What is doctoral impact?

During the “trying to find a supervisor” period of my early EdD I met a few UBC professors for “bad academic first dates”. One of whom was a well known LGBTQ researcher who has done some wonderful and creative work in cancer care, and has written/blogged about their own cancer experiences. I was steered in their direction by several people who told me, “you must have heard of XXX, you would love their work”.  We did meet, but I wasn’t sure at that point exactly what I wanted to do and certainly didn’t really know what to ask of a potential supervisor. I was also worried that I came across as a stumbling imbecile! Apart from this blog, I hadn’t really written or spoken about (what would become) my research subject and was still wondering if I would be able to tackle it at all.

The development of learning through a professional doctorate (although for me incomplete and in progress) is partly gaining confidence to use your voice. A lot of us (women, people in traditionally marginalised populations) are used to being either ignored or actively silenced. Finding the courage (and having the support) to speak up was, for me, a huge part of my growth. I don’t think I would have been ready to do this work before now and certainly not without the framework offered by the program. I was asked the other day why I was doing the EdD. Would I get a teaching job, a better position? I usually say something neutral, as I am pretty sure those weren’t my motivations – but as I opened my mouth I suddenly realised why. I have wanted to do this research since I finished my Masters 15 years ago. There have been a couple of aborted attempts. One as a survey (not the right fit) and one with a colleague as a series of interviews (we were both too busy with other things, and nervous about the subject matter). I always felt it was too niche, too personal. I was doing it for the wrong reasons. Because I had struggled at times with being a lesbian and being a radiation therapist didn’t mean it was an issue that affected others. It was just me.

It took 6 courses, 2 electives, numerous papers and a lot of reflection for me to realize that just because it is personal, doesn’t mean it isn’t important. Just because it is difficult, doesn’t mean it shouldn’t be done. Part of the ongoing work is related to my own identity, which is relevant and enriches both process and product.  And (as my comps exam chair reminded me) it isn’t bias, it’s positionality!

So, apart from personal growth, confidence and the ability to speak openly (and, some would say, endlessly) about sexual identify and being out in the world – what has been the impact? Academically I could cite one publication, and a four keynotes/invited talks (Australia, UK, Canada) and this blog which has had more than a thousand visits. But is that the spirit of the EdD where the intent is to intensively study and (hopefully) affect/improve a problem or set of circumstances in practice?

I was at work last week writing an email to the same UBC professor I met almost two years ago. I was writing on behalf of a group looking to improve the experience of underserved populations. A few months ago, when there was a call for suggestions regarding what “underserved” populations should be looked at first, I had the knowledge and confidence to step into the silence and tell the group how some LGBTQ people have a hard time in cancer care. I said that I had written an article, did they want to see it? Also done a few talks and I had some good resources I could share.  The group agreed and we went ahead, steered by evidence and passion. We’re a new group, and it is early days. The first step is to ask how LGBTQ people have experienced us/the agency and how we could do better. I am convinced that this community outreach (including looping back to UBC) will make a difference and change how we care for LGBTQ patients – most importantly that they will finally be seen in our system. I had a moment of fierce pride as I sent the email. To me THIS is what impact looks like!

 

 

 

 

 

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*This blog was inspired by Janice St. John Matthew’s recent series “The impact of my doctorate” . Thanks Janice!

Candidacy, writing

I’ve been thinking a lot abut writing lately. I talked to a new friend and fellow blogger recently who passed on Nadia Bolz-Weber’s wonderful advice that you should “write from your scars, not your open wounds”. Wounded writing is reactionary but has a powerful immediacy and emotive quality. Writing from scar tissue allows distance, reflection but perhaps doesn’t carry as much emotional punch as the pain is recalled, remembered. I found an echo of this in Gloria Anzaldúa’s autobiographical book “Borderlands”. She describes her writing process as a state of psychic unrest, a cactus needle wounding her skin that she needs to remove and ultimately a way of making meaning from experience.

Experience is at the heart of my research proposal. It was interesting to see the different members of my committee this week reacting to that word. The poet saw experience at the heart of narrative inquiry (NI), my chosen methodology. The authors I am primarily drawing from are the social scientists Clandinnin and Connolly who themselves call on Dewey, the father of learning through experience. The physician saw patient experience, how healthcare professions could judiciously use their own spectrum of identity (such as being a mother, or being a lesbian) to extend themselves and find common ground, risky though that might be.  My supervisor saw recognition of each other – really seeing who that person is in all their complexities and identities – as the first step to experience and the key to moving forward and improving it.

I have written before about how one of the challenges of this EdD is finding other ways to express myself, and write beyond the usual 3,000 passive words describing methods, results, discussion and conclusion.  In my proposal meeting this week we talked about different ways of crafting a narrative inquiry (NI) dissertation. NI has many forms, but I am interested in storytelling and so I need to be comfortable with typical elements like plot, characterization, tempo, genre to produce an engaging and readable piece of work. Some NI dissertations throw off the typical chapter headings and incorporate all the familiar elements (such as the literature review) in a story, poem or other arts based format. I am using autoethnography – an autobiographical way of researching and writing that “displays multiple levels of consciousness, connecting the personal to the cultural*”. My participants and fellow story makers are friends and fellow LGB radiation therapists. From field texts (my interview transcripts, personal writing and perhaps artefacts like photographs) we will negotiate back and forth using interim texts (rough drafts of the final collective story, emails and discussions) as we move towards the final research text – the story or representation we have made together. It’s an intimate and time-consuming process that will involve a constant renegotiation of what is told and untold, what is revealed and what is left private.

With lots to consider going forward, my proposal was approved this week and I am officially a doctoral candidate! After ethics, I can begin my research. I am certainly feeling the itch to write, the needle in the skin and I am eager to get started. If I think about my own stories, there are scars but (now) few wounds. I wonder about my participants who are working clinically and those who are not. Are they smarting from wounds, living with scars? What will we uncover, disturb, heal?

