Narrative Inquiry into the Professional Identity-Making of Ghanaian Midwives.

Professional identity-making is a complex life-making endeavor that is shaped by both the personal and professional knowledge landscapes in which people live and work. Using narrative inquiry, four midwives who had worked in diverse contexts in Ghana were purposively selected. We highlight how midwives' experiences across time, place, and in diverse contexts shape their professional identity-making. Three main life experiences that shape professional identity-making were discovered: 1. Childhood experiences, 2. Education experiences, and 3. Professional work experiences. Midwifery education should prepare students to attend to this complex and ongoing identity development, in order to enhance midwifery practice.

Waiting as Performative and Relational: A Narrative Inquiry Study Into the Experiences of Women Who Use Substances.

BACKGROUND AND PURPOSE: The act of waiting in health care is becoming increasingly prevalent worldwide. Waiting in health care is not a neutral activity; it is filled with expectations marked by cultural and social norms. In this article, we consider the performative nature of waiting by reflecting on the experiences of two participants in a narrative inquiry study. METHODS: Drawing on a narrative inquiry study focused on the experiences of three women who disclosed illegal substance use during their pregnancy or early postnatal period, we inquired into two participants' experiences of waiting. The study which took place in a large urban center in Western Canada, where the researcher connected with participants who faced numerous challenges due to poverty, stigma, and discrimination. RESULTS: Sharing the narratives of Georgia Dewart, and participants Renate, and Marilynn, we explore the performative act of waiting in their interactions with health care. We consider the political and social implications of the act in order to explore the subtleties and overlooked consequences of waiting. This work encourages the nursing profession to address overlooked aspects of care, such as the act of waiting. IMPLICATIONS FOR PRACTICE: Our findings draw attention to the normative expectations within participants' experiences of waiting. This work offers methodological considerations for those engaging with Butler's concept of performativity when considering everyday acts. We also challenge care providers to reflect on their experiences working with clients, families, and communities to consider both the relational and performative nature of these interactions.

The necessity and possibilities of playfulness in narrative care with older adults.

For us, narrative care is grounded in pragmatist philosophy and focused on experience. Narrative care is not merely about acknowledging or listening to people's experiences, but draws attention to practical consequences. We conceptualize care itself as an intrinsically narrative endeavour. In this article, we build on Lugones' understanding of playfulness, particularly to her call to remain attentive to a sense of uncertainty, and an openness to surprise. Playfulness cultivates a generative sense of curiosity that relies on a close attentiveness not only to the other, but to who we each are within relational spaces. Generative curiosity is only possible if we remain playful as we engage and think with experiences and if we remain responsive to the other. Through playfulness, we resist dominant narratives and hold open relational spaces that create opportunities of retelling and reliving our experiences. Drawing on our work alongside older adults, as well as people who work in long-term care, we show the possibilities of playfulness in the co-composition of stories across time. By intentionally integrating playfulness, narrative care can be seen as an intervention, as well as a human activity, across diverse social contexts, places and times.

A Narrative Care approach for persons living with dementia in institutional care settings.

AIMS AND OBJECTIVES: We will provide insights in the theoretical background and key concepts of a Narrative Care approach, such as narrative cultures, narrative curiosity, narrative co-composition and narrative reflective practice. BACKGROUND: Care understood as narrative practice underscores the importance of experiences and how these shape identities. Important to the quality of care in institutional care settings is the ability of care providers to cope with complexities and uncertainties in older adults' stories, which can be realised by attending to ways that foster and co-compose evolving and forward-looking narratives. Recognising these ongoing co-compositions means that persons living in institutional care settings and care providers live, tell, retell and relive their experiences. A change in the current institutional culture is necessary to implement care as narrative practice. To support such a change, approaches are needed that foster a focus on experiences and relationships and make relational ethics central to care. METHODS: The proposed Narrative Care approach is the result of an iterative development process involving a literature review, interviews with, and observations of, care providers, dialogues with an advisory committee, and consultation with experts. MAIN CONTRIBUTIONS: The proposed Narrative Care approach aims to help care providers (a) to recognise the importance of curiosity in a person's verbal and embodied narratives-especially for those living with dementia; (b) to take note of individual experiences in all of their complexity and uncertainty; (c) to respect these narratives; (d) to open up spaces to co-compose new narratives; and (e) to allow care providers to engage in narrative reflective practices that shape who they are and are becoming. CONCLUSION: The introduced approach responds to the need of implementing strategies to think and work narratively in institutional care settings. IMPLICATIONS FOR PRACTICE: Narrative Care has the potential to reshape task-oriented, technical notions of care. Concepts such as embodied narratives, relational ethics, narrative co-composition and narrative reflective practice must be integrated in the education of all care providers.

