Exploring Professional Identity Formation and Communities of Practice Through Anesthesiology Resident Confessions: A Retrospective Qualitative Study

Matthew Hirschfeld
University of Rochester


Background: “Confessions” is a program leadership-moderated explicit learning activity in which residents discuss anonymously submitted confessions. Confessions allows a safe space for resident feedback, permits an opening for discussions on Professional Identity Formation (PIF), and the opportunity for identification with a Community of Practice (CoP).

Objective: This retrospective qualitative study analyzed typed confessions from Clinical Base Year residents to identify themes impacting resident PIF and participation within a CoP. We also investigated confessions from senior anesthesiology residents and from piloted interdisciplinary Confessions for progression of these themes throughout residency training.

Methods: We analyzed 244 confessions collected during 21 Confessions conducted between October, 2016 and anuary, 2020 at a single institution.

In keeping with Grounded Theory and the Constant Comparative Method, confessions were qualitatively coded in three stages: open, axial, and selective. Researcher triangulation, a code book, and member checking were used to enhance the study’s trustworthiness. The concepts of PIF and CoP served as the theoretical perspective for the study.

Results: Interrelated, longitudinal themes associated with PIF and CoP, such as “support” and “knowledge,” were uncovered. Longitudinal themes were related to important transitions during residency training and evolved over time. Episodic themes were related to local concerns.

Conclusions: Transition periods are important milestones in physician PIF and identification within a CoP. The graduate medical community should continue to focus efforts to allow residents time for studying and self- care during normal clinical hours, as well as on teaming with non- physician healthcare workers. Confessions is an easily adaptable activity for other programs and institutions.

Kathleen Timme Spotlight

Kathleen Timme recently started a new podcast called Teaching in Medicine where she interviews current and aspiring clinician-educators as a means to explore triumphs, struggles, and effective approaches in medical education.  The first two episodes feature Dr. Benjamin Chan, Associate Dean of Admissions for the University of Utah School of Medicine (and 2018 graduate of the MEd program), where they discuss the reasons why they chose our online MEd program.

Kathleen’s inspiration for the podcast came from her relationship with the Rural Underserved Utah Training Experience (RUUTE) program and her work on creating a trainee-as-teacher program for students and residents doing rural rotations. As a means to reach remote populations, she considered audio and video content for learners to access while away from the academic hub.  On a personal note, she enjoys listening to podcasts while driving and exercising and thought that this would be a good way to bring brief lessons to learners that can be accessed at their convenience.  She was also inspired by Dr. Benjamin Chan's podcast Talking Admissions and Med Student Life that brings to life the stories of medical students and how they ended up in medical school.  Her hope is to capture the stories of clinician-educators and how they ended up in medical education.

In the future, Kathleen hopes that the Teaching In Medicine podcast will become a place where medical students, trainees, and clinician-educators alike can learn about the art of teaching as a healthcare provider.  She hopes that students and trainees can find inspiration in the "Meet The Educator" episodes and that we all improve our teaching skills through careful exploration of pedagogy, teaching approaches, and review of the literature on medical education.

Kathleen invites those interested in being a guest on the show or those with questions to teachinginmedicinepodcast@gmail.com.  You can subscribe anywhere you get podcasts: anchor.fm/teachinginmedicine.  New episodes come out every other Monday.

Bio:
Kathleen Timme is an Assistant Professor of Pediatric Endocrinology at the University of Utah and serves as Director of Educational Development for the Graduate Medical Education Committee and Co-Director of the Students-as-Teachers pathway. She attended the State University of New York at Buffalo School of Medicine, followed by pediatrics residency and endocrine fellowship at Yale.

Kathleen is a current student in the online Master of Education program here at the University of Cincinnati.  Her research interest is in training physicians how to effectively teach. She is currently working on an asynchronous trainee-as-teacher program for the Rural Underserved Utah Training Experience (RUUTE) and creating material to supplement resident-as-teacher programs throughout the University.

Exploring The Use of Curriculum-Based & Structured Simulation as A Tool to Improve Staff Response to Critical Incidences; A Model of Improvement In A District General Hospital - Pediatric Unit

Amal Mohamed
St Helens and Knowsley Teaching Hospitals NHS Trust / Whiston Hospital

Leveraging Creativity to Teach Science: Incorporating Sketchnotes in the Medical Laboratory Science Curriculum

Catherine Dixon
University of Cincinnati

The Strength of Our Stories: Oral storytelling as a tool for building resilience in graduate medical education

Maren Olson
University of Minnesota / Children's Minnesota

The Cumulative Experience with Peripheral Nerve Blockade of Anesthesiology Residents at University of Pittsburgh Medical Center

Lindsay Hahn
University of Pittsburgh Medical Center

Teaching the Social Determinants of Health to Family Medicine Residents Through a Community Field Experience

Megan Rich
Christ Hospital / University of Cincinnati College of Medicine