Table 1
Correlation of study findings with Transformative Learning (TL) theory
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TL phases [7] 1. A disorienting dilemma 2. A self-examination with feelings of guilt or shame 3. A critical assessment of epistemic, sociocultural or psychic assumptions 4. Recognition that one’s discontent and the process of transformation are shared and that others have negotiated a similar change 5. Exploration of options for new roles, relationships and actions 6. Planning of a course of action, renegotiating relationships and negotiating new relationships 7. Acquisition of knowledge and skills for implementing one’s plans 8. Provisional trying of new roles 9. Building of competence and self-confidence in new roles and relationship 10. A reintegration into one’s life on the basis of conditions dictated by one’s perspective |
THEME 1: Perspectival shift in educational practice A substantive shift in concepts of learning and/or teaching based on experiences in the workshop and subsequent application in practice | |
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1.1 New ideas, practices or approaches 1.2 New insights into existing concepts about education 1.3 New relationships foster critical discourse for learning | ||
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THEME 2: Deepening, validating, and re-affirming current practices The workshop experience serves to clarify and structure prior ideas on teaching–learning and to affirm the associated beliefs and values | ||
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THEME 3: Being and/or becoming an educator Health professionals (HPs) identify as clinicians and not all HPs have developed an educator identity in addition to the HP identity. Attunement and growth mindset is necessary for transformative learning | ||
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3.1 Having or developing an educator identity in addition to the HP identity 3.2 Attunement and growth mindset are necessary for transformative learning | ||
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THEME 4: Valuing faculty development that accommodates HPs’ multiple communities of practice Faculty development for HPs should recognize competing clinical priorities and the workplace community of practice | ||
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4.1 Design of faculty development sensitive to HPs’ complex clinical/workplace needs 4.2 The workplace educator community of practice influences transformative learning gained through formal faculty development | ||
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Phase |
Study findings that correlate with TL | |
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1–3 |
THEME 1 (Subthemes 1.1 and 1.2) | |
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Confirmatory finding: A review of empirical evidence for Mezirow’s model found that the 10 phases are not necessarily sequential nor universally present and broadened the original definition of disorientating dilemma triggered by acute personal crisis [6] to include disequilibrium provoked by experiences incongruent with established meaning perspectives [37]. Our study findings are consistent with this. Contribution to TL: Several of our participants describe disorienting dilemma in terms of positive rather than negative emotions (e.g., excitement at new conceptual understanding). Many of the original TL studies involved participants with illness or from marginalized groups [37], while a recent education study described emotions ranging from joyful to unpleasant [38]. We suggest that strong emotion is required as catalyst while the type of emotion is less relevant | ||
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THEME 2 | ||
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Confirmatory finding: Self-examination leads to critical assessment of epistemic assumptions about teaching–learning. A deeper understanding reinforces and improves on previous practices, by emphasizing incompletely recognized aspects of practice | ||
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4 |
THEME 1 (Subtheme 1.3) | |
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Confirmatory finding: Reflection and critical discourse is important for TL [13]. The workshop provided a new opportunity to discuss education with educators that allowed a deeper understanding of concepts and stimulated ideas | ||
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5–9 |
THEME 1 (Subthemes 1.1 and 1.2) | |
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Confirmatory finding: The workshop utilized strategies to foster TL (ESM, Appendix 1) [1, 5, 16, 17]. Additional TL research highlights the influence of context, the importance of relationships and other factors like feelings and support structures that promote and inhibit perspective transformation [17]. Our study findings confirm the efficacy of such strategies in promoting TL and reinforce the influence of contextual support factors | ||
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10 |
THEME 3 (Subthemes 3.1 and 3.2); THEME 4 (Subtheme 4.2) | |
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Confirmatory findings: 12/17 participants described enactment of TL. They were those with stronger educator identity, displayed educator characteristics of reflecting on teaching practice, valued FD and regularly engaged with others on education matters within their workplace communities of practice. These findings suggest that a strong educator identity with a supportive “pro-education” community of practice promotes enactment of TL. Our study corroborates Mezirow’s revised TL [12] where he placed more emphasis on the social/relationship aspects of perspective transformation | ||