The data revealed rich insights into educator identity formation amongst dermatology residents. Overall, 20 participants took part in the study in years 2, 3, 4 of the 4-year residency program. Seventeen participants were female and 3 were male. Based on the 60 written reflections and 20 interviews, we broadly categorized our themes into: content themes and process themes. Content themes comprise participants' views and experiences of education and educational practice in medicine. These themes include definitions of education, the process of education, and professional development. Process-oriented themes included the various identities residents constructed. In what follows, we organize these themes according to our research questions.
How do dermatology residents form identities as educators?
Defining education
In response to the question ‘Who am I as an educator?’ participants wrote in their personal professional portfolios and shared during the interviews definitions of education, attributes of a good educator, and their aspirations of becoming a better educator. Some residents defined education within the confines of the residency program:
“So as part of our residency program we're kind of obligated to give lectures that are carried out as part of the training. Those lectures are either joint or within the hospital that we rotate in. This is one of our roles as educators.” (Resident 5)
Another participant defined education more holistically, drawing attention to the environment:
“I mean, to me, it's the cultivating, supportive, and professional relationship you have. The encouragement of self-inquiry and research and reflective activity is going to culminate into allowing you to be part of this educator establishment or educational establishment. In my career, I don't think I-- it's not the process of teaching itself. It's the entire environment you're in” (Resident 8)
Another participant defined education beyond residency:
“I'm the eldest of the family among my brothers and sisters. So I always try to share my experiences with my brothers and sisters…give advice. I'm always willing to help out with their studies if someone has difficulty understanding a certain topic. My younger sister was enrolled in medical school for a while, so I was helping her out with that” (Resident 9)
Some participants described attributes of being a successful educator, suggesting that being a good educator, required committing to lifelong learning, having an ability to design and communicate:
“In my opinion, to be a successful educator, a person needs to be a lifelong learner in the first place, a designer who’s able to simplify and deliver information using creative teaching methods and lastly a good communicator who can discuss and view knowledge from different perspectives” (Resident 13)
Participants reflected on their aspirations of becoming better educators by engaging in informal activities with juniors. These authentic personal experiences, as reported by participants, helped them become better learners:
“Yes. So I do group studies, and most of the time, I've been teaching more junior residents, and I found it really helpful for me, more than the residents themselves…I'll never forget it if I give it to someone or if I explain it.” (Resident 15)
The process of education
Participants reflected on how they went about educating others. One participant conceptualized education as prioritizing and guiding learners to appropriate learning resources:
“Sharing important resources and highlighting important topics is more important than offering a piece of information that might be forgotten at the end of the day.” (Resident 17)
Some participants spoke of education as an act of paying it forward, as a resident shared:
“because if you get benefits from those sessions from the people who are senior to you at that time, it's like a mandate in a way to give it to the juniors.” (Resident 12)
The process of education was also viewed as context-based: in the clinical setting or in the lecture hall.
“Being an R3 resident we're also sharing information during clinics with our colleague residents…This is my role as an educator.” (Resident 20)
Educator identity formation
One participant struggled with their identity as an educator:
“Okay. Actually, I don't find myself that much as an educator. But I have things I did in my med school, also during residency. We did summaries, we did lectures, we did seminars, we did also some lectures during our residency. Those are the things that I did, and I don't find them that much for a purpose as education. I think I have to fulfill all the things that I need, then I can be educator. Uh-huh. So– Yeah, I have to gain all the knowledge I need, then, I can deliver it to people” (Resident 15)
While other residents formed educator identities in several multifaceted ways:
Educator as leader
“After the program, I have ambitions of creating more dermatology programs. I can do it, now that I know about the need. We don’t have many (programs) in Saudi Arabia” (Resident 13)
Educator as simplifier
“Some people tell me that I'm good at teaching. I try to simplify ideas as much as I can. I've had the sort of feedback before that I simplify what people find difficult. And people usually tend to come to me to explain certain things that they find difficult. However, I don't think I'm an excellent educator. I'm still working on that aspect, but I'm always willing to help.” (Resident 13)
Educator as knowledge curator
In the following quote, the participant forms their identity as an eductor, and speaks using plural pronouns:
“We do a formal topic review, which is our Tuesday activity. So you've been assigned to a certain topic, and you're going to read through this topic from different resources, and then you're going to approach it in a way where it's presentable and simplified for your colleagues to learn about and to know. This is the formal aspect of it. But then you have the broader part of this process which is the journal club reviews, for example, or the grand rounds. This is the time to challenge and to explore. So if it's the journal club, you're going to decide which, for-- you're going to be given options to read, for example, from different journals out there, and then you're going to choose a topic of interest, and you're going to explore that. So you're going to learn how to-- this is your own learning experience. Then you're going to relay it to the rest.” (Resident 19)
Educator as community advocate
“As an educator, I love doing teaching sessions because it gives me a positive feeling. It gives me motivation. It gives me a feeling that I helped my community; I helped my colleague. And it's like retaining the feeling” (Resident 6)
Educator as self-motivated
“Of course self-motivation is one of the cards as a teacher that helped me encourage myself before giving any session to any group, I motivate myself saying that: you can do it! This is a small group.” (Resident 16)
Educator as learner
“You need to have an open-minded approach to learning. As a learner to be able to educate from anything that is surrounding you. So it is a process. It's not something that you can take. It's not a certificate that you can just work for. It's a lifelong process of learning.” (Resident 17)
Educator as collaborator
“It's always a two-way street. You need the other person, the recipients to want to learn or to want to be good teachers. If you teach a person who doesn't want to be taught, you're going to waste your time. It's going to have to be a two-way street.” (resident 9)
What is the role of professional development programs in residents’ development?
Participants agreed that developing their educator knowledge, skills, and attitudes is a continuous endeavor that must be tended to. Participants viewed their professional development as an individual lifelong effort, an interpersonal effort, and as a structured part of residency education. As an individual effort, one participant shared:
“As an educator I am trying to develop my skills continuously, I try to teach other residents, interns during the clinic simple basic things, as well as I try to encourage them to read interesting things related to the cases we see.” (Resident 14)
Another sub-theme found was collegiality in becoming an educator, as one senior resident came to share:
“When you trust your colleagues it makes the process of learning and working together more enjoyable.” (Resident 14)
Finally, the role of the residency program and the larger field of dermatology in the development of residents as educators, one participant shared:
“Several fields (Medical specialties) excel in growing educators by permitting them chances and opportunities, but for us we don’t have the proper skills sometimes” (Resident 13)
Another participant looked to the future and that residency programs should take a more active role in in the development of residents as educators:
“Well, as a resident we don't get a lot of opportunities to be educators. But, thankfully, in our program, we get to present to other residents. Continuous practice of teaching and learning and professional development will help healthcare providers build excellent educators. Hopefully, residency training will pave the way for me to develop new skills and grow as an educator” (Resident 12)