Kind and Sinful, the Meaning of My Leadership Experience in Medical Education. An Autoethnographic Narrative Inquiry
Journal: Advances in Medicine and Engineering Interdisciplinary Research DOI: 10.32629/ameir.v3i1.3577
Abstract
Introduction: Much emphasis has been placed on investigating the attributes of the educational leader, but less attention has been given to understanding his/her leadership experience. Nonetheless, exploring that experience is crucial to reduce the gap between what that person should be doing and what he/she is actually doing. Aim: To understand the meaning of my experience as a leader in medical education from a personal and pragmatic perspective. Methods: I adopt a qualitative approach, supported by an autoethnographic narrative inquiry. For this reason, the manuscript was written in first person. I collected journal records and conducted four (auto)semi-structured interviews to recall critical events (directly or indirectly) related to my life as an educational leader. I analyzed the texts looking for characters, temporality and locations, as well as cultural aspects, tensions and metaphors of my life stories. Results: I composed four resonant plots represented in the following metaphors: a) the original sin, b) the bad son leaves home, c) snakes' heads must be cut off, and d) the apocalypse arrived. Conclusion: My story led me to hold a different understanding of medical education leadership. This understanding accounts for intrapersonal tensions and how the use of power changes you in practice, more than it changes other people around you (as theoretically assumed).
Keywords
anthropology; cultural; education; medical; leadership; narration; qualitative research
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[2] Matsas B, Goralnick E, Bass M, Barnett E, Nagle B, Sullivan E. Leadership Development in U.S. Undergraduate Medical Education: A Scoping Review of Curricular Content and Competency Frameworks. Acad Med [Internet]. 2022 [consultado el 10 de marzo del 2022]; 97(6): 899-908. https://doi.org/10.1097/ACM.0000000000004632
[3] Davenport D, Alvarez A, Natesan S, Caldwell MT, Gallegos M, Landry A, et al. Faculty Recruitment, Retention, and Representation in Leadership: An Evidence-Based Guide to Best Practices for Diversity, Equity, and Inclusion from the Council of Residency Directors in Emergency Medicine. West J Emerg Med [Internet]. 2022;23(1): 62-71. https://doi.org/10.5811/westjem.2021.8.53754
[4] Simonsen KA, Shim RS. Embracing Diversity and Inclusion in Psychiatry Leadership. Psychiatr Clin North Am [Internet]. 2019;42(3):4 63-471. https://doi.org/10.1016/j.psc.2019.05.006
[5] Diaz DHS, Kothari P, Williams RL, Lee R, Mancias P, Davis JA, et al. Office of Medical Education: Opportunities for Trainees to Engage and Lead in Curricular Innovation and Reform. MedEdPORTAL [Internet]. 2021;17:11112. https://doi.org/10.15766/mep_2374-8265.11112
[6] Keane AM, Larson EL, Santosa KB, Vannucci B, Waljee JF, Tenenbaum MM, et al. Women in Leadership and Their Influence on the Gender Diversity of Academic Plastic Surgery Programs. Plast Reconstr Surg [Internet]. 2021;147(3): 516-526. https://doi.org/10.1097/PRS.0000000000007681
[7] Sundberg K, Josephson A, Reeves S, Nordquist J. Power and Resistance: Leading Change in Medical Education. Studies in Higher Education. 2017 Mar 4;42(3): 445-62. https://doi.org/10.1080/03075079.2015.1052735
[8] Spears R. Social Influence and Group Identity. Annu Rev Psychol [Internet]. 2021;72: 367-390. https://doi.org/10.1146/annurev-psych-070620-111818
[9] Yukl G. Effective Leadership Behavior: What We Know and What Questions Need More Attention. Acad Manag Perspect [Internet]. 2012;26(4): 66-85. https://doi.org/10.5465/amp.2012.0088
[10] Abdel-Razig S, Ibrahim H. Roles, Responsibilities, and Needs of Institutional GME Leaders: A Multinational Characterization of Designated Institutional Officials. J Grad Med Educ [Internet]. 2019;11(4 Suppl): 110-117. https://doi.org/10.4300/JGME-D-19-00192
[11] Velthuis F, Helmich E, Dekker H, Koole T, Jaarsma ADC. "My Right-Hand Man" versus "We Barely Make Use of Them": Change Leaders Talking About Educational Scientists in Curriculum Change Processes - A Membership Categorization Analysis. Adv Health Sci Educ Theory Pract [Internet]. 2019;24(4): 725-737. https://doi. org/10.1007/s10459-019-09894-5
[12] Molzahn AE, Sheilds L, Antonio M, Bruce A, Schick-Makaroff K, Wiebe R. Ten Minutes to Midnight: A Narrative Inquiry of People Living with Dying with Advanced COPD and Their Family Members. Int J Qual Stud Health Well-being [Internet]. 2021;16(1): 1893146. https://doi.org/10.1080/17482631.2021.1893146
[13] Killingback C, Clark C, Green A. Being More than "Just a Bog-Standard Knee": The Role of Person-Centred Practice in Physiotherapy: A Narrative Inquiry. Disabil Rehabil [Internet]. 2021;6: 1-8. https://doi.org/10.1080/09638288.2021.1948118
[14] Flores MA. Feeling Like a Student but Thinking Like a Teacher: A Study of the Development of Professional Identity in Initial Teacher Education. J Educ Teach [Internet]. 2020;46(2): 145-58. https://doi.org/10.1080/02 607476.2020.1724659
[15] Turner J, Morrison A. Designing Slow Cities for More than Human Enrichment: Dog Tales-Using Narrative Methods to Understand Co-Performative Place-Making. Multimodal Technol Interact [Internet]. 2020;5(1): 1. https://doi.org/10.3390/mti5010001
[16] Velthuis F, Varpio L, Helmich E, Dekker H, Jaarsma ADC. Navigating the Complexities of Undergraduate Medical Curriculum Change: Change Leaders' Perspectives. Acad Med [Internet]. 2018;93(10): 1503-1510. https://doi.org/10.1097/ACM.0000000000002165
[17] Clandinin J, Cave MT, Cave A. Narrative Reflective Practice in Medical Education for Residents: Composing Shifting Identities. Adv Med Educ Pract [Internet]. 2010;2: 1-7. https://doi.org/10.2147/AMEP.S13241
[18] Caine V, Clandinin J, Lessard S. Considering Response Communities: Spaces of Appearance in Narrative Inquiry. Qual Inq [Internet]. 2021;27(6): 661-666. https://doi.org/10.1177/1077800420948105
[19] Blix BH, Caine V, Clandinin DJ, Berendonk C. Considering Silences in Narrative Inquiry: An Intergenerational Story of a Sami Family. J Contemp Ethnogr [Internet]. 2021;50(4): 580-594. https://doi. org/10.1177/08912416211003145
[20] Kim, JH. Understanding Narrative Inquiry: The Crafting and Analysis of Stories as Research. Los Angeles: Sage publications; 2015.
