How do clinicians become teachers? A communities of practice perspective

Area of Science:

• Medical Education
• Sociology of Professions
• Organizational Studies

Background:

• Faculty development for clinicians faces challenges with attendance and learning transfer.
• There's a growing trend towards situating teacher development within clinical settings.
• Theorization of the link between becoming a teacher and clinical workplace contexts is limited.

Purpose of the Study:

• To explore how clinicians develop into teachers within their clinical communities and institutions.
• To investigate the structural influences on clinical teacher development using a communities of practice framework.

Main Methods:

• Qualitative research design.
• Conceptual framework: communities of practice (CoP).
• Sensitizing concepts: regimes of competence, vertical and horizontal planes of accountability.
• Data collection: developmental timelines and semi-structured interviews with 14 hospital physicians.

Main Results:

• Clinicians' teacher identities and practices were congruent despite diverse developmental paths.
• Teacher identity negotiation occurred between horizontal (clinical teams, junior doctor communities) and vertical (hospitals, medical schools) accountability planes.
• Congruence with CoP regimes of competence facilitated recognition and legitimacy.
• Institutional values influenced the adaptation of teacher identities and practices.

Conclusions:

• Becoming a clinical educator requires negotiating identity and practice between professional communities and institutional expectations.
• Clinical communities of practice tend to be conservative, reproducing existing teaching practices.
• Institutional accountability can be disruptive to established teacher identities and practices.