolerance is when the teacher accepts the new experience but they continue to use old ways of thinking, their previous frames of reference. So they just tolerate the new normal. 
  • Resistance is when the teacher rejects the new experience, and they dig in their heels and end up strengthening their old ways. 

The authors of this study start with the idea of engagement of moving into the curriculum renewal process. Some participants had deep rooted uncertainty about their identity as a teacher that created real resistance to the curriculum change. In fact, some participants alluded to having identities as clinicians and as scientists, OVER their role as teacher. In fact, some talked about how teaching wasn’t part of their employment contract. So, for some, the curriculum renewal highlighted that, in the landscape of practice, they lived in the interstitial fluid — between the old curriculum and the new curriculum, AND between disciplinary community and the teaching community. When it came to alignment, to coordinating and connecting their identity with the various communities of practice’s in the broader systems and discourses of the landscape, many participants experienced dissonance between who they were as a content expert and their new roles in the curriculum. They demonstrated some degree of accommodating to the new expectations, but there was also a lot of tolerance — in that several participants continued to draw on their primary professional identity as basic scientists or clinicians 

When it came to imagining the future and how they might fit into the changing landscape of practice, a lot of dialogue and collaboration was needed to help participants modify their ideas of teaching and who they would be in this new curriculum. For some it was very hard to imagine this new curriculum and so struggle to imagine themselves therein.  

Conclusions 

One point that the authors highlight in the discussion is that we need to remember that not all educators identify as educators. There are a lot of people who primarily identify as scientists or clinicians, and teaching is just a small corner of their work or even their identity. So when we ask people who primarily think of themselves as content experts to then uphold a role of critical consciousness educator, it may not align with their expectations 

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