title: Emotions and identity in the figured world of becoming a doctor.
abstract: BACKGROUND
  There is little room in clerkship curricula for students to express emotions, particularly those associated with the development of a caring identity. Yet it is recognised that competence, alone, does not make a good doctor. We therefore set out to explore the relationship between emotions and identity in clerkship education. Our exploration was conceptually oriented towards Figured Worlds theory, which is linked to Bakhtin's theory of dialogism.
  
  
  METHODS
  Nine female and one male member of a mixed student cohort kept audio-diaries and participated in both semi-structured and cognitive individual interviews. The researchers identified 43 emotionally salient utterances in the dataset and subjected them to critical discourse analysis. They applied Figured Worlds constructs to within-case and cross-case analyses, supporting one another's reflexivity and openness to different interpretations, and constantly comparing their evolving interpretation against the complete set of transcripts.
  
  
  RESULTS
  Students' emotions were closely related to their identity development in the world of medicine. Patients were disempowered by their illnesses. Doctors were powerful because they could treat those illnesses. Students expressed positive emotions when they were granted positions in the world of medicine and were able to identify with the figures of doctors or other health professionals. They identified with doctors who behaved in caring and professionally appropriate ways towards patients and supportively towards students. Students expressed negative emotions when they were unable to develop their identities.
  
  
  CONCLUSIONS
  Critical discourse analysis has uncovered a link between students' emotions and their identity development in the powerful world of becoming and being a doctor. At present, identity development, emotions and power are mostly tacit in undergraduate clinical curricula. We speculate that helping students to express emotions and exercise power in the most effective ways might help them to develop caring identities.
authors: Department of Education Development and Research, Maastricht University, Maastricht, The Netherlands.
authors: Tim
authors: T
authors: Dornan
authors: Emma
authors: E
authors: Pearson
authors: Peter
authors: P
authors: Carson
authors: Esther
authors: E
authors: Helmich
authors: Christine
authors: C
authors: Bundy
mesh_terms: D001291:Attitude of Health Personnel; D002982:Clinical Clerkship; D004504:Education, Medical, Undergraduate; D004644:Emotions; D005260:Female; D006801:Humans; D007062:Identification, Psychological; D008297:Male; D008962:Models, Theoretical; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D036301:Qualitative Research; D013337:Students, Medical / Q000523:psychology*; D006113:United Kingdom