Intersectionality theory examines how matrices of power and interlocking structures of oppression... more Intersectionality theory examines how matrices of power and interlocking structures of oppression shape and influence people's multiple identities. It reminds us that people's lives cannot be explained by taking into account single categories, such as gender, race, sexuality, or socio-economic status. Rather, human lives are multi-dimensional and complex, and people's lived realities are shaped by different factors and social dynamics operating together. Therefore, when someone occupies multiple marginalized intersections, their individual-level experiences reflect social and structural systems of power, privilege, and inequality. And yet, knowing that people occupy different social locations that afford them unique experiences is not the same as knowing how to analyze data in an intersectional way. Intersectional analyses are rigorous, and require the use of theory at multiple levels to see theoretical connections that are often only implicit.In this paper, we ask "How does one actually do intersectional research and what role does theory play in this process?" In an effort to make intersectionality theory more accessible to health professions education research, this article describes the simpler version of intersectional analyses followed by the more complex version representing how it was originally intended to be used; a means to fight for social justice. Using pilot data collected on first-generation medical students' professional identity experiences, we demonstrate the thinking and engagement with theory that would be needed to do an intersectional analysis. Along the way, we describe some of the challenges researchers may find in using intersectionality in their own work. By re-situating the theory within its original roots of Black feminist thought, we hope other health professions education (HPE) researchers consider using intersectionality in their own analyses.
Issue: As medical education continues to grapple with issues of systemic racism and oppression wi... more Issue: As medical education continues to grapple with issues of systemic racism and oppression within its institutions, educational researchers will undoubtedly turn to critical theory to help illuminate these issues. Critical theory refers both to a "school of thought" and a process of critique that reveals the dynamic forces impacting minoritized groups and individuals. Critical theory can be helpful when researchers want to examine or expose social structures for their asymmetrical power differentials, and subsequently act upon them to create change. Evidence: However, despite the repeated calls for more critical work in medical education, merely describing critical theory's school of thought has not forwarded researchers' engagement with these theories. Presently, critical analyses remain rare in medical education. One potential reason for the lack of critical analyses is that there is little guidance for how researchers might engage with their data and approach their findings. Implications: In this paper, we go beyond merely describing critical theory and demonstrate how critical theory can be used as an analytic approach to interrogate the experiences of minoritized individuals in medical education. Using three critical theories: critical race theory, feminist theory, and postcolonial theory, we provide an illustration of how researchers might approach their data using one of three critical theories. In doing so, we hope to assist researchers in better understanding the utility of critical analyses to illuminate sociohistorical forces at work within medical education.
In the wake of worldwide events coalescing in 2020, the presence of anti-Black racism in the Unit... more In the wake of worldwide events coalescing in 2020, the presence of anti-Black racism in the United States was made visible to those abroad and its egregiousness made more explicit to some citizens previously unaware of it in the U.S. In addition to the onset of the COVID-19 pandemic exposing deep-seated structural health disparities between white and non-white communities, a global mass uprising emerged in response to George Floyd's death [1, 2]. In ways that could not have been anticipated even a few years earlier, segments of American society have had to reckon with the pervasive, powerful forces of white supremacy and the ways society and its structures have disadvantaged racially minoritized groups. In this wide-sweeping shift, medical education and medicine have also grappled with these issues, especially the ways in which medical education perpetuates institutional racism.
This manuscript is submitted in partial fulfillment of the Educational Innovation Institute’s (EI... more This manuscript is submitted in partial fulfillment of the Educational Innovation Institute’s (EII) Educational Research Fellowship Project in 2018.
Author(s): Gilliland, Sarah Jean | Advisor(s): Sandholtz, Judith H | Abstract: This dissertation ... more Author(s): Gilliland, Sarah Jean | Advisor(s): Sandholtz, Judith H | Abstract: This dissertation study examined how physical therapist (PT) students from two entry-level physical therapist educational programs characterized practice and engaged in clinical reasoning. The theoretical frame for this study identified four capacities, a well-organized knowledge base, the ability to effectively interact with patients, the ability to manage decision making in a context of uncertainty, and a patient-centered, biopsychosocial orientation to practice, required for effective clinical reasoning. This study addressed four primary research questions: How do PT students characterize physical therapy practice? During an encounter with a patient, what clinical decisions do PT students make, and what clinical reasoning strategies underlie their decisions? What is the relationship between PT students’ characterizations of practice and their clinical decisions? Do PT students’ clinical decisions and r...
