Professionalism lapses and hierarchies: A qualitative analysis of medical students’ narrated acts of resistance

Malissa Kay Shaw, Charlotte E. Rees, Nina Bjerre Andersen, Lori Faye Black, Lynn V. Monrouxe

研究成果: 雜誌貢獻文章

3 引文 (Scopus)

摘要

Resistance is classified as a reaction against confining social structures. During their education, medical students encounter traditional medical and interprofessional hierarchies as they learn to become doctors. These create a power disparity that may prevent their empowerment and ability to resist. Despite their subordinate position, students are not always powerless when encountering situations that contradict their ethical, moral, and professional understandings of appropriate medical practice – so called ‘professionalism dilemmas.’ A qualitative analysis of over 1500 narratives from interviews, focus groups, and questionnaires with 808 medical students in the UK and Australia highlights how students draw on a number of direct and indirect, verbal and bodily, instantaneous and delayed forms of resistance to counter the professionalism lapses of their seniors, which they face in everyday clinical and educational interactions. Within students’ narratives of resistance we come to see how they resist hegemonic practices and their reasons for doing so, such as to prevent patient and student abuse, promote hygienic practice, and uphold patient consent. Through these various acts of resistance (and their narration), medical students may promote the subtle transformation of the dominant medical structure either consciously or unconsciously. They may do this through reflecting on acts of resistance to professionalism lapses, making sense of their moral position and the development of their professional identities, by encouraging others to also resist through sharing resistance narratives, and finally, by altering the professional conduct of their seniors. We encourage all workplace learning stakeholders to better understand the social dynamics of hierarchies and resistance and to encourage the enactment of resistance in the face of professionalism lapses in order to protect the health and wellbeing of learners and patients.

原文英語
頁(從 - 到)45-53
頁數9
期刊Social Science and Medicine
219
DOIs
出版狀態已發佈 - 十二月 1 2018
對外發佈Yes

指紋

Medical Students
medical student
Students
Social Hierarchy
Moral Development
Narration
Aptitude
Focus Groups
narrative
Workplace
student
Learning
Interviews
Education
Professionalism
professionalism
Lapse
Qualitative Analysis
Health
narration

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science

引用此文

Professionalism lapses and hierarchies : A qualitative analysis of medical students’ narrated acts of resistance. / Shaw, Malissa Kay; Rees, Charlotte E.; Andersen, Nina Bjerre; Black, Lori Faye; Monrouxe, Lynn V.

於: Social Science and Medicine, 卷 219, 01.12.2018, p. 45-53.

研究成果: 雜誌貢獻文章

Shaw, Malissa Kay ; Rees, Charlotte E. ; Andersen, Nina Bjerre ; Black, Lori Faye ; Monrouxe, Lynn V. / Professionalism lapses and hierarchies : A qualitative analysis of medical students’ narrated acts of resistance. 於: Social Science and Medicine. 2018 ; 卷 219. 頁 45-53.
@article{0cf3688637dc4d7697bc1494ba474976,
title = "Professionalism lapses and hierarchies: A qualitative analysis of medical students’ narrated acts of resistance",
abstract = "Resistance is classified as a reaction against confining social structures. During their education, medical students encounter traditional medical and interprofessional hierarchies as they learn to become doctors. These create a power disparity that may prevent their empowerment and ability to resist. Despite their subordinate position, students are not always powerless when encountering situations that contradict their ethical, moral, and professional understandings of appropriate medical practice – so called ‘professionalism dilemmas.’ A qualitative analysis of over 1500 narratives from interviews, focus groups, and questionnaires with 808 medical students in the UK and Australia highlights how students draw on a number of direct and indirect, verbal and bodily, instantaneous and delayed forms of resistance to counter the professionalism lapses of their seniors, which they face in everyday clinical and educational interactions. Within students’ narratives of resistance we come to see how they resist hegemonic practices and their reasons for doing so, such as to prevent patient and student abuse, promote hygienic practice, and uphold patient consent. Through these various acts of resistance (and their narration), medical students may promote the subtle transformation of the dominant medical structure either consciously or unconsciously. They may do this through reflecting on acts of resistance to professionalism lapses, making sense of their moral position and the development of their professional identities, by encouraging others to also resist through sharing resistance narratives, and finally, by altering the professional conduct of their seniors. We encourage all workplace learning stakeholders to better understand the social dynamics of hierarchies and resistance and to encourage the enactment of resistance in the face of professionalism lapses in order to protect the health and wellbeing of learners and patients.",
keywords = "Australia, Hierarchies, Medical education, Medical students, Professionalism, Resistance, Social structures, UK",
author = "Shaw, {Malissa Kay} and Rees, {Charlotte E.} and Andersen, {Nina Bjerre} and Black, {Lori Faye} and Monrouxe, {Lynn V.}",
year = "2018",
month = "12",
day = "1",
doi = "10.1016/j.socscimed.2018.10.009",
language = "English",
volume = "219",
pages = "45--53",
journal = "Social Science and Medicine",
issn = "0277-9536",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Professionalism lapses and hierarchies

