RESUMO
The Education Innovation Institute (EII) of Medical College of Georgia, Augusta University, hosted a conference on Twitter about Professional Identity Formation (PIF), #MCGConf2021PIF, on February 25, 2021. The conference featured five presentations by 15 authors from Canada and the U.S. A Twitter conference is a versatile, affordable, and accessible digital option for medical education groups interested in diversifying conference offerings and reaching a broader audience. It was low-cost, organized in six months, and garnered over 9,000 Twitter impressions. Small networks and interest groups can organize Twitter conferences for their constituencies and larger conference organizations can host online mini-conferences to supplement in-person events.
Le 25 février 2021, l'Educational Innovation Institute (EII) du Medical College of Georgia de l'Université Augusta a tenu une conférence sur la construction de l'identité professionnelle sur le réseau social Twitter (#MCGConf2021PIF). Cinq communications y ont été présentées par 15 chercheurs du Canada et des États-Unis. Elle a été organisée en six mois, à coût modeste, et elle a recueilli plus de 9000 impressions sur Twitter. La conférence Twitter s'avère être une option numérique polyvalente, abordable et accessible pour les membres du milieu de l'éducation médicale désireux de diversifier leur offre de symposiums et de toucher un public plus large. Twitter offre aux petits réseaux et groupes d'intérêt la possibilité de convier leurs membres à des conférences restreintes et aux organisateurs de conférences plus importantes la possibilité de tenir des mini-conférences en ligne pour compléter leurs activités en personne.
RESUMO
PHENOMENON: The social contract is an implicit agreement that governs medicine's values, beliefs, and practices in ways that uphold the profession's commitment to society. While this agreement is assumed to include all patients, historical examples of medical experimentation and mistreatment suggest that medicine's social contract has not been extended to Black patients. We suggest that is because underlying medicine's contract with society is another contract; the racial contract, which favors white individuals and legitimizes the mistreatment of those who are nonwhite. When Black/African American physicians enter medicine, they enter into the social contract as an agreement with society, but must navigate the realities of the racial contract in ways that have yet to be acknowledged. This study examines how Black/African American physicians interpret and enact the social contract in light of the country's racial contract by investigating the ways in which Black/African American physicians discuss their interactions with Black patients. APPROACH: This qualitative study reexamines cross-sectional data previously collected in 2018-2019 examining the professional identity formation (PIF) experiences of Black/African American trainees and physicians in the Southern part of the U.S. The goal of the larger study was to explore participants' professional identity formation experiences as racialized individuals within a predominantly white profession. The current study examines these data in light of medicine's social contract with society and Mill's (1997) theory of the racial contract to understand how Black physicians interpret and enact the social contract. Participants included 10 Black/African American students, eight residents, and nine attending physicians. FINDINGS: The findings show that Black/African American physicians and trainees are aware of the country's racial contract, which has resulted in Black patients being historically excluded from what has been described in the social contract that governs all physicians. As such, they are actively working to extend the social contract so that it includes Black patients and their communities. Specifically, they engage in trust building with the Black community to make sure all patients are included. Building trust includes ensuring a consistent stream of new Black/African American trainees, and equipping Black trainees and patients with the skills needed to improve the healthcare within the Black/African American community. INSIGHTS: While it been has assumed that all patients are included in the social contract between medicine and society, historical examples of medical mistreatment and experimentation demonstrate this is inaccurate; Black/African American communities have not been included. In an effort to dismantle systemic racism in the U.S., medical education must teach about its racist past and divulge how some communities have been historically excluded, providing new ways to think about how to include everyone in medicine's social contract.
Assuntos
Médicos , Racismo , Negro ou Afro-Americano , Estudos Transversais , Atenção à Saúde , Humanos , Identificação SocialRESUMO
OBJECTIVES: Professional identity formation (PIF) is a growing area of research in medical education. However, it is unclear whether the present research base is suitable for understanding PIF in physicians considered to be under-represented in medicine (URM). This meta-ethnography examined the qualitative PIF literature from 2012 to 2019 to assess its capacity to shine light on the experiences of minoritised physicians. METHODS: Data were gathered using a search of six well-known medical education journals for the term 'professional identit*' in titles, keywords, abstracts and subheadings, delineated with the date range of 2012-2019. All non-relevant abstracts were removed and papers were then further reduced to those that focused only on learners' experiences. This left 67 articles in the final dataset, which were analysed using a collaborative approach among a team of researchers. The team members used their professional expertise as qualitative researchers and personal experiences as minoritised individuals to synthesise and interpret the PIF literature. RESULTS: Four conceptual categories were identified as impacting PIF: Individual versus Sociocultural Influences; the Formal versus the Hidden Curriculum; Institutional versus Societal Values; and Negotiation of Identity versus Dissonance in Identity. However, a major gap was identified; only one study explored experiences of PIF in URM physicians and there was an almost complete absence of critical stances used to study PIF. Combined, these findings suggest that PIF research is building on existing theories without questioning their validity with reference to minoritised physicians. CONCLUSIONS: From a post-colonial perspective, the fact that race and ethnicity have been largely absent, invisible or considered irrelevant within PIF research is problematic. A new line of inquiry is needed, one that uses alternative frameworks, such as critical theory, to account for the ways in which power and domination influence PIF for URM physicians in order to foreground how larger sociohistorical issues influence and shape the identities of minoritised physicians.