161 General discussion 6 We used the levels of the Korthagen model to cluster the participants qualitatively into educator phenotypes. The levels that individual participants emphasised as most relevant were leading for the clustering. The clustering process generated four educator phenotypes, which are hierarchically ordered by inclusiveness. This means that phenotype B includes the levels of phenotype A; phenotype C includes the levels of phenotype B; phenotype D includes the levels of phenotype C, but not vice versa. The Critic phenotype (A) represents the educators who emphasise the environment, focusing in particular on adverse environmental circumstances. The Practitioner phenotype (B) represents the educators who are aware of the environment and focus on their educational behaviours and competencies. The Role model phenotype (C) represents the educators who extend their awareness to include their educational identity. In the Inspirer phenotype (D) the educators are aware of the levels of the other phenotypes and focus on their educational mission. The educator phenotype model thus takes into account the educational environment or context. While all four phenotypes are aware of the importance of the educational context, the Critic phenotype specifically focuses on adverse contextual aspects. This can be interpreted as an affirmation that education sometimes receives less priority within academia than the other academic core tasks of patient care and research.12,14,15 We assume that this phenotype may not be a permanent end-stage phenotype nor a ‘starting’ phenotype. Our findings suggest that the perspectives on being a teacher may be temporarily distorted due to dissatisfaction with professional or personal circumstances. Figure 6.2 illustrates how the four phenotypes are hierarchically ordered, including their focus and awareness of the different levels related to perspectives on being a teacher. We also discovered that the perspectives of the Role model and Inspirer phenotypes consist of predominantly affective aspects. For example, as their mission, they articulate the desire to bring out the best in the student, or as their identity, to be someone who enjoys teaching. This confirms the conclusions of two review studies which emphasise the importance of affective personal attributes for clinical teachers.16,17 For faculty initiatives this finding implies that, in order to become aware of one’s educational identity and mission, it is helpful to accommodate these affective aspects (see under Practical implications).
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