T2 - A qualitative analysis of medical students’ narrated acts of resistance

AU - Shaw, Malissa Kay

AU - Rees, Charlotte E.

AU - Andersen, Nina Bjerre

AU - Black, Lori Faye

AU - Monrouxe, Lynn V.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Resistance is classified as a reaction against confining social structures. During their education, medical students encounter traditional medical and interprofessional hierarchies as they learn to become doctors. These create a power disparity that may prevent their empowerment and ability to resist. Despite their subordinate position, students are not always powerless when encountering situations that contradict their ethical, moral, and professional understandings of appropriate medical practice – so called ‘professionalism dilemmas.’ A qualitative analysis of over 1500 narratives from interviews, focus groups, and questionnaires with 808 medical students in the UK and Australia highlights how students draw on a number of direct and indirect, verbal and bodily, instantaneous and delayed forms of resistance to counter the professionalism lapses of their seniors, which they face in everyday clinical and educational interactions. Within students’ narratives of resistance we come to see how they resist hegemonic practices and their reasons for doing so, such as to prevent patient and student abuse, promote hygienic practice, and uphold patient consent. Through these various acts of resistance (and their narration), medical students may promote the subtle transformation of the dominant medical structure either consciously or unconsciously. They may do this through reflecting on acts of resistance to professionalism lapses, making sense of their moral position and the development of their professional identities, by encouraging others to also resist through sharing resistance narratives, and finally, by altering the professional conduct of their seniors. We encourage all workplace learning stakeholders to better understand the social dynamics of hierarchies and resistance and to encourage the enactment of resistance in the face of professionalism lapses in order to protect the health and wellbeing of learners and patients.

AB - Resistance is classified as a reaction against confining social structures. During their education, medical students encounter traditional medical and interprofessional hierarchies as they learn to become doctors. These create a power disparity that may prevent their empowerment and ability to resist. Despite their subordinate position, students are not always powerless when encountering situations that contradict their ethical, moral, and professional understandings of appropriate medical practice – so called ‘professionalism dilemmas.’ A qualitative analysis of over 1500 narratives from interviews, focus groups, and questionnaires with 808 medical students in the UK and Australia highlights how students draw on a number of direct and indirect, verbal and bodily, instantaneous and delayed forms of resistance to counter the professionalism lapses of their seniors, which they face in everyday clinical and educational interactions. Within students’ narratives of resistance we come to see how they resist hegemonic practices and their reasons for doing so, such as to prevent patient and student abuse, promote hygienic practice, and uphold patient consent. Through these various acts of resistance (and their narration), medical students may promote the subtle transformation of the dominant medical structure either consciously or unconsciously. They may do this through reflecting on acts of resistance to professionalism lapses, making sense of their moral position and the development of their professional identities, by encouraging others to also resist through sharing resistance narratives, and finally, by altering the professional conduct of their seniors. We encourage all workplace learning stakeholders to better understand the social dynamics of hierarchies and resistance and to encourage the enactment of resistance in the face of professionalism lapses in order to protect the health and wellbeing of learners and patients.

KW - Australia

KW - Hierarchies

KW - Medical education

KW - Medical students

KW - Professionalism

KW - Resistance

KW - Social structures

KW - UK

UR - http://www.scopus.com/inward/record.url?scp=85055195854&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055195854&partnerID=8YFLogxK

U2 - 10.1016/j.socscimed.2018.10.009

DO - 10.1016/j.socscimed.2018.10.009

M3 - Article

C2 - 30366129

AN - SCOPUS:85055195854

VL - 219

SP - 45

EP - 53

JO - Social Science and Medicine

JF - Social Science and Medicine

SN - 0277-9536

ER -