As medical education grapples with larger issues of race and racism, researchers will need new to... more As medical education grapples with larger issues of race and racism, researchers will need new tools to capture society's complex issues. One promising approach is bricolage, a methodological and theoretical approach that allows researchers to bend analytical tools to meet their needs. Bricolage is both a metaphor and an activity to describe the cognitively creative process researchers engage in while conducting interdisciplinary and multidimensional research.
Abstract Issue Practices of systemic and structural racism that advantage some groups over others... more Abstract Issue Practices of systemic and structural racism that advantage some groups over others are embedded in American society. Institutions of higher learning are increasingly being pressured to develop strategies that effectively address these inequities. This article examines medical education’s diversity reforms and inclusion practices, arguing that many reify preexisting social hierarchies that privilege white individuals over those who are minoritized because of their race/ethnicity. Evidence: Drawing on the work of French theorist Michel Foucault, we argue that medical education’s curricular and institutional practices reinforce asymmetrical power differences and authority in ways that disadvantage minoritized individuals. Practices, such as medical education’s reliance on biomedical approaches, cultural competency, and standardized testing reinforce a racist system in ways congruent with the Foucauldian concept of “normalization.” Through medical education’s creation of subjects and its ability to normalize dominant forms of knowledge, trainees are shaped and socialized into ways of thinking, being, and acting that continue to support racial violence against minoritized groups. The systems, structures, and practices of medical education need to change to combat the pervasive forces that continue to shape racist institutional patterns. Individual medical educators will also need to employ critical approaches to their work and develop strategies that counteract institutional systems of racial violence. Implications: A Foucauldian approach that exposes the structural racism inherent in medical education enables both thoughtful criticism of status-quo diversity practices and practical, theory-driven solutions to address racial inequities. Using Foucault’s work to interrogate questions of power, knowledge, and subjectivity can expand the horizon of racial justice reforms in medicine by attending to the specific, pervasive ways racial violence is performed, both intra- and extra-institutionally. Such an intervention promises to take seriously the importance of anti-racist methodology in medicine.
Professional identity formation (PIF) is a growing area of research in medical education. However... more Professional identity formation (PIF) is a growing area of research in medical education. However, it is unclear whether the present research base is suitable for understanding PIF in physicians considered to be under‐represented in medicine (URM). This meta‐ethnography examined the qualitative PIF literature from 2012 to 2019 to assess its capacity to shine light on the experiences of minoritised physicians.
Purpose The United States has an implicit agreement known as the racial contract that exists betw... more Purpose The United States has an implicit agreement known as the racial contract that exists between white and non-white communities. Recently, the racial contract has produced much tension, expressed in racial violence and police brutality. This study explores how this racial violence and police brutality have affected the practice and education of Black trainees and physicians who are members of the racial community being targeted. Method This qualitative cross-sectional study interviewed 7 Black trainees and 12 physicians from 2 Southern medical schools in 2020. Interview data were collected using aspects of constructivist grounded theory, and then analyzed using the concept of racial trauma; a form of race-based stress minoritized individuals experience as a result of inferior treatment in society. Data were then organized by the causes participants cited for feeling unsafe, conditions they cited as producing these feelings, and the consequences these feelings had on their education and practice. Results The results show that even though participants were not direct victims of racial violence, because their social identity is linked to the Black community, they experienced these events vicariously. The increase in racial violence triggered unresolved personal and collective memories of intergenerational racial trauma, feelings of retraumatization after more than 400 years of mistreatment, and an awakening to the fact that the white community was unaware of their current and historical trauma. These events were felt in both their personal and professional lives. Conclusions As more minoritized physicians enter medicine and medical education, the profession needs a deeper understanding of their unique experiences and sociohistorical contexts, and the effect that these contexts have on their education and practice. While all community members are responsible for this, leaders play an important role in creating psychologically safe places where issues of systemic racism can be addressed.