[21] Ellis C. Telling Secrets, Revealing Lives: Relational Ethics in Research with Intimate Others. Qual Inq [Internet]. 2007;13(1): 3-29. https://doi.org/10.1177/1077800406294947
[22] Mertova P, Webster L. Using Narrative Inquiry as a Research Method: An Introduction to Critical Event Narrative Analysis in Research, Teaching and Professional Practice. 2a ed. Oxon: Routledge; 2020.
[23] Schaefer L, Hennig L, Clandinin J. Intentions of Early Career Teachers: Should We Stay or Should We go Now? Teaching Education [Internet]. 2021;32(3):309-22. https://doi.org/10.1080/10476210.2020.1730317
[24] Saleh M, Menon J, Clandinin DJ. Autobiographical Narrative Inquiry: Tellings and Retellings. Learn Landsc. [Internet]. 2014 [consultado el 20 de febrero del 2022];7(2):271-82. https://doi.org/10.36510/learnland. v7i2.665
[25] Small R. Codes Are not Enough: What Philosophy Can Contribute to the Ethics of Educational Research. Journal of Philosophy of Education [Internet]. 2001;35(3): 387-406. https://doi.org/10.1111/1467-9752.00234
[26] Tobon S, Juarez-Hernández LG, Herrera-Meza SR, Nuñez-Rojas AC. Evaluación de las prácticas directivas en directores escolares: validez y confiabilidad de una rúbrica. Educación XX1 [Internet]. 2020;23(2): 187-210. https://doi.org/10.5944/educXX1.23894
[27] Gorsky D, Barker JR, MacLeod A. Servant and Supervisor: Contrasting Discourses of Care and Coercion in Senior Medical School Leadership Roles. Studies in Higher Education [Internet]. 2018;43(12): 2238-50. https:// doi.org/10.1080/03075079.2017.1318366
[28] Wijk H, Heikkila K, Ponzer S, Kihlstrom L, Nordquist J. Successful Implementation of Change in Postgraduate Medical Education a Qualitative Study of Programme Directors. BMC Med Educ [Internet]. 2021;21(1): 213. https://doi.org/10.1186/s12909-021-02606-x
[29] Rodriguez-Pulido J, Artiles-Rodriguez J. Aprendizajes y Buenas Prácticas para la Gestión de la Institución Superior. REICE [Internet]. 2017 [consultado el 15 de febrero de 2022];15(1). https://doi.org/10.15366/rei- ce2017.15.1.00
[30] Aravena F, Pineda-Baez C, Lopez-Gorosave G, Garcia-Garduño JM. Liderazgo de Directores Noveles de Latinoamérica a través de las Metáforas: Chile, Colombia y México. REICE [Internet]. 2020 [consultado el 15 de febrero de 2022];18(3): 71-9. https://doi.org/10.15366/reice2020.18.3.004
[31] Taghavinia M, Maleki MR, Arabshahi KS. Educational Leadership in Education Development Centers: A Qualitative Study. J Educ Health Promot [Internet]. 2021;10: 46. https://doi.org/10.4103/jehp.jehp_733_20
[32] Libby AM, Ingbar DH, Nearing KA, Moss M, Albino J. Developing Senior Leadership for Clinical and Translational Science. J Clin Transl Sci [Internet]. 2018;2(3): 124-8. https://doi.org/10.1017/cts.2018.34
[33] Dumulescu D, Muţiu AI. Academic Leadership in the Time of COVID-19-Experiences and perspectives. Front Psychol [Internet]. 2020;12: 1272. https://doi.org/10.3389/fpsyg.2021.648344
[34] Chaaban Y, Al-Thani H, Du X. A Narrative Inquiry of Teacher Educators' Professional Agency, Identity Renegotiations, and Emotional Responses Amid Educational Disruption. Teach Teach Educ [Internet]. 2021;108: 103522. https://doi.org/10.1016/j.tate.2021.103522
[35] Quintão C, Andrade P, Almeida F. How to Improve the Validity and Reliability of a Case Study Approach? Journal of Interdisciplinary Studies in Education [Internet]. 2020;9(2): 264-75. https://doi.org/10.32674/jise.v9i2.2026
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