Esther Helmich

Entering medical practice for the very first time: emotional talk, meaning and identity development

Medical Education 2012: 46: 1074–1087

Emotions and identity in the figured world of becoming a doctor

There is little room in clerkship curricula for students to express emotions, particularly those associated with the development of a caring identity. Yet it is recognised that competence, alone, does not make a good doctor. We therefore set out to explore the relationship between emotions and identity in clerkship education. Our exploration was conceptually oriented towards Figured Worlds theory, which is linked to Bakhtins theory of dialogism.

Early clinical experience: do students learn what we expect?

Medical Education 2011: 45: 731–740

Medical students’ professional identity development in an early nursing attachment

Medical Education 2010: 44: 674–682

Do you really want to be a doctor? The highs and lows of identity development

Helmich, Esther Dornan, Tim Comment England Med Educ. 2012 Feb;46(2):132-4. doi: 10.1111/j.1365-2923.2011.04189.x.

Emotional learning of undergraduate medical students in an early nursing attachment in a hospital or nursing home

Background: Entering medicine for the first time is highly impressive for students, but we know little about the actual emotional learning processes taking place. Aims: We aimed to get more insight into expectations, experiences and emotions of students during their first clinical experiences in a hospital compared to a nursing home. Methods: We carried out a qualitative and a quantitative survey by administering questionnaires about expectations, impressive experiences and learning activities within two cohorts of first-year medical students before and after a 4-week nursing attachment. Results: Despite different expectations, students reported similar experiences and learning activities for the nursing home and the hospital. Most impressive events were related to patient care, being a trainee, or professional identities being challenged. Students in nursing homes most often referred to their own relationships with patients. Students expressed different emotions, and frequently experienced positive and negative emotions at the same time. Conclusions: Rewarding experiences (not only difficult or stressful events) do matter for medical professional development. Students need to learn how to deal with and feel strengthened by the emotions evoked during clinical experiences, which should be supported by educators. The nursing home and the hospital seem to be equally suited as learning environments.

Becoming a Doctor in Different Cultures: Toward a Cross-Cultural Approach to Supporting Professional Identity Formation in Medicine

Becoming a doctor is fundamentally about developing a new, professional identity as a physician, which in and of itself may evoke many emotions. Additionally, medical trainees are increasingly moving from one cultural context to another and are challenged with navigating the resulting shifts in their professional identify. In this Article, the authors aim to address medical professional identity formation from a polyvocal, multidisciplinary, cross-cultural perspective. They delineate the cultural approaches to medical professionalism, reflect on professional identity formation in different cultures and on different theories of identity development, and advocate for a context-specific approach to professional identity formation. In doing so, the authors aim to broaden the developing professional identity formation discourse to include non-Western approaches and notions.

Context matters when striving to promote active and lifelong learning in medical education

In the 30 years that have passed since The Edinburgh Declaration on Medical Education, we have made tremendous progress in research on fostering ‘self‐directed and independent study’ as propagated in this declaration, of which one prime example is research carried out on problem‐based learning. However, a large portion of medical education happens outside of classrooms, in authentic clinical contexts. Therefore, this article discusses recent developments in research regarding fostering active learning in clinical contexts.

‘Oh my God, I can't handle this!’: trainees’ emotional responses to complex situations

Dealing with emotions is critical for medical trainees’ professional development. Taking a sociocultural and narrative approach to understanding emotions, we studied complex clinical situations as a specific context in which emotions are evoked and influenced by the social environment. We sought to understand how medical trainees respond to emotions that arise in those situations.

Authoring the identity of learner before doctor in the figured world of medical school

IntroductionStudents enter the ‘figured world’ of medical school with preconceptions of what it means to be axa0doctor. The meeting of these early preconceptions and their newly developing identities can create emotional tensions. The aim of this study was to advance our understanding of how such tensions were experienced and managed. Using figured worlds as axa0theoretical framework we explored students’ interactions of preconceptions with their newly developing professional identities in their first year at medical school. Advancing our understanding of this phenomena provided new insights into the complex process of identity formation.MethodsThis was axa0qualitative study underpinned by axa0constructivist epistemology. We ran biannual focus groups with 23xa0first year students in one UK medical school. Data were recorded, transcribed and then template analysis used to undertake an inductive, iterative process of analysis until it was considered the template provided axa0detailed representation of the data.ResultsSignificant preconceptions associated with the identity of axa0doctor were ‘to help’ and ‘to be axa0leader’. These early preconceptions were in conflict with realities of the figured world of medical school creating the emotional tensions of ‘being unable to help’ and ‘lacking power’, with implications for interactions with patients. By the end of year one students’ negotiated tensions and ‘self-authored’ their identity as axa0learner as opposed to an imagined ‘as if’ identity of axa0doctor.DiscussionWe revealed how preconceptions associated with becoming axa0doctor can conflict with axa0newly developing professional identity highlighting the importance of supporting students to embrace the formation of axa0‘learner’ identity, axa0necessary part of the process of becoming axa0doctor.