Health professions education (HPE) is built on a structural foundation of modernity based on Euro... more Health professions education (HPE) is built on a structural foundation of modernity based on Eurocentric epistemologies. This foundation privileges certain forms of evidence and ways of knowing and is implicated in how dominant models of HPE curricula and healthcare practice position concepts of knowledge, equity, and social justice. This invited perspectives paper frames this contemporary HPE as the "Master's House", utilizing a term referenced from the writings of Audre Lorde. It examines the theoretical underpinnings of the "Master's House" through the frame of Quijano's concept of the Colonial Matrix of Power (employing examples of coloniality, race, and sex/gender). It concludes by exploring possibilities for how these Eurocentric structures may be dismantled, with reflection and discussion on the implications and opportunities of this work in praxis.
American Journal of Pharmaceutical Education, 2019
Objective. In the course of daily teaching responsibilities, pharmacy educators collect rich data... more Objective. In the course of daily teaching responsibilities, pharmacy educators collect rich data that can provide valuable insight into student learning. This article describes the qualitative data analysis method of content analysis, which can be useful to pharmacy educators because of its application in the investigation of a wide variety of data sources, including textual, visual, and audio files. Findings. Both manifest and latent content analysis approaches are described, with several examples used to illustrate the processes. This article also offers insights into the variety of relevant terms and visualizations found in the content analysis literature. Finally, common threats to the reliability and validity of content analysis are discussed, along with suitable strategies to mitigate these risks during analysis. Summary. This review of content analysis as a qualitative data analysis method will provide clarity and actionable instruction for both novice and experienced pharmacy education researchers.
This autoethnography makes use of 10 years of field notes that the author collected while living ... more This autoethnography makes use of 10 years of field notes that the author collected while living and working as an educational researcher in Greenland and Hawaii. Using Kaomea’s framework for thinking about when non-Native people should step forward, step back, or step out, the author’s analysis of these field notes indicates that she struggled around knowing her role in these post-colonial communities. The author was hesitant in moving into leadership positions in Greenland because it was only recently decolonized and she feared being perceived as someone interested in usurping qualified Greenlanders to fill important leadership positions. However, in Hawaii, which has had more time to consider its colonial past, the author felt less threatened, which gave her greater freedom to explore opportunities for where she could step forward. The study provides another dimension on white researchers working in post-colonial educational settings, and demonstrates the complexity of navigating...
Reasoning as Part of Clinical Reasoning Clinical reasoning in expert practitioners entails a comp... more Reasoning as Part of Clinical Reasoning Clinical reasoning in expert practitioners entails a complex interweaving of empiricodeductive and narrative reasoning. 7 Diagnostic reasoning, a critical skill within clinical reasoning, is a clinical classification process that involves relating the patient's level of disability with his or her physical function and pathology. 8,9 Through the diagnostic process, the clinician develops an understanding of the patient and his or her problems. 10 In all health care practices, the diagnostic process directs the clinician toward the selection of appropriate interventions.
As a result of health science educators' shift to more active formats of teaching and learning, m... more As a result of health science educators' shift to more active formats of teaching and learning, many educators are implementing innovative teaching strategies that were designed in other educational contexts. In some cases, this transfer from one context to another is smooth and unproblematic, but in others, educators must make informed decisions about how to adjust the innovation or incoming context to fit their needs. This paper presents a framework that draws on principles of design-based research to guide educators in analyzing and adapting teaching tools to fit new contexts.
Background and Purpose. Clinical reasoning is a complex, nonlinear problem–solving process that i... more Background and Purpose. Clinical reasoning is a complex, nonlinear problem–solving process that is influenced by models of practice. The development of physical therapists’ clinical reasoning abilities is a crucial yet underresearched aspect of entry-level (professional) physical therapist education. Objectives. The purpose of this qualitative study was to examine the types of clinical reasoning strategies physical therapist students engage in during a patient encounter. Methods. A qualitative descriptive case study design involving within and across case analysis was used. Eight second-year, professional physical therapist students from 2 different programs completed an evaluation and initial intervention for a standardized patient followed by a retrospective think-aloud interview to explicate their reasoning processes. Participants’ clinical reasoning strategies were examined using a 2-stage qualitative method of thematic analysis. Results. Participants demonstrated consistent sig...