*Ellis, C., & Bochner, A. P. (2000). Autoethnography, personal narrative, reflexivity: researcher as subject. In N. Denzin & Y. Lincoln (Eds.), Handbook of qualitative research (2nd ed., pp. 733–768). Thousand Oaks, CA: Sage p. 739

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Pondering the proposal

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When I was investigating doctorates – a phase that lasted about ten years – some of the programs requested a proposal up front. The idea was to reassure the university (and any potential supervisors) that the research project could be completed within the allotted time, and that the candidate had the skills and experience to do so.  PhDs and professional doctorates are different. For an EdD the proposal comes after the competency exam is passed but essentially does the same job as a PhD proposal. We have been well prepared to tackle the proposal; our comps paper is essentially the proposal literature review with the theoretical framework in some cases. What we were missing was the methodology – the mechanics of the data gathering and analysis.

When I think of my data analysis, the fitting together of four peoples’ stories, I see myself serenely reclining in a sunlit meadow or sitting at a window (perhaps like a pre-Raphaelite beauty with a loom and pet swan*). The actual “how” was a bit blurry.   For qualitative analysis in general there is a lot of confusion. Vague statements like “emergent themes” sound like a magical process and don’t reflect the reality of a time-consuming slog through pages and pages of words.  I found the book “The Good, the Bad, and the Data: Shane the Lone Ethnographer’s Basic Guide to Qualitative Data Analysis” has a very helpful, step by step way of explaining (text based) qualitative analysis (plus it has cartoons!)  For narrative inquiry I turned to Clandinin and Connolly’s approach. They stress that that the process is never linear, and the researcher continually moves back and forth between field texts (transcripts, notes, reflections made after interviews for example), interim texts (shared with the participants like rough drafts of the story, emails etc.) and final research texts (the final story – my results section) as they navigate the process.

My timeline at the moment is tight; I would ideally like to talk to my participants in Toronto in late September. That means I have to have an approved proposal to attach to my Research Ethics Board application soon, and then pass the UBC ethics approval process in time for my trip to Toronto.  The first full committee meeting is next week, a just-in-time scramble before the committee members leave for their summer vacations.  At the moment I am stalled as I wait for that meeting and any changes that might be requested afterwards. If (a big if) my proposal is approved with minor changes I can apply for candidacy. A doctoral candidate has completed all of the requirements for the doctoral degree with the exception of the dissertation. It’s the next big step!

*I take no responsibility for my imaginative processes

 

Gaiman S. (2013). The Good, the Bad, and the Data: Shane the Lone Ethnographer’s Basic Guide to Qualitative Data Analysis. Walnut Creek, CA: Left Coast Press

Clandinin, D. J., & Connelly, F. M. (2000). Narrative Inquiry: Experience, Story in Qualitative Research. San Francisco, US: Jossey-Bass

 

 

 

Year three: Beyond the comps

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For many graduate level courses the comprehensive examination (“comps”) is a pass/fail checkpoint in the program (often after mandatory coursework) that assesses knowledge and work done to date. Once passed, the student can progress to their research. Comps seem to be more common in US and Canadian higher education – and Wikipedia, that rigorous source of academic information, says that “preparing for comprehensive exams is normally both stressful and time consuming!”

Our EdD comps were last weekend and preparing for them was indeed stressful and time consuming.  We wrote a 7,500 word paper on our research ideas (and questions) to date, that included a literature review and (in some cases) details of our theoretical framework.  We had to present for 20 minutes on our paper and our work so far. A panel of six UBC professors (familiar to us from our classes) then asked us questions for 40 minutes – it was pretty much open season! I am happy to report that I did get a question on Foucault. In fact, I think I managed to dodge/deflect enough to insinuate that, yes, I was intimately familiar with his groundbreaking contribution to the history of western morality – the three-volume L’Histoire de la sexualité (in the original French of course) and it was, in fact, my regular bedtime reading.

We have been together as a cohort for 2 very long years, and we are pretty familiar with each other’s areas of interest. Some of us haven’t varied much from our original idea, and many others have taken a long and winding journey to settle on something that may not have even been a consideration back in 2015. Members of the group have changed jobs, had personal and professional crises and questioned why they are doing this in the first place! There has been crying, anger, hugging and lots and lots of reflection.  Some of us have supervisors, some have a committee, a few others are still exploring. Regardless of where we are it was a significant weekend for all of us and marked the last time we will be “officially” together as a cohort.

We’re currently waiting for our results; we may have to do some extra work on our submitted papers before we move on. Next hurdle is the proposal, after which we can finally be referred to as doctoral candidates.  After a few bad academic first dates I finally have a committee – consisting of a philosopher, a poet and a physician. I am particularly thrilled with this and I am in the process of writing a “….walks into a bar” joke so please forward any suggestions you have. They haven’t got together yet, that comes after the proposal is approved by my supervisor, but I hope that happens before the end of the summer.

So – year three begins tomorrow! It’s not an overstatement to say the last two years have been life-altering, but I think that was the point. I have gone from being acutely uncomfortable speaking up about LGBTQ issues to never shutting up about them and I can’t wait to get into the rich conversations with my participants and find out what it’s like for LGB radiation therapists working today. Stay tuned!

Coming out: Reflections on UKRCO 2017

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So, last week I did a talk at UKRCO 2017 on “Coming Out in Healthcare”. The focus was on patients and healthcare professionals who are LGBTQ, and how we can normalise the coming out process. I had an amazing time at the conference, and met a lot of wonderful people I have so far only known on Twitter. While I was there my friend Rachel Harris gave me some wise