170 Chapter 6 prepared and discussed the interview protocols with experts in medical education research outside the team. In addition, we received and used feedback from pilot interviewees who did not participate in the main study. Furthermore, the provision of thick descriptions of quotes in each study enhanced the rigour of the research. Another strength is the design of the research covering a time span of 10-year follow-up period. Because maturation takes time and studies with such a long interval in their design are rare, the follow-up study yielded valuable data to gain insight into the long-term maturation of medical educators’ beliefs and perspectives, which might not have emerged in a shorter research period. Because the number of interviews per participant is limited to two (plus a third interview with those who showed maturity), we cannot exclude that a longitudinal design of a more than 2-point study could have provided additional insights into the maturation trajectories of individual physician-educators. The way we selected the participants has implications for the interpretation of our findings. Since participants were recruited from two medical schools from two different continents, a strength is that our results are not limited to one national educational culture and organisation. We selected medical schools that were carrying out innovations towards learning-centred education during a similar time period, i.e. about a decade prior to the initial interviews. It is conceivable that the selection of schools with a longer or shorter tradition of learning-centred education would have resulted in a different distribution of belief orientations. We selected medical educators with a variety of educational roles: both educators involved in educational administration and educators half of whom taught clinical topics while the others taught basic science topics, which adds to the generalisability of our conclusions. We also deliberately chose to select participants who are known for their exemplary teaching. It is important to note that we did not aim to generalise across all educators, but that we were particularly interested in the beliefs of the most committed, exemplary, and therefore most influential educators. We assume that the selection of involved and committed teachers contributed significantly to the fact that almost all participants were still available for the follow-up study after ten years. However, this selection may have limited the variation in both belief orientations (Chapter 2) and educator phenotypes (Chapter 3). Nonetheless, as discussed in Chapter 2, all six belief orientations from the original framework of Samuelowicz & Bain1 were represented. Likewise, all the levels from Korthagen’s model, which were decisive for the development of the phenotypes, were represented in the initial study (see Chapter 3). The sampling may also have resulted in a limited number of
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