Identity without milestones: a narrative inquiry into the rites of passage shaping professional identity formation in health professions educators.

Abstract

Introduction: Professional Identity Formation (PIF) in medicine is typically supported by certain milestones and well-researched rites of passage. In contrast, educators who enter Health Professions Education (HPE) often do so without such signposts, inhabiting a liminal space where identity is constantly negotiated. Despite the growing availability of HPE academic programs, little is known about how these programs shape educators' identities or which experiences serve as significant identity-forming moments. Our study aims to identify the transformative 'aha' moments, which can serve as rites of passage, helping to strengthen the health professions educators' identity.

Methods: Guided by a social constructionist stance, we employed narrative inquiry to explore the stories of 16 healthcare professionals enrolled in, or recently graduated from HPE academic programs. Semi-structured interviews were conducted and analysed using a re-storying technique. Transformative Learning Theory (TLT) informed the understanding of cognitive, emotive, and affective dimensions of identity shifts, which were captured through the lens of epiphanies.

Results: Through the analytical interpretation of these stories, we identified four epiphanies. The 'power of people' in the form of competent faculty to develop educational alliances, which influenced all dimensions of TLT. The 'Language of HPE', articulated through paradigmatic orientations and vocabulary, instilled cognitive shifts. The 'burden of tasks', reflecting the distinct nature of the HPE-related assignments, exerted emotional weight. Finally, the 'sense of belonging' through live social interactions between faculty and peers, strengthened the modes of belonging.

Conclusion: Identification of these transformative 'aha' moments provides clear, measurable steps into how educator identity formation can be fostered and strengthened in the context of HPE academic programs. Such insights call for thoughtful faculty selection, improved curriculum structuring, and scheduling practices. By honoring the educators' stories, we give voice to their lived realities and recognize the significance of HPE academic programs as beautiful avenues for identity formation.