Abstract
This thesis provides an account of a qualitative doctoral project which explored health professional students’ experiences of studying material which intersected with aspects of their own lives. This project had two aims: firstly, to provide an account of life-study overlap in health professional education and, secondly, to highlight students’ perspectives on how teaching practices and tertiary education structures could be adapted to better recognise and support life-study overlap. In this thesis, I employ a critical theory framework to explore life-study overlap in settings which often implicitly treat curriculum content as not reflective of students’ personal, family, or collective experiences. Within this framework, I draw on tools for theorising and valuing multiple ways of knowing, including decolonial critiques of higher education, epistemological pluralism and feminist perspectives on situated knowledges and embodiment. I also draw on tools for critiquing the way the formal, informal, and hidden curricula create an ‘implied student’ in health professional education, and exploring the ways the human body and the embodied self is represented in teaching.
The data for this study were collected through 22 in-depth individual interviews, conducted between 2018 and 2020. Participants were health professional students and graduates who had studied at university in Aotearoa New Zealand and who self-identified as having experienced a significant overlap between their own lives and the content of their studies. Participants were studying or had studied in a range of health professional programmes, including medicine, radiation therapy, public health, biomedical sciences, and social work. I analysed participants’ interviews using a reflexive thematic approach.
Participants’ lives intersected with their study as they learnt about personally-relevant content through programme curricula, and when, as health professional students, they were also managing their own health. Personal, family and community-level experiences of healthcare, illness, disability, or health inequities shaped participants’ decisions to become health professionals. Studying health was often framed as a way of contributing to one’s whānau (extended family) or contributing to better outcomes for others with similar experiences. Learning about personally-relevant content could be especially engaging when content was taught with respect and when students could see how such material made a real-world difference. Conversely, teaching on personally-relevant topics could be alienating when it simplified complex experiences, involved racism from peers or teachers, or marginalised life experience as a source of legitimate health knowledge. Both learning about personally-relevant content and managing one’s own health as a health professional student were often deeply embodied experiences in contexts where being able to project a seemingly dis-embodied ‘neutrality’ was a desirable professional attribute. Students integrated knowledge from formal academic study with existing experiential knowledge in ways that valued both. When necessary, students drew on support to manage challenging aspects of life-study overlap, including self-care, support from family, friends and teachers, and caring structures or spaces in and beyond tertiary education.
This thesis will contribute to efforts to develop a health workforce that reflects the diverse identities and experiences of the whole population. The findings of the study support recognising students’ individual, familial and community experiences of health as epistemically valuable perspectives that can be integrated with formal curriculum content. Study findings highlight the importance of recognising life-study overlap as a normal and expected part of health professional education across all curriculum areas. Teaching practices which may support students’ sense-making as they encounter life-study overlap and affirm their experiences include: considering that any teaching topic may reflect some students’ lives; avoiding deficit framing in teaching about inequities; and recognising the value of complexity, multiple perspectives and multiple ways of knowing about health and healthcare. This study affirms the importance of recruitment and mentoring programmes that aim to develop a diverse health workforce. It identifies scope for improvement in supporting students to complete their studies while managing their own health through developing flexible study pathways, practising shared decision-making, and strengthening student healthcare. This study also highlights the importance of both physical spaces and learning communities where students are able to connect with others who have similar life experiences.