Ole Lund

Positioning health professional identity: on-campus training and work-based learning

Purpose Drawing on positioning theory, the purpose of this paper is to characterize the activities and positions of students and supervisors at workplaces and on-campus skills training sites across the higher health professional educations of medicine, sports science, and nursing. Furthermore, the study explored the impact of work-based learning (WBL) and skills training on students’ personal professional identity development. Design/methodology/approach A qualitative case study was conducted across six workplace sites and three on-campus skills training sites with 20 days of observation and 21 in-depth interviews. The data were inductively analyzed resulting in the identification of 12 characteristic narratives. This was followed by abductive analysis using Harre’s concept of positioning as the theoretical framework. Findings Across the three higher health professional educations, work-based and on-campus skills training sites were characterized by two learning spaces with distinct positions, rights, and duties. The WBL sites gave the students rich opportunities to position themselves, act independently, and behave as professionals seriously striving for mastery. On the on-campus sites, the students behaved less seriously, and were conscious of their rights to try out things, get support, and have fun. Research limitations/implications The authors recommend that future studies explore aspects of professional identity formation due to its consequences for curriculum design, including the distribution of simulated spaces and professional spaces in students’ learning environments. Originality/value This study adds to the empirical evidence and conceptual frameworks of personal and shared professional identity development in the field of skills and WBL, and it underlines the ongoing value of Harre’s positioning theory in educational research.

Qualitative analysis of MMI raters' scorings of medical school candidates: A matter of taste?

Recent years have seen leading medical educationalists repeatedly call for a paradigm shift in the way we view, value and use subjectivity in assessment. The argument is that subjective expert raters generally bring desired quality, not just noise, to performance evaluations. While several reviews document the psychometric qualities of the Multiple Mini-Interview (MMI), we currently lack qualitative studies examining what we can learn from MMI raters’ subjectivity. The present qualitative study therefore investigates rater subjectivity or taste in MMI selection interview. Taste (Bourdieu 1984) is a practical sense, which makes it possible at a pre-reflective level to apply ‘invisible’ or ‘tacit’ categories of perception for distinguishing between good and bad. The study draws on data from explorative in-depth interviews with 12 purposefully selected MMI raters. We find that MMI raters spontaneously applied subjective criteria—their taste—enabling them to assess the candidates’ interpersonal attributes and to predict the candidates’ potential. In addition, MMI raters seemed to share a taste for certain qualities in the candidates (e.g. reflectivity, resilience, empathy, contact, alikeness, ‘the good colleague’); hence, taste may be the result of an ongoing enculturation in medical education and healthcare systems. This study suggests that taste is an inevitable condition in the assessment of students’ performance. The MMI set-up should therefore make room for MMI raters’ taste and their connoisseurship, i.e. their ability to taste, to improve the quality of their assessment of medical school candidates.