Exploring medical educators’ expressions of identity through visual prompts and use of metaphor; a grounded theory study utilising focus groups

Background: This project aimed to explore which metaphors, similies, or other forms of imagery medical educators use to express their identity as a ‘medical educator’ and to discuss what these expressions might tell us about their connection to, attitude to, and views of this identity. Medical educators are essential stakeholders in effective learning experiences for our future healthcare workforce and gaining insight into their identity development will be valuable in supporting them in their crucial roles. Methods: Utilising a constructivist grounded theory approach, two focus group/workshop hybrids were carried out with a total of 16 participants in January and February of 2020. The focus group/workshops were used to encourage participant discussion about their educator identity, which included the use of visual prompts to promote use of metaphor in their expressions. Data were analysed using open and then focused coding. Iterative reviews of the literature relating to the study area took place throughout the timeframe of the project. Results: Participants used a range of metaphors for their medical educator identity which fell into the themes of: metaphors around movement, entertainment and environment. The metaphors used included that of a gardener, farmer, role model, traveller, formula 1 pitstop team, and orchestral conductor. When expressing their educator identity, participants spoke of the burden of juggling clinical and educator workload and of the impact of the clinical learning environment upon their ability to do so. Conclusions: Using a creative approach to collect data through metaphors and imagery, our study gave a valuable insight into how medical educators’ view their identity and experiences. It gave insight into the influence of environment upon their identity and the potential role for faculty development in promoting medical educators to converse with each other about the challenges faced when juggling roles and making sense of differing and clashing identities.