Abstract
Abstract
Introduction
Senior residents occupy a structurally peculiar position in clinical training: Simultaneously learners and teachers, they bear responsibility for both trainee development and patient safety. Although residents‐as‐teachers programmes have proliferated, most target technical skills rather than the identity work involved in becoming a clinical teacher. Little is known about
what
identities senior residents construct, or
how
, as they narrate their teaching experiences.
Methods
Informed by positioning theory within a social constructionist paradigm, we conducted a discursive narrative inquiry using 23 longitudinal individual interviews with 14 purposively sampled senior internal medicine residents (R3–R4; nine female, five male) at a tertiary medical centre in northern Taiwan (2018–2021). Data analysis proceeded in two stages: thematic framework analysis to identify key narrative plotlines, followed by three‐level positioning analysis examining character trope construction within stories, between narrator and interviewer and in relation to broader societal discourses.
Results
Three narrative plotlines organised senior residents' teaching stories:
guarding
,
guiding
and
growing
. Within these, 14 character tropes were identified, including experienced doctor, inexperienced teacher, guardian, guide and persistent learner. They were drawn upon fluidly and often simultaneously, revealing identity constructions that were dynamic and contextually contingent. Two overlapping socialisation transitions were visible across the data: From inexperienced trainee to experienced doctor and from experienced doctor to inexperienced teacher, each carrying emotional labour that institutional structures largely left unaddressed.
Discussion
Senior residents' identity constructions are neither fixed nor unidirectional but continuously negotiated in the flow of clinical teaching interactions. Our findings expose an underexamined tension: The emotional and ethical burden of dual‐role navigation is routinely borne by individuals rather than absorbed by organisations. Residents‐as‐teachers programmes that attend only to technical competence risk missing this entirely. Fostering reflective identity work and distributing accountability for clinical supervision represent more productive directions.