How to Grow a Professional Identity: Philosophical Gardening in the Field of Medical Education.

Abstract

In this philosophical reflection, we - following the philosopher Heidegger - introduce two farmers who represent different ways in which one can develop growth (see https://www.youtube.com/watch?v=g7jZigyfKHI for instructional video). One is a traditional farmer who entrusts the seeds to the soil and cultivates them with care and trust. The other is a modern farmer who takes an industrialized approach and positions the seeds and 'challenges-forth' the crops to show themselves in a certain way. We use these farmers as an analogy for the ways in which we as medical educators can and should relate to those we 'care' for: medical students and trainees. Taking a philosophical stance, and accounting for our own positionality and involvement in the analysis, we focus on 'Professional Identity Formation' and its operationalization in the field of medical education. We identify three main approaches medical education has taken to identity: as an individual trait, as a set of behaviors, and as a socialization process. All these approaches have at their root a similar assumption, namely that all inner processes can be made visible. We challenge this representational paradigm and use 'philosophical gardening' to raise awareness of what can and cannot be measured and controlled. Finally, we suggest educational approaches that leave space for diversity in students' experiences, learning approaches, and growth. We share good practices of brave teachers and curriculum designers whose interventions are characterized by less control and fewer measurements of personal growth, but more trust and free spaces for authentic learning.