Whenever we find ourselves on the horns of a dilemma (with) two opposites that both seem desirable, the right question to ask ourselves is not which we should choose, but whether we have the dimensions rightGlenn Regher
I recall when I first started thinking about my tentative research project – 2 years ago – readily struggling to formulate my research question. I suspect, when one is given a degree of autonomy over what they get to study, and if one is to carefully consider the topic of their research query, perhaps, two paths emerge: One in which learning the method takes precedence, and another where the topic itself is the locus of interest. In addition, and perhaps especially true if the project is of qualitative nature, one is largely constrained by the environment in which they operate. Time, resources, and individual limitations become real considerations. In qualitative research, reflexivity emerges as the medium with which one can account for these fundamental limitations.
I was lucky to have been, previously, exposed to the incredible world of basic-science research, and to have marveled at the subtle but important differences in how undergraduate and graduate education manifest. After that, I went through professional training which I was utterly convinced would mirror graduate structure, only to find out it was routinely undergraduate. Nonetheless, it had nuanced differences. It was interspersed with elements of problem-based learning and workplace-based assessment; Unique didactic and practical components. In Dentistry, we have clinical instructors and we have lecturers (usually professors or specialists). Inevitably, and if you’re attuned to your surrounding, you might notice a disconnect at one point or another, between theory and practice. You may notice it early on; and you may realize it at the conclusion of your training.
I used to spend a lot of time thinking about which subjects I enjoyed the most in Dentistry. This interest did not particularly stem from a desire to specialize, rather, the ways in which the curriculum (both structured and hidden) was operationalized. University of Toronto is where I trained, and naturally, I want to proclaim pride in having trained at that prestigious faculty. And I do, immensely. But we were also taught to be critical. We had significant exposure to areas of basic sciences, and research methods, though they were seldom explicitly integrated. I had many classmates who had little interest in those domains. I can’t blame them. But I saw value in it, and often retrospectively. I suspect I was biased because it was reminiscent of my past. And now I have the benefit of knowing that transfer of domain knowledge does not just manifest in immediate future, rather it can, and should, extend longitudinally with time.
Radiology was particularly well done. The department was very prescriptive in their training. Simulation was early and authentic to real life scenarios. You lost points for not placing lead apron on a manikin, and significantly lost points for not adhering to infection control and cross contamination standards. Interpretation of radiographs was systematic and formulaic. It was useful, and somehow that dogma fit the subject so well. Radiology, however, is dear to me for another reason. Unbeknownst to me, it would become my gateway to another field of study altogether; Namely, learning sciences.
In our clinical placements, I often reflected on why we had such holistic clinical assessment rubrics, yet only got assessed strictly on procedural elements, with little discussion (be it pre- , intra- , or even post-operatively) and impetuous feedback. How there were often palpable inter-rater inconsistencies, and different philosophies across specialties, with some more progressive (e.g. asynchronous online modules) and others more traditional. This nascent curiosity propelled me in the direction of more research into the cognitive and contextual elements that push people to elevate their knowledge in one domain or another. I also had a nascent desire to elevate the quality of the learning and education science discourse taking place in Dentistry. In retrospect, I belonged to that latter camp who wanted to delve deeper into conceptual topics and subsequently try to find a sustained, meaningful, clinical application. But if there is something I learned well during my health professions education fellowship: it is to be suspicious of binaries. Glenn Regehr famously said “Whenever we find ourselves on the horns of a dilemma (with) two opposites that both seem desirable, the right question to ask ourselves is not which we should choose, but whether we have the dimensions right”. Even though I wanted to choose that latter path, I still had to learn the method; even more, the methodology, for they are not one and the same. If there was another big lesson I learned from my HPE research fellowship, it was the importance of framing research in theory. Only then can you justify methodology.
As I write this, I am reminded of when I was finishing my thesis write up for my master’s in science in immunology. As much as I was fascinated by the research, I could not say the same about the write up. It was nearly, completely, technical and the only leeway for a bit of theorizing and tangential thought was in the discussion; perhaps a little in the introduction. The palpable presence of humanities (sociology, psychology, philosophy) in Health Professions Education (HPE) research made me, not only fascinated, but enamoured with the writing process. As I have come to learn, self-regulation of learning is one thing, and motivation is a whole other.
(The above is a modified version of a longer reflection representing one aspect of a portfolio submission required for completion of my master in health professions education)