"You're a trainee telling your consultant to hold their question until later": Using a resident-led faculty...

Medical education traditionally involves directional flow of knowledge/skills/attitudes from a senior to junior individual. However, medical training also provides opportunities for expertise role-reversal, where the direction of flow is reversed. Unlike fields such as aviation, medicine has not yet begun to fully realise the educational potential of this approach.

To better understand how role-reversal is viewed by medical education participants, necessary for its use as a tool to advance both education and patient care.

A senior resident designed and led a feedback-writing workshop for her own consultants (conducted 2022). After the session, eight consultants were interviewed in a semi-structured format. Analysis was conducted using the Stenfors-Hayes phenomenographical approach.

A multiplicity of experiential perspectives was identified by both consultants (teacher/participant/supporter/hierarchy member/colleague/holder of multiple perspectives) and trainee (presenter/subordinate/learner/researcher). The exercise increased appreciation and awareness of the complexity of the trainee-consultant educational-power relationship, though both parties maintained traditional hierarchy despite altered informational flow. Participants often held multiple articulated experiential perspectives simultaneously.

Consultants were able to assume a learning mindset while simultaneously maintaining awareness of their existing hierarchical relationship to the trainee-presenter; the trainee, conversely, struggled to adopt the teacher mindset. Deliberately viewing moments where trainees present new information to consultants as expertise role-reversal may provide a starting point for more equitable knowledge exchange between both parties in the clinical routine, and a foil for epistemic injustice. Increasing recognition and use of expertise role reversal can play a critical role in improving educational culture.