Narrative inquiry: a relational research methodology for medical education.

CONTEXT: Narrative research, an inclusive term for a range of methodologies, has rapidly become part of medical education scholarship. CONCEPTS: In this paper we identify narrative inquiry as a particular theoretical and methodological framework within narrative research and outline its characteristics. We briefly summarise how narrative research has been used in studying medical learners' identity making in medical education. USES OF NARRATIVE INQUIRY: We then turn to the uses of narrative inquiry in studying medical learners' professional identity making. With the turn to narrative inquiry, the shift is to thinking with stories instead of about stories. CONCLUSIONS: We highlight four challenges in engaging in narrative inquiry in medical education and point toward promising future research and practice possibilities.

Creating pedagogical spaces for developing doctor professional identity.

OBJECTIVES: Working with doctors to develop their identities as technically skilled as well as caring, compassionate and ethical practitioners is a challenge in medical education. One way of resolving this derives from a narrative reflective practice approach to working with residents. We examine the use of such an approach. METHODS: This paper draws on a 2006 study carried out with four family medicine residents into the potential of writing, sharing and inquiring into parallel charts in order to help develop doctor identity. Each resident wrote 10 parallel charts over 10 weeks. All residents met bi-weekly as a group with two researchers to narratively inquire into the stories told in their charts. RESULTS: One parallel chart and the ensuing group inquiry about the chart are described. In the narrative reflective practice process, one resident tells of working with a patient and, through writing, sharing and inquiry, integrates her practice and how she learned to be a doctor in one cultural setting into another cultural setting; another resident affirms her relational way of practising medicine, and a third resident begins to see the complexity of attending to patients' experiences. CONCLUSIONS: The process shows the importance of creating pedagogical spaces to allow doctors to tell and retell, through narrative inquiry, their stories of their experiences. This pedagogical approach creates spaces for doctors to individually develop their own stories by which to live as doctors through narrative reflection on their interwoven personal, professional and cultural stories as they are shaped by, and enacted within, their professional contexts.

Revisiting the journal club.

BACKGROUND: Recent descriptions of journal clubs identify their purpose as reading current medical literature, critically appraising it for validity and applicability to the readers' patient population, and distilling the best available clinical evidence. A clinical problem or question from practice within a discipline is identified, and relevant literature is selected and critically appraised. The process addresses the first tenet of evidence-based medicine; that is, gathering the best evidence from research data, but there is little information about when and how the second and third tenets (namely, incorporating individual clinician's expertise and individual patient's perspective) are addressed. AIMS: The study aim was to explore the value, for physician-learners, of reading physician-authored books within the context of an ongoing conversation group. This paper draws on the results of a year-long study with a group of medical students, residents, and novice physicians who read physician-authored books about their practice areas and subsequently met in a conversation group. DESCRIPTION: The study process facilitated learning around two neglected tenets of evidence-based medicine: the integration of clinical expertise, and incorporating patients' perspectives into clinical decision-making. It also fulfilled an earlier purpose of journal clubs, namely the fostering of collegiality and the development of professional identity in physicians. CONCLUSION: This study shows the value of reading a type of medical literature that is different, but complementary, to the kind read in contemporary journal clubs.