Exploring the role of classroom-based learning in professional identity formation of family practice residents using the experiences, trajectories, and reifications framework

Abstract

Background: Classroom-based learning such as academic half day has undervalued social aspects. We sought to explore its role in the professional identity development of family medicine residents.

Methods: In this case study, residents and faculty from four training sites in the University of British Columbia Department of Family Practice were interviewed. The “experiences, trajectories, and reifications (ETR) framework” was used as a sensitizing tool for modified inductive (thematic) analysis of the transcripts.

Results: Classroom-based learning provided a different context for residents’ interpretation of their clinical experiences, characterized as a “home base” for rotating urban residents, and a connection to a larger academic community for residents in rural training sites. Both these aspects were important in creating a positive trajectory of professional identity formation. Teaching directed at the learning needs of family physicians, and participation of family practice faculty as teachers and role models was a precipitation of a curriculum “centered in family medicine.” Interactions between family medicine residents and faculty in the classroom facilitated the necessary engagements to reify a shared understanding of the discipline of family practice.

Conclusions: Classroom-based learning has substantial impact on professional identity formation at an individual and collective level.

Acknowledgements

The authors thank Dr. Daniel Pratt, Dr. Pim Teunissen, Dr. Sandra Jarvis-Selinger and Dr. Laura Nimmon for their critical review of this manuscript.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Luke Chen, MD, MMEd, is Clinical Associate Professor, University of British Columbia Department of Medicine and Centre for Health Education Scholarship. His interests include classroom-based learning and clinical reasoning.

Maria Hubinette, MD, MMEd, is Clinical Associate Professor, University of British Columbia Department of Family Practice and Centre for Health Education Scholarship. She is a qualitative researcher with interests in identity formation, social learning and advocacy.

Glossary

• Academic half day: A form of classroom-based learning, generally employed in graduate medical education/residency programs, which is:

  (1) A half or full day

  (2) Regularly scheduled

  (3) Directed primarily at residents/trainees

  (4) Removed from the sphere of patient care

  Chalk C. 2004. The academic half-day in Canadian neurology residency programs. Can J Neurol Sci. 31:511–513.

• Classroom-based learning: In graduate medical education/residency, learning is typically situated in the workplace. However, most programs provide a complementary classroom-based learning program in the form of Academic Half Days, Noon Rounds, or other formats. The primary purpose of classroom-based learning in residency is knowledge acquisition, but it also serves as an important forum for peer support and professional identity formation (1).

• Chen LY, McDonald JA, Pratt DD, Wisener KM, Jarvis-Selinger S. 2015. Residents' views of the role of classroom-based learning in graduate medical education through the lens of academic half days. Acad Med. 90:532–538.

• Reification: Reification is the process of giving form to our experience by producing objects that congeal this experience into “thingness” (Wenger 1998). In other words, reification means both the processes and the products or objects by which we enact our daily practice. An example is patient charting, which is both a process and a product by which medical practice is reified. Practice both creates, and is created by, recurring patterns of activities which are the result of, and shape, our experiences and possible trajectories.

• Wenger EC. 1998. Communities of practice: learning, meaning, and identity. Cambridge: Cambridge University Press.

• Teunissen PW. 2015. Experience, trajectories, and reifications: an emerging framework of practice-based learning in healthcare workplaces. Adv Health Sci Educ Theory Pract. 20:843–856.

Additional information

Funding

This study was funded by the Hal Kettleson Hematology Research Fund.