Recovering Hope and a Sense of Agency Through Transformative Education for Internationally Educated Healthcare Professionals in Canada

Abstract

This study examines the outcomes of transformative education in the program Fostering Canadian Integration for IEHPs: From Learning to Action, created to accompany internationally educated health professionals (IEHPs) in the difficult journey to find fair professional employment in Canada. It shows the importance of self-reflection, a learning community and a welcoming, participatory approach to learning that led to cognitive, emotional and conative transformation for participants. Increased self-awareness of their life journey and emotional patterns, together with critical understanding of their worldviews and new reality supported the participants in the recovery of hope and a sense of agency.

Keywords

transformative education critical reflection personal transformation internationally educated health professionals healthcare hope agency

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References

Adamson

C. W.

Bailie

J. W.

(2012). Education versus learning: Restorative practices in higher education. Journal of Transformative Education, 10(3), 139–156. https://doi.org/10.1177/1541344612463

Barbour

R. S.

(2005). Making sense of focus groups. Medical Education, 39(7), 742–750. https://doi.org/10.1111/j.1365-2929.2005.02200.x

Bardin

(2013). L’analyse de contenu. Presses universitaires de France. https://doi.org/10.3917/puf.bard.2013.01

Basran

G. S.

Zong

(1998). Devaluation of foreign credentials as perceived by visible minority professional immigrants. Canadian Ethnic Studies Journal, 30(3), 7–23. https://link-gale-com.proxy.bib.uottawa.ca/apps/doc/A82883434/LitRC?u=anon∼f29a6f32&sid=googleScholar&xid=bc1e2d32

Bourgeault

I. L.

Neiterman

LeBrun

Viers

Winkup

(2010). Brain gain, drain & waste: The experiences of internationally educated health professionals in Canada. University of Ottawa. Retrieved Sept. 2023 at. https://www.hhr-rhs.ca/fr/?view=article&id=1274:brain-gain-drain-a-waste-the-experiences-of-internationally-educated-health-professionals-in-canada&catid=183

Carter

(2020). Academic identity and the place of stories: The personal in the professional. Springer.

Covell

C. L.

Neiterman

Bourgeault

I. L.

(2016). Scoping review about the professional integration of internationally educated health professionals. Human Resources for Health, 14(1), 38. https://doi.org/10.1186/s12960-016-0135-6

Cranton

Taylor

(2012). Transformative education theory: Seeking a more unified theory. In Taylor

Cranton

(Eds.), The handbook of transformative education: Theory, research, and practice (pp. 3–20). Jossey-Bass.

Dirkx

J. M.

(1997). Nurturing soul in adult learning. In Cranton

(Ed.), Transformative education in action. New directions for adult and continuing education (pp. 79–88). Jossey-Bass.

10.

Dirkx

J. M.

(2006). Engaging emotions in adult learning: A jungian perspective on emotion and transformative education. New Directions for Adult and Continuing Education, 2006(109), 15–26. https://doi.org/10.1002/ace.204

11.

Eschenbacher

Fleming

(2020). Transformative dimensions of lifelong learning: Mezirow, Rorty and COVID-19. International Review of Education, 66(5-6), 657–672. https://doi.org/10.1007/s11159-020-09859-6

12.

Goodfellow

Zohni

Kouri

(2023). A missing part of me: A pan-Canadian report on the licensure of internationally educated health professionals. National Newcomer Navigation Network. Retrieved Nov. 2023 at. https://www.newcomernavigation.ca/en/our-tools/site-visit-report.aspx

13.

Gordon

Darbyshire

Baker

(2012). Non-technical skills training to enhance patient safety: A systematic review. Medical Education, 46(11), 1042–1054. https://doi.org/10.1111/j.1365-2923.2012.04343.x

14.

Green

(2022). Agency: The force and compass of transformation. Journal of Transformative Education, 20(2), 105–121. https://doi.org/10.1177/15413446211028522

15.

Green

(2023). No ground: Disorientation as prerequisite for transformation. Journal of Transformative Education, 21(2), 190–206. https://doi.org/10.1177/15413446221105577

16.

