Understanding Emotional Experiences in Clinic within their Context: A Narrative Ethnographic Study and Contextual...

Background: Clinical education and healthcare work occur within their own complex sociocultural contexts, where interactions can be emotionally intense. Scholars have begun to conceptualize emotional experiences using a socio-cultural lens, examining emotions within their own complexity and contextuality. To better understand and help providers process the intense emotional experiences inherent to clinical education and work, it is important to analyze them from a socio-cultural perspective. Objective: This study aimed to identify the emotional experiences of clinical providers engaged in healthcare work and to determine the value of adopting a reflective approach to processing intense emotions. Our research questions were (1) What clinical activities prompt emotional response among providers, and how does context (system, socio-cultural, political, etc.) shape these experiences? (2) How does providers' reflectivity about their emotional experiences in context affect their understanding and outcomes? Method: The study was conducted between 12 July 2021 and 07 January 2022 at a university hospital's general surgery clinic in the Eastern Anatolia Region of Türkiye. This narrative, ethnographic study analyzed the emotional narratives embedded in clinical work. The participant group consisted of 31 volunteers from a single clinical team: five faculty members, five residents, six nurses, 15 sixth-year medical students (interns). We analyzed narratives generated from participant observation and narrative interviewing using the "Three Stage Contextual Theme Analysis Framework" model. Findings: We created a tripartite conceptual framework to convey (a) the multi-level context in which emotional experiences occur, (b) providers' reflection on emotional experiences in context, and (c) the consequences of contextual, reflective emotional experiences. Our analysis revealed two main contexts in which emotional experiences take place: "institutional and clinical context" and "national and local context." The institutional and clinical context consists of "social, emotional," "physical," and "institutional and clinical system" subcontexts, while the national and local context consists of "health system" and "socio-cultural life" subcontexts. Conclusion: Given the consequences of intense emotional experiences in clinical education and healthcare work, it is important to understand them in context, using a reflective narrative approach. This approach allows educators to reframe both clinical education and healthcare work in a more humane and socioculturally sensitive manner.