Moving Beyond Static, Individualistic Approaches to Agency: Theories of Agency for Medical Education Researchers: AMEE Guide No. 177.
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| Title: | Moving Beyond Static, Individualistic Approaches to Agency: Theories of Agency for Medical Education Researchers: AMEE Guide No. 177. |
|---|---|
| Authors: | Konopasky, Abigail1 akonopasky@dartmouth.edu, Finn, Gabrielle M.2, Varpio, Lara3 |
| Source: | Medical Teacher. Aug2025, Vol. 47 Issue 8, p1252-1261. 10p. |
| Subject Terms: | *Medical school faculty, *Medical education, *Interprofessional relations, *Education research, *Discrimination against people with disabilities, *Psychology of medical students, *Teacher-student relationships, Self-efficacy, Social theory, Patient care, Hospital medical staff, Racism, Minorities, Self-perception, Psychosocial factors |
| Abstract: | Agency – the capacity to produce an effect – is a foundational aspect of medical education. Agency is usually conceptualized at the level of the individual, with each learner charged with taking responsibility to pull themselves up by their bootstraps. This conceptualization is problematic. First, collaboration is a central component of patient care, which does not align well with an individualistic approach. Second, a growing body of literature documents how minoritized and marginalized trainees experience inequitable restrictions on their agency. Third, a myriad of structures across medicine restricts individual agency. In this guide, we present four conceptualizations of agency beyond the individual that medical researchers can incorporate to modernize and broaden their understanding of agency: (a) temporal: how individuals wrestle with their own agency across time; (b) relational: how agency is co-created dialogically with other individuals and structures; (c) cultural: how culture and cultural resources shape possibilities for agency; and (d) structural: how restrictive structures – like racism and ableism that unjustly curtail individual agency – are created, maintained, and resisted. For each dimension, we first describe it by drawing from and summarizing the work of theorists across disciplines. Next, we highlight an article from medical education that makes particularly good use of this dimension, discussing some of its relevant findings. Finally, we offer a set of questions that researchers in medical education can ask to highlight the dimension of agency in their work, and we suggest potential directions for future inquiry. We conclude by offering an example of how a researcher might understand a resident's educational experiences through each of the four proposed dimensions and further explicating the complexity of agency in medical education. [ABSTRACT FROM AUTHOR] |
| Copyright of Medical Teacher is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Education Research Complete |
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| Header | DbId: ehh DbLabel: Education Research Complete An: 186774720 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Moving Beyond Static, Individualistic Approaches to Agency: Theories of Agency for Medical Education Researchers: AMEE Guide No. 177. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Konopasky%2C+Abigail%22">Konopasky, Abigail</searchLink><relatesTo>1</relatesTo><i> akonopasky@dartmouth.edu</i><br /><searchLink fieldCode="AR" term="%22Finn%2C+Gabrielle+M%2E%22">Finn, Gabrielle M.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Varpio%2C+Lara%22">Varpio, Lara</searchLink><relatesTo>3</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Medical+Teacher%22">Medical Teacher</searchLink>. Aug2025, Vol. 47 Issue 8, p1252-1261. 10p. – Name: Subject Label: Subject Terms Group: Su Data: *<searchLink fieldCode="DE" term="%22Medical+school+faculty%22">Medical school faculty</searchLink><br />*<searchLink fieldCode="DE" term="%22Medical+education%22">Medical education</searchLink><br />*<searchLink fieldCode="DE" term="%22Interprofessional+relations%22">Interprofessional relations</searchLink><br />*<searchLink fieldCode="DE" term="%22Education+research%22">Education research</searchLink><br />*<searchLink fieldCode="DE" term="%22Discrimination+against+people+with+disabilities%22">Discrimination against people with disabilities</searchLink><br />*<searchLink fieldCode="DE" term="%22Psychology+of+medical+students%22">Psychology of medical students</searchLink><br />*<searchLink fieldCode="DE" term="%22Teacher-student+relationships%22">Teacher-student relationships</searchLink><br /><searchLink fieldCode="DE" term="%22Self-efficacy%22">Self-efficacy</searchLink><br /><searchLink fieldCode="DE" term="%22Social+theory%22">Social theory</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+care%22">Patient care</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+medical+staff%22">Hospital medical staff</searchLink><br /><searchLink fieldCode="DE" term="%22Racism%22">Racism</searchLink><br /><searchLink fieldCode="DE" term="%22Minorities%22">Minorities</searchLink><br /><searchLink fieldCode="DE" term="%22Self-perception%22">Self-perception</searchLink><br /><searchLink fieldCode="DE" term="%22Psychosocial+factors%22">Psychosocial factors</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Agency – the capacity to produce an effect – is a foundational aspect of medical education. Agency is usually conceptualized at the level of the individual, with each learner charged with taking responsibility to pull themselves up by their bootstraps. This conceptualization is problematic. First, collaboration is a central component of patient care, which does not align well with an individualistic approach. Second, a growing body of literature documents how minoritized and marginalized trainees experience inequitable restrictions on their agency. Third, a myriad of structures across medicine restricts individual agency. In this guide, we present four conceptualizations of agency beyond the individual that medical researchers can incorporate to modernize and broaden their understanding of agency: (a) temporal: how individuals wrestle with their own agency across time; (b) relational: how agency is co-created dialogically with other individuals and structures; (c) cultural: how culture and cultural resources shape possibilities for agency; and (d) structural: how restrictive structures – like racism and ableism that unjustly curtail individual agency – are created, maintained, and resisted. For each dimension, we first describe it by drawing from and summarizing the work of theorists across disciplines. Next, we highlight an article from medical education that makes particularly good use of this dimension, discussing some of its relevant findings. Finally, we offer a set of questions that researchers in medical education can ask to highlight the dimension of agency in their work, and we suggest potential directions for future inquiry. We conclude by offering an example of how a researcher might understand a resident's educational experiences through each of the four proposed dimensions and further explicating the complexity of agency in medical education. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Medical Teacher is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1080/0142159X.2024.2445045 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 1252 Subjects: – SubjectFull: Medical school faculty Type: general – SubjectFull: Medical education Type: general – SubjectFull: Interprofessional relations Type: general – SubjectFull: Education research Type: general – SubjectFull: Discrimination against people with disabilities Type: general – SubjectFull: Psychology of medical students Type: general – SubjectFull: Teacher-student relationships Type: general – SubjectFull: Self-efficacy Type: general – SubjectFull: Social theory Type: general – SubjectFull: Patient care Type: general – SubjectFull: Hospital medical staff Type: general – SubjectFull: Racism Type: general – SubjectFull: Minorities Type: general – SubjectFull: Self-perception Type: general – SubjectFull: Psychosocial factors Type: general Titles: – TitleFull: Moving Beyond Static, Individualistic Approaches to Agency: Theories of Agency for Medical Education Researchers: AMEE Guide No. 177. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Konopasky, Abigail – PersonEntity: Name: NameFull: Finn, Gabrielle M. – PersonEntity: Name: NameFull: Varpio, Lara IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 08 Text: Aug2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 0142159X Numbering: – Type: volume Value: 47 – Type: issue Value: 8 Titles: – TitleFull: Medical Teacher Type: main |
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