167 General discussion 6 Thus, our finding that maturation occurs according to the order of Practitioner via Role model to Inspirer phenotype, suggests that educators focus on their competencies first before becoming aware of their identity as teachers. In other words, feeling competent as a teacher appears to be a prerequisite for shifting focus to one’s identity as a teacher, as a review article in the context of higher education confirms.24 Interestingly, the same order in developmental stages has been described in the development of medical students as physicians-in-training.35 As the student progresses, the development expands from an initial focus on the ‘knowing and doing,’ i.e. the core competencies of a physician-in-training, to ‘being,’ i.e. the identity as a physician. Similarly, our findings show that educators focus on their identity first before becoming aware of their mission as teachers. We assume that only when an educator has gained sufficient confidence in their own identity as a teacher, and is no longer concerned with positioning themselves as a teacher, can they shift their focus from themselves to the students’ learning and development, and mature towards a clear understanding of why they want to be a teacher. A similar shift in focus from self towards others, the learners, was reported in a study on the development of mentors in medical education.37 Interestingly, the ’why‘ question also appeared in a recent publication on leadership development in medical education.38 Although the term ‘mission’ was not used, the study emphasised the relevance of ’finding your purpose and passion’ as an educator in the context of developing as a leader. Because the phenotypes are hierarchically ordered from less to more inclusive this means that the perspective on being a teacher is extended from an educator’s awareness of their competencies (the Practitioner phenotype) to, successively, an awareness of their identity (the Role model phenotype) and mission (the Inspirer phenotype) as a teacher. In other words, maturation can be perceived as an expansion in perspective, in the sense of a growing awareness towards a more inclusive, more holistic perspective on being a teacher. This view on development is consistent with the theory of transformative learning, a theory of how adults learn by making meaning of their experiences, developed by Mezirow.39 According to this theory, learning is a transformation of perspective, where the new perspective is more inclusive, in the sense of being open to alternative viewpoints, and guides future action.39,40 At each step of the educational development process, maturation appears to occur primarily in the setting of the everyday workplace. This finding is in agreement with Jippes et al.41 who concluded that informal learning in the workplace has more impact on the development of clinical educators than formal faculty development interventions.
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