PDF(Pubmed)
Abstract：
By virtue of their teaching role and contact with students, health professions (HP) educators are often the first point of connection for students who are experiencing mental health difficulties. Educators are increasingly expected to include some form of pastoral care in their role. Mental health-related interactions with students may have a negative emotional impact on educators, particularly when roles and expectations are not clearly defined and where boundaries are not managed effectively. Using positioning theory as a lens, this study explored how educators experienced such interactions and how this manifested in positions, storylines, and speech acts. Interviews were conducted with 27 HP educators at a faculty of medicine and health sciences. Reflexive thematic analysis using inductive coding identified themes corresponding to the nearing, weighted, ambivalent, and distancing positions participants adopted in relation to students with mental health difficulties. There was fluidity in and between positions, and more than one position could be occupied simultaneously; participants each moved through different positions in response to different relational situations. Multiple storylines informed these positions, representing how moral- and care-informed responsibility intersected with responsiveness to make certain actions possible or impossible. Normative and personal value narratives were evident in storylines, in many cases underscored by care or justice ethics. The value of positioning theory in facilitating reflective faculty development initiatives for educators engaged in these interactions is discussed.
摘要：
凭借他们的教学角色和与学生的联系，健康专业（HP）教育工作者通常是遇到心理健康困难的学生的第一个连接点。人们越来越期望教育工作者在他们的角色中包括某种形式的牧师关怀。与学生心理健康相关的互动可能会对教育工作者产生负面的情绪影响，特别是当角色和期望没有明确定义，边界没有得到有效管理时。用定位理论作为透镜，这项研究探讨了教育工作者是如何经历这种互动的，以及这种互动是如何在职位上表现出来的，故事情节,和言语行为。采访了医学和健康科学学院的27名HP教育工作者。使用归纳编码进行自反主题分析，确定了与临近主题相对应的主题，加权，矛盾的,参与者在与心理健康有困难的学生相关时采用的距离姿势。位置内部和位置之间有流动性，并且可以同时占用多个职位；参与者每个人都在不同的位置移动以响应不同的关系情况。多个故事情节告知了这些职位，代表道德和护理告知责任与响应能力如何相交，以使某些行动成为可能或不可能。规范性和个人价值叙事在故事情节中很明显，在许多情况下，关怀或正义伦理都强调了这一点。讨论了定位理论在促进参与这些互动的教育工作者的反思性教师发展计划中的价值。
