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Unravelling epistemic injustice in medical education: The case of the underperforming learner.

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Title: Unravelling epistemic injustice in medical education: The case of the underperforming learner.
Authors: Luong, Victoria, Ajjawi, Rola, Burm, Sarah, Olson, Rebecca, MacLeod, Anna
Source: Medical Education. Nov2024, Vol. 58 Issue 11, p1286-1295. 10p.
Subjects: Medical education, Social justice, Prejudices, Terms & phrases, Medical students, Academic achievement, Theory of knowledge, Personality, Educational psychology, Learning strategies, Discrimination (Sociology)
Abstract: Context: Epistemic injustice refers to a wrong done to someone in their capacity as a knower. While philosophers have detailed the pervasiveness of this issue within healthcare, it is only beginning to be discussed by medical educators. The purpose of this article is to expand the field's understanding of this concept and to demonstrate how it can be used to reframe complex problems in medical education. Methods: After outlining the basic features of epistemic injustice, we clarify its intended (and unintended) meaning and detail what is required for a perceived harm to be named an epistemic injustice. Using an example from our own work on introversion in undergraduate medical education, we illustrate what epistemic injustice might look like from the perspectives of both educators and students and show how the concept can reorient our perspective on academic underperformance. Results: Epistemic injustice results from two things: (1) social power dynamics that give some individuals control over others, and (2) identity prejudice that is associated with discriminatory stereotypes. This can lead to one, or both, forms of epistemic injustice: testimonial and hermeneutical. Our worked example demonstrates how medical educators can be unaware of when and how epistemic injustice is happening, yet the effects on students' well‐being and sense of selves can be profound. Thinking about academic underperformance with epistemic injustice in mind can reveal an emphasis within current educational practices on diagnosing learning deficiencies, to the detriment of holistically representing its socially constructed and structural nature. Conclusions: This article builds upon recent calls to recognise epistemic injustice in medical education by clarifying its terminology and intended use and providing in‐depth application and analysis to a particular case: underperformance and the introverted medical student. Equipped with a more sophisticated understanding of the term, medical educators may be able to re‐conceptualise long‐standing issues including, but also beyond, underperformance. .@victoriamluong and colleagues explain how epistemic injustice can help us reframe complex problems in medical education as a means of treating people as fully human. [ABSTRACT FROM AUTHOR]
Copyright of Medical Education is the property of Wiley-Blackwell 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.)
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  Data: Unravelling epistemic injustice in medical education: The case of the underperforming learner.
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  Data: <searchLink fieldCode="AR" term="%22Luong%2C+Victoria%22">Luong, Victoria</searchLink><br /><searchLink fieldCode="AR" term="%22Ajjawi%2C+Rola%22">Ajjawi, Rola</searchLink><br /><searchLink fieldCode="AR" term="%22Burm%2C+Sarah%22">Burm, Sarah</searchLink><br /><searchLink fieldCode="AR" term="%22Olson%2C+Rebecca%22">Olson, Rebecca</searchLink><br /><searchLink fieldCode="AR" term="%22MacLeod%2C+Anna%22">MacLeod, Anna</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Medical+Education%22">Medical Education</searchLink>. Nov2024, Vol. 58 Issue 11, p1286-1295. 10p.
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  Data: Context: Epistemic injustice refers to a wrong done to someone in their capacity as a knower. While philosophers have detailed the pervasiveness of this issue within healthcare, it is only beginning to be discussed by medical educators. The purpose of this article is to expand the field's understanding of this concept and to demonstrate how it can be used to reframe complex problems in medical education. Methods: After outlining the basic features of epistemic injustice, we clarify its intended (and unintended) meaning and detail what is required for a perceived harm to be named an epistemic injustice. Using an example from our own work on introversion in undergraduate medical education, we illustrate what epistemic injustice might look like from the perspectives of both educators and students and show how the concept can reorient our perspective on academic underperformance. Results: Epistemic injustice results from two things: (1) social power dynamics that give some individuals control over others, and (2) identity prejudice that is associated with discriminatory stereotypes. This can lead to one, or both, forms of epistemic injustice: testimonial and hermeneutical. Our worked example demonstrates how medical educators can be unaware of when and how epistemic injustice is happening, yet the effects on students' well‐being and sense of selves can be profound. Thinking about academic underperformance with epistemic injustice in mind can reveal an emphasis within current educational practices on diagnosing learning deficiencies, to the detriment of holistically representing its socially constructed and structural nature. Conclusions: This article builds upon recent calls to recognise epistemic injustice in medical education by clarifying its terminology and intended use and providing in‐depth application and analysis to a particular case: underperformance and the introverted medical student. Equipped with a more sophisticated understanding of the term, medical educators may be able to re‐conceptualise long‐standing issues including, but also beyond, underperformance. .@victoriamluong and colleagues explain how epistemic injustice can help us reframe complex problems in medical education as a means of treating people as fully human. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Education is the property of Wiley-Blackwell 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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              Text: Nov2024
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