Too much radiology education is focused on the knowledge and skills learners need to acquire from the outside, whereas too little attention is paid to the work of transformation that needs to take place within them. A flourishing radiologist is not just someone who can pass a lengthy multiple choice examination or perform procedures according to specified protocols. Thriving radiologists continue to learn, grow, and develop throughout their careers, find ways to bring their distinctive interests and abilities to life in the work they do, and enjoy the practice of their craft.
Self-authorship
One relatively new way of thinking about this challenge is self-authorship. It emphasizes that the course of our careers and lives represents something more than reading from a script. Instead, each of us needs to actively draw on our experiences to construct our own sense of meaning, a process that takes place over a long period of time. For example, one radiologist whose research proposal received a low score might conclude that she has no talent for research and simply abandon plans for a research career, whereas another might regard such a result as an important learning opportunity to improve the quality of the proposal and forge ahead with a revision.
Self-authorship involves taking personal responsibility not just for decisions and actions, but also for the very way we view the world. For developing medical students, residents, and early-career radiologists, this involves asking hard questions about received world views and abandoning, exchanging, or refining them, as experiences seem to warrant. For example, an idealistic resident might enter radiology with the assumption that patient benefit is the sole concern of radiology’s professional organizations, only to experience disillusionment and demoralization on discovering that their policies are also shaped by the economic self-interest of radiologists themselves.
There are, however, multiple ways in which such a disillusioned learner could respond to such a realization. One would be to abandon radiology and perhaps the profession of medicine in disgust. Another would be to adopt a cynical perspective on professional life, supposing that radiologists are always acting from self-interested motives. But another would be to develop a more balanced and mature understanding of the role of professional organizations, which will always bend somewhat toward the economic welfare of the professionals they represent, but can nevertheless take highly principled and even noble stands in the best interest of patients and communities.
Like all human beings, radiology learners come to points in their lives that represent crossroads, which challenge them to reexamine and revise or perhaps even radically transform their worldviews. For example, faced with a high-stakes examination that they must pass to gain professional certification, some candidates may decide that they will devote as much time and attention as possible to passing the test. Others, however, may learn to treat such a hurdle as an opportunity to focus on something even more important—namely, learning what they need to develop into the best radiologist they can be.
Educators can play an important role in helping learners to grapple with such crossroads experiences. For example, they can share with learners their own such experiences, the alternative ways of thinking about the world they were presented with, and the ways in which they eventually developed a new way of looking at things. Such an approach lets learners know that they are not alone, that others have harbored doubts and fears about their path in life yet emerged intact and even more robust on the other side. It also reminds them that they have a choice about how they come to understand their careers and their lives.
Dimensions of Self-authorship
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Elements of Self-authorship
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Conclusion
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References
1. Kegan R.: In over our heads: the mental demands of modern life.1994.Harvard University PressCambridge
2. Magolda M.B.B.: Three elements of self-authorship. J Coll Stud Dev 2008; 49: pp. 269-284.