Hoggan

(2016). Transformative education as a metatheory: Definition, criteria and typology. Adult Education Quarterly, 66(1), 57–75. https://doi.org/10.1177/0741713615611216

17.

Hou

Frank

Schimmele

(2020). Economic impact of COVID-19 among visible minority groups, Statcan COVID-19: Data to insights for a better Canada. Statistics Canada. Retrieved May 2023 at. https://www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00042-eng.htm

18.

Kass

(2017). A person-centered approach to psychospiritual maturation. Palgrave MacMillan.

19.

Kegan

(1983). The evolving self: Problem and process in human development. Harvard University Press.

20.

Kegan

(2000). What “form” transforms? A constructive-developmental approach to transformative education. In Mezirow

& Associates (Eds.), Learning as transformation: Critical perspectives on a theory in progress (pp. 35–70). Jossey-Bass.

21.

Kelaghan

(2010). Evaluation research. In Peterson

Baker

McGaw

(Eds.), International encyclopedia of education (pp. 150–155). Elsevier Science.

22.

Kerins

Smith

Phillips

E. C.

Clarke

Hamilton

A. L.

Tallentire

V. R.

(2020). Exploring transformative learning when developing medical students' non-technical skills. Medical Education, 54(3), 264–274. Wiley. https://doi.org/10.1111/medu.14062

23.

Lewin

L. O.

McManamon

Stein

M. T. O.

Chen

D. T.

(2019). Minding the form that transforms: Using Kegan’s model of adult development to understand personal and professional identity formation in medicine. Academic Medicine, 94(9), 1299–1304. https://doi.org/10.1097/ACM.0000000000002741

24.

Lofters

Slater

Fumakia

Thulien

(2014). “Brain drain” and “brain waste”: Experiences of international medical graduates in Ontario. Risk Management and Healthcare Policy, 2014(7), 81–89. https://doi.org/10.2147/RMHP.S60708

25.

Mälkki

(2012). Rethinking disorienting dilemmas within real-life crises: The role of reflection in negotiating emotionally chaotic experiences. Adult Education Quarterly, 62(3), 207–229. https://doi.org/10.1177/0741713611402047

26.

Mezirow

(1994). Understanding transformation theory. Adult Education Quarterly, 44(4), 222–232. https://doi.org/10.1177/074171369404400403

27.

Mezirow

(2009a). Transformative education theory. In Mezirow

Taylor

E. W.

(Eds.), Transformative education in practice: Insights from community (pp. 18–32). Jossey-Bass.

28.

Mezirow

(2009b). An overview of transformative learning. In Knud

(Ed.), Contemporary theories of learning: Learning theorists ...in their own words (pp. 90–105). Routledge.

29.

Neiterman

Bourgeault

(2015). Professional integration as a process of professional resocialization: Internationally educated health professionals in Canada. Social Science & Medicine, 2015(131), 74–81. https://doi.org/10.1016/j.socscimed.2015.02.043

30.

Sawyer

Stukey

M. R.

(2020). Professional learning redefined: An evidence-based guide. Corwin.

31.

Scharmer

(2015). The blindspot: Uncovering the grammar of the social field. The Huffington Post. Retrieved May, 2023 at https://www.huffpost.com/entry/uncovering-the-grammar-of-the-social-field_b_7524910.

32.

Taylor

E. W.

(2009). Fostering transformative education. In Mezirow

Taylor

E. W.

(Eds.), Transformative education in practice (pp. 3–18). Jossey-Bass.

33.

Tilburt

Geller

(2007). Viewpoint: The importance of worldviews for medical education. Academic Medicine, 82(8), 819–822. https://doi.org/10.1097/ACM.0b013e3180d098cc

34.

Wallace

B. A.

Shapiro

S. L.

(2006). Mental balance and well-being: Building bridges between Buddhism and Western psychology. American Psychologist, 61(7), 690–701. https://doi.org/10.1037/0003-066X.61.7.690

35.

Walton-Roberts

(2023). The future of healthcare work and the place of migrant workers within it: Internationally educated nurses in Ontario Canada during the COVID-19 pandemic. Journal of Immigrant and Refugees Studies, 21(1), 59–72. https://doi.org/10.1080/15562948.2022.2153393