Browsing by Author "Brown, Allison"

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    Exploring How Best to Teach Trauma-Informed Care in Undergraduate Medical Education
    (2023-05-09) Young, Jessica Lynn; Brown, Allison; Cooke, Lara; Jalil, Rabiya; Waegemakers Schiff, Jeannette
    Trauma-informed care (TIC) is an approach that recognizes the potential for patients to have experienced trauma and requires care to be sensitive and adaptive to this; ongoing calls to action continue to highlight the need for TIC to be incorporated into the training of medical doctors. This exploratory qualitative study employed constructivist grounded theory methods to empirically investigate how leading physicians in Canada conceptualize and operationalize TIC and further examine how it could be effectively taught to medical learners during undergraduate medical education (UME). The study found that physicians view TIC as a practice philosophy, rather than a specific framework or set of skills, oriented around seven principles. Rather than viewing trauma as a biomedical or psychiatric condition, physicians saw structures and systems of oppression as mediators for – and causes of – trauma. Findings illuminate foundational knowledge and skills necessary to augment the translation of TIC in clinical practice that can be used to inform what and how medical schools teach TIC. This study identified the importance of longitudinal integration, spirality, and meaningful applications of TIC in a UME-level TIC curriculum, which ensures that all learners are introduced to the construct of TIC and are able to apply it in early clinical interactions. However, challenges such as the contradictory and powerful influence of the hidden curriculum as well as the critical need for faculty development must be addressed. Overall, this emphasizes the need for physician training to cultivate context- dependent and adaptable approaches to TIC in an effort to break the cycle of systemic violence and trauma in medicine.
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    Exploring Resistance in the Context of Social Justice Education in Undergraduate Medical Education
    (2024-06-18) Adel, Adibba; Brown, Allison; Ellaway, Rachel; Jalil, Rabiya
    Background: This study explores the nuanced phenomenon of student resistance to social justice education, aiming to understand how and why students may resist this in the context of a new undergraduate medical curriculum at the University of Calgary. This curriculum features a longitudinal integration of a health equity and structural competency curriculum. Previous resistance from students towards this aspect of the curriculum hinted at this being a possible phenomenon in the new curriculum, thus warranting empirical investigation. Methods: This qualitative case study utilized semi-structured interviews with first-year medical students and faculty members at the University of Calgary to gain insight into student resistance and the ways it manifests. Phenomenography was used as a supplemental analytic lens to examine variation in resistance as a phenomenon. Results: Between September and December 2023, 23 semi-structured interviews were conducted with medical students and faculty members. Student resistance manifested in various emotional, cognitive, and behavioural responses. Reasons for student resistance also varied from feelings of discomfort and guilt, fear of being called out, anxiety surrounding medical knowledge and clinical competence, and personal biases and prejudice. Based on these findings, an outcome space delineates a spectrum of student resistance. Conclusion: Resistance to social justice education from medical students is a complex phenomenon that requires careful consideration. Findings from this case study reveal the diverse ways students may resist social justice education, ranging from emotional discomfort to skepticism about the relevance of social justice education to clinical practice. The findings also highlight the importance of taking proactive measures in addressing this resistance. Medical schools can work towards this by meaningfully integrating social justice education into curricula, utilizing pedagogical approaches that could mitigate potential resistance, prioritizing faculty development, and diversifying assessment strategies.