169 General discussion 6 with the theory of transformative learning, which states that adult learning is triggered by ‘disorienting dilemmas’ (comparable to meaningful experiences), coupled with ‘critical reflection’ (comparable to intrapersonal aspects).39 Interestingly, the Critic phenotype educators who initially focused on the adverse educational environment, also attributed their maturation when shifting from the Critic phenotype to both categories of factors. They recognised that, next to a perceived positive change in the circumstances (categorised as meaningful experience), their personal attitude to these circumstances (categorised as intrapersonal aspect) had changed. For example, they reflected on an improved organisational structure or the arrival of a new department head, as well as acknowledged that they had learned to come to terms with the perceived restrictions of the educational context. This means that a change in the educational environment alone will not be enough to help educators shift from the Critic phenotype. Congruent with our conclusions under the ‘Environment’ section, it is the perception of and reflection on the environment, next to the reflection on inner processes, which will influence maturation. These conclusions have important implications for faculty development, which we will describe below. Strengths, limitations, and suggestions for future research Next to study-specific methodological considerations, which have been described in the previous chapters (Chapters 2 to 5), we will address general strengths and limitations of our research here, and also include suggestions for future research. One strength of the research is the methodological rigour used. In each study, multiple researchers independently analysed the transcripts and discussed their interpretation among themselves, and then within the research team. The team members come from diverse backgrounds, both medical and non-medical. This approach ensured reflexivity to identify and address any personal beliefs or biases that may have influenced the research process, and intersubjectivity to reach agreement on the interpretation of the findings through dialogue and the sharing of meanings. Additionally, the data collection for both the baseline studies and the follow-up study were conducted by the same interviewer, which eliminated interpersonal variations and enabled a deeper insight into the person of the interviewees. Executing the interviews by a single rather than more than one interviewer creates a safe environment for the interviewee. To counteract the limitations of having a single interviewer, the research team carefully
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