November in this issue

This study investigates how surgical and intensive care trainees come to understand the quality of their performance and the role of feedback conversations. Trainees reported some commonalities between specialty, but they also indicated highly divergent experiences. They had to ‘patch together’ performance information into an evolving picture of overall progress; this was particularly challenging in intensive care, which was a more ambiguous and emotional clinical context. Attending to how, when and where trainee meaning making takes place may allow for effective conversations within specialty feedback cultures.

Bearman, M, Ajjawi, R, Castanelli, D, et al Meaning making about performance: A comparison of two specialty feedback cultures. Med Educ. 2023;57(11):1010–1019. doi:10.1111/medu.15118

The authors confirm that interprofessional identity is a source of intrinsic motivation towards interprofessional collaboration related to wider group membership. Their study provides additional evidence for the extended professional identity theory that combines two psychological identity approaches - identity theory and social identity theory - applied to interprofessional group membership. The findings imply that interprofessional identity can affect interprofessional collaboration apart from an established team or network.

Reinders, J-J, Krijnen, W. Interprofessional identity and motivation towards interprofessional collaboration. Med Educ. 2023;57(11):1068–1078. doi:10.1111/medu.15096

This study explores how mentorship relationships in surgery initiate, persist, and evolve. Interviews with mentors and mentees revealed key themes: success begins with a good fit, continues through timely communication, and deepens via mutual investment and learning. Addressing tensions, balancing formality and friendship, recognising transitions, and identifying areas of contribution are essential. The study underscores that successful mentorship is dynamic, demanding active engagement and shared responsibility from both mentors and mentees. Co-regulation and mutual investment play crucial roles in nurturing growth and learning within these relationships.

Louridas M, Enani GN, Brydges R, MacRae HM. Exploring Mentorship in Surgery: An Interview Study on How People Stick Together. Med Educ. 2023;57(11):1028-1035. doi:10.1111/medu.15157

This study examines how physicians address social determinants of health that are beyond their control, aiming to improve trainee preparedness. ‘Helplessness’ stories reveal emotional distress when unable to support patients, while ‘Shortcoming’ and ‘Transformation’ narratives show how realisations about shortcomings lead to personal transformation. ‘Doctor-patient relationship’ stories emphasise its importance, and ‘System advocacy’ stories stress the need for advocacy to change broken systems. The study suggests that current approaches focusing solely on altering social circumstances may lead to distress and burnout, advocating for alternative coping strategies such as self-improvement, patient connection, and advocacy efforts.

Peebles ER, Pack R, Goldszmidt M. From Helplessness to Transformation: An Analysis of Clinician Narratives about the Social Determinants of Health and their Implications for Training and Practice. Med Educ. 2023;57(11):1054-1067. doi:10.1111/medu.15184