This study captured a moment of conflict between Danish and Greenlandic educational leaders as th... more This study captured a moment of conflict between Danish and Greenlandic educational leaders as they engaged in a joint endeavor to implement Greenland's nationwide reform. After adopting the Standards for Effective Pedagogy developed by the Center for Research on Education, Diversity, and Excellence (CREDE), reform leaders were in disagreement on two strategies that explicitly used Greenland's Native culture to teach. This study analyzes reform leaders' arguments on the disputed Standards, Contextualization and Modeling. Results indicate that while both groups were committed to the task, their goals for implementation differed. Greenlandic reform leaders were concerned with whether the use of the two Standards would increase and strengthen Native representation and identity. Danish reform leaders were interested in understanding the best way to use the pedagogy in Greenland's educational context. This study points to the complexity of joint endeavors in post-colonial societies, particularly where Native cultural revitalization is the goal. Although it is easy to dismiss conflict and resistance as a product of post-colonialism, arguments made by each side should be analyzed for its contribution to the overall goal of educational reform. I n many post-colonial contexts, indigenous reform leaders are changing their educational systems to reflect the values and cultures of their Native communities. To accomplish their goals, subordinated groups may need to elicit the assistance of the dominating group until they are self-sustaining (Kaomea, 2005). These joint tasks may incite conflict as group members' negotiate different perspectives for what is best in the education of Native students. This study captures a moment of conflict between Greenland's reform leaders in the implementation of a nationwide reform. As part of the reform process, Greenland's Ministry of Education officials adopted the Standards for Effective Pedagogy developed by U.S. researchers at the Center for Research on Education, Diversity, and Excellence (CREDE). Initially, Danish and Greenlandic reform leaders embraced the pedagogical model citing its appropriateness in the Greenlandic context. In time, Danish reform leaders strongly resisted Contextualization and Modeling, two Standards that make explicit use of culture to teach.
... Lois A. Yamauchi, Tasha R. Wyatt, and Jacquelin H. Carroll ... know, (d) supporting complex t... more ... Lois A. Yamauchi, Tasha R. Wyatt, and Jacquelin H. Carroll ... know, (d) supporting complex thinking by focusing on higher level thought and providing feed-back; and (e) enacting instructional conversationsteaching through small group discourse (Tharp, Estrada, Dalton, & ...
Intersectionality theory examines how matrices of power and interlocking structures of oppression... more Intersectionality theory examines how matrices of power and interlocking structures of oppression shape and influence people's multiple identities. It reminds us that people's lives cannot be explained by taking into account single categories, such as gender, race, sexuality, or socio-economic status. Rather, human lives are multi-dimensional and complex, and people's lived realities are shaped by different factors and social dynamics operating together. Therefore, when someone occupies multiple marginalized intersections, their individual-level experiences reflect social and structural systems of power, privilege, and inequality. And yet, knowing that people occupy different social locations that afford them unique experiences is not the same as knowing how to analyze data in an intersectional way. Intersectional analyses are rigorous, and require the use of theory at multiple levels to see theoretical connections that are often only implicit.In this paper, we ask "How does one actually do intersectional research and what role does theory play in this process?" In an effort to make intersectionality theory more accessible to health professions education research, this article describes the simpler version of intersectional analyses followed by the more complex version representing how it was originally intended to be used; a means to fight for social justice. Using pilot data collected on first-generation medical students' professional identity experiences, we demonstrate the thinking and engagement with theory that would be needed to do an intersectional analysis. Along the way, we describe some of the challenges researchers may find in using intersectionality in their own work. By re-situating the theory within its original roots of Black feminist thought, we hope other health professions education (HPE) researchers consider using intersectionality in their own analyses.
Issue: As medical education continues to grapple with issues of systemic racism and oppression wi... more Issue: As medical education continues to grapple with issues of systemic racism and oppression within its institutions, educational researchers will undoubtedly turn to critical theory to help illuminate these issues. Critical theory refers both to a "school of thought" and a process of critique that reveals the dynamic forces impacting minoritized groups and individuals. Critical theory can be helpful when researchers want to examine or expose social structures for their asymmetrical power differentials, and subsequently act upon them to create change. Evidence: However, despite the repeated calls for more critical work in medical education, merely describing critical theory's school of thought has not forwarded researchers' engagement with these theories. Presently, critical analyses remain rare in medical education. One potential reason for the lack of critical analyses is that there is little guidance for how researchers might engage with their data and approach their findings. Implications: In this paper, we go beyond merely describing critical theory and demonstrate how critical theory can be used as an analytic approach to interrogate the experiences of minoritized individuals in medical education. Using three critical theories: critical race theory, feminist theory, and postcolonial theory, we provide an illustration of how researchers might approach their data using one of three critical theories. In doing so, we hope to assist researchers in better understanding the utility of critical analyses to illuminate sociohistorical forces at work within medical education.
In the wake of worldwide events coalescing in 2020, the presence of anti-Black racism in the Unit... more In the wake of worldwide events coalescing in 2020, the presence of anti-Black racism in the United States was made visible to those abroad and its egregiousness made more explicit to some citizens previously unaware of it in the U.S. In addition to the onset of the COVID-19 pandemic exposing deep-seated structural health disparities between white and non-white communities, a global mass uprising emerged in response to George Floyd's death [1, 2]. In ways that could not have been anticipated even a few years earlier, segments of American society have had to reckon with the pervasive, powerful forces of white supremacy and the ways society and its structures have disadvantaged racially minoritized groups. In this wide-sweeping shift, medical education and medicine have also grappled with these issues, especially the ways in which medical education perpetuates institutional racism.
This manuscript is submitted in partial fulfillment of the Educational Innovation Institute’s (EI... more This manuscript is submitted in partial fulfillment of the Educational Innovation Institute’s (EII) Educational Research Fellowship Project in 2018.
Author(s): Gilliland, Sarah Jean | Advisor(s): Sandholtz, Judith H | Abstract: This dissertation ... more Author(s): Gilliland, Sarah Jean | Advisor(s): Sandholtz, Judith H | Abstract: This dissertation study examined how physical therapist (PT) students from two entry-level physical therapist educational programs characterized practice and engaged in clinical reasoning. The theoretical frame for this study identified four capacities, a well-organized knowledge base, the ability to effectively interact with patients, the ability to manage decision making in a context of uncertainty, and a patient-centered, biopsychosocial orientation to practice, required for effective clinical reasoning. This study addressed four primary research questions: How do PT students characterize physical therapy practice? During an encounter with a patient, what clinical decisions do PT students make, and what clinical reasoning strategies underlie their decisions? What is the relationship between PT students’ characterizations of practice and their clinical decisions? Do PT students’ clinical decisions and r...
As medical education grapples with larger issues of race and racism, researchers will need new to... more As medical education grapples with larger issues of race and racism, researchers will need new tools to capture society's complex issues. One promising approach is bricolage, a methodological and theoretical approach that allows researchers to bend analytical tools to meet their needs. Bricolage is both a metaphor and an activity to describe the cognitively creative process researchers engage in while conducting interdisciplinary and multidimensional research.
Abstract Issue Practices of systemic and structural racism that advantage some groups over others... more Abstract Issue Practices of systemic and structural racism that advantage some groups over others are embedded in American society. Institutions of higher learning are increasingly being pressured to develop strategies that effectively address these inequities. This article examines medical education’s diversity reforms and inclusion practices, arguing that many reify preexisting social hierarchies that privilege white individuals over those who are minoritized because of their race/ethnicity. Evidence: Drawing on the work of French theorist Michel Foucault, we argue that medical education’s curricular and institutional practices reinforce asymmetrical power differences and authority in ways that disadvantage minoritized individuals. Practices, such as medical education’s reliance on biomedical approaches, cultural competency, and standardized testing reinforce a racist system in ways congruent with the Foucauldian concept of “normalization.” Through medical education’s creation of subjects and its ability to normalize dominant forms of knowledge, trainees are shaped and socialized into ways of thinking, being, and acting that continue to support racial violence against minoritized groups. The systems, structures, and practices of medical education need to change to combat the pervasive forces that continue to shape racist institutional patterns. Individual medical educators will also need to employ critical approaches to their work and develop strategies that counteract institutional systems of racial violence. Implications: A Foucauldian approach that exposes the structural racism inherent in medical education enables both thoughtful criticism of status-quo diversity practices and practical, theory-driven solutions to address racial inequities. Using Foucault’s work to interrogate questions of power, knowledge, and subjectivity can expand the horizon of racial justice reforms in medicine by attending to the specific, pervasive ways racial violence is performed, both intra- and extra-institutionally. Such an intervention promises to take seriously the importance of anti-racist methodology in medicine.
Professional identity formation (PIF) is a growing area of research in medical education. However... more Professional identity formation (PIF) is a growing area of research in medical education. However, it is unclear whether the present research base is suitable for understanding PIF in physicians considered to be under‐represented in medicine (URM). This meta‐ethnography examined the qualitative PIF literature from 2012 to 2019 to assess its capacity to shine light on the experiences of minoritised physicians.
Purpose The United States has an implicit agreement known as the racial contract that exists betw... more Purpose The United States has an implicit agreement known as the racial contract that exists between white and non-white communities. Recently, the racial contract has produced much tension, expressed in racial violence and police brutality. This study explores how this racial violence and police brutality have affected the practice and education of Black trainees and physicians who are members of the racial community being targeted. Method This qualitative cross-sectional study interviewed 7 Black trainees and 12 physicians from 2 Southern medical schools in 2020. Interview data were collected using aspects of constructivist grounded theory, and then analyzed using the concept of racial trauma; a form of race-based stress minoritized individuals experience as a result of inferior treatment in society. Data were then organized by the causes participants cited for feeling unsafe, conditions they cited as producing these feelings, and the consequences these feelings had on their education and practice. Results The results show that even though participants were not direct victims of racial violence, because their social identity is linked to the Black community, they experienced these events vicariously. The increase in racial violence triggered unresolved personal and collective memories of intergenerational racial trauma, feelings of retraumatization after more than 400 years of mistreatment, and an awakening to the fact that the white community was unaware of their current and historical trauma. These events were felt in both their personal and professional lives. Conclusions As more minoritized physicians enter medicine and medical education, the profession needs a deeper understanding of their unique experiences and sociohistorical contexts, and the effect that these contexts have on their education and practice. While all community members are responsible for this, leaders play an important role in creating psychologically safe places where issues of systemic racism can be addressed.
Health professions education (HPE) is built on a structural foundation of modernity based on Euro... more Health professions education (HPE) is built on a structural foundation of modernity based on Eurocentric epistemologies. This foundation privileges certain forms of evidence and ways of knowing and is implicated in how dominant models of HPE curricula and healthcare practice position concepts of knowledge, equity, and social justice. This invited perspectives paper frames this contemporary HPE as the "Master's House", utilizing a term referenced from the writings of Audre Lorde. It examines the theoretical underpinnings of the "Master's House" through the frame of Quijano's concept of the Colonial Matrix of Power (employing examples of coloniality, race, and sex/gender). It concludes by exploring possibilities for how these Eurocentric structures may be dismantled, with reflection and discussion on the implications and opportunities of this work in praxis.
American Journal of Pharmaceutical Education, 2019
Objective. In the course of daily teaching responsibilities, pharmacy educators collect rich data... more Objective. In the course of daily teaching responsibilities, pharmacy educators collect rich data that can provide valuable insight into student learning. This article describes the qualitative data analysis method of content analysis, which can be useful to pharmacy educators because of its application in the investigation of a wide variety of data sources, including textual, visual, and audio files. Findings. Both manifest and latent content analysis approaches are described, with several examples used to illustrate the processes. This article also offers insights into the variety of relevant terms and visualizations found in the content analysis literature. Finally, common threats to the reliability and validity of content analysis are discussed, along with suitable strategies to mitigate these risks during analysis. Summary. This review of content analysis as a qualitative data analysis method will provide clarity and actionable instruction for both novice and experienced pharmacy education researchers.
This autoethnography makes use of 10 years of field notes that the author collected while living ... more This autoethnography makes use of 10 years of field notes that the author collected while living and working as an educational researcher in Greenland and Hawaii. Using Kaomea’s framework for thinking about when non-Native people should step forward, step back, or step out, the author’s analysis of these field notes indicates that she struggled around knowing her role in these post-colonial communities. The author was hesitant in moving into leadership positions in Greenland because it was only recently decolonized and she feared being perceived as someone interested in usurping qualified Greenlanders to fill important leadership positions. However, in Hawaii, which has had more time to consider its colonial past, the author felt less threatened, which gave her greater freedom to explore opportunities for where she could step forward. The study provides another dimension on white researchers working in post-colonial educational settings, and demonstrates the complexity of navigating...
Reasoning as Part of Clinical Reasoning Clinical reasoning in expert practitioners entails a comp... more Reasoning as Part of Clinical Reasoning Clinical reasoning in expert practitioners entails a complex interweaving of empiricodeductive and narrative reasoning. 7 Diagnostic reasoning, a critical skill within clinical reasoning, is a clinical classification process that involves relating the patient's level of disability with his or her physical function and pathology. 8,9 Through the diagnostic process, the clinician develops an understanding of the patient and his or her problems. 10 In all health care practices, the diagnostic process directs the clinician toward the selection of appropriate interventions.
As a result of health science educators' shift to more active formats of teaching and learning, m... more As a result of health science educators' shift to more active formats of teaching and learning, many educators are implementing innovative teaching strategies that were designed in other educational contexts. In some cases, this transfer from one context to another is smooth and unproblematic, but in others, educators must make informed decisions about how to adjust the innovation or incoming context to fit their needs. This paper presents a framework that draws on principles of design-based research to guide educators in analyzing and adapting teaching tools to fit new contexts.
Background and Purpose. Clinical reasoning is a complex, nonlinear problem–solving process that i... more Background and Purpose. Clinical reasoning is a complex, nonlinear problem–solving process that is influenced by models of practice. The development of physical therapists’ clinical reasoning abilities is a crucial yet underresearched aspect of entry-level (professional) physical therapist education. Objectives. The purpose of this qualitative study was to examine the types of clinical reasoning strategies physical therapist students engage in during a patient encounter. Methods. A qualitative descriptive case study design involving within and across case analysis was used. Eight second-year, professional physical therapist students from 2 different programs completed an evaluation and initial intervention for a standardized patient followed by a retrospective think-aloud interview to explicate their reasoning processes. Participants’ clinical reasoning strategies were examined using a 2-stage qualitative method of thematic analysis. Results. Participants demonstrated consistent sig...
This study captured a moment of conflict between Danish and Greenlandic educational leaders as th... more This study captured a moment of conflict between Danish and Greenlandic educational leaders as they engaged in a joint endeavor to implement Greenland's nationwide reform. After adopting the Standards for Effective Pedagogy developed by the Center for Research on Education, Diversity, and Excellence (CREDE), reform leaders were in disagreement on two strategies that explicitly used Greenland's Native culture to teach. This study analyzes reform leaders' arguments on the disputed Standards, Contextualization and Modeling. Results indicate that while both groups were committed to the task, their goals for implementation differed. Greenlandic reform leaders were concerned with whether the use of the two Standards would increase and strengthen Native representation and identity. Danish reform leaders were interested in understanding the best way to use the pedagogy in Greenland's educational context. This study points to the complexity of joint endeavors in post-colonial societies, particularly where Native cultural revitalization is the goal. Although it is easy to dismiss conflict and resistance as a product of post-colonialism, arguments made by each side should be analyzed for its contribution to the overall goal of educational reform. I n many post-colonial contexts, indigenous reform leaders are changing their educational systems to reflect the values and cultures of their Native communities. To accomplish their goals, subordinated groups may need to elicit the assistance of the dominating group until they are self-sustaining (Kaomea, 2005). These joint tasks may incite conflict as group members' negotiate different perspectives for what is best in the education of Native students. This study captures a moment of conflict between Greenland's reform leaders in the implementation of a nationwide reform. As part of the reform process, Greenland's Ministry of Education officials adopted the Standards for Effective Pedagogy developed by U.S. researchers at the Center for Research on Education, Diversity, and Excellence (CREDE). Initially, Danish and Greenlandic reform leaders embraced the pedagogical model citing its appropriateness in the Greenlandic context. In time, Danish reform leaders strongly resisted Contextualization and Modeling, two Standards that make explicit use of culture to teach.
... Lois A. Yamauchi, Tasha R. Wyatt, and Jacquelin H. Carroll ... know, (d) supporting complex t... more ... Lois A. Yamauchi, Tasha R. Wyatt, and Jacquelin H. Carroll ... know, (d) supporting complex thinking by focusing on higher level thought and providing feed-back; and (e) enacting instructional conversationsteaching through small group discourse (Tharp, Estrada, Dalton, & ...
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Papers by Tasha R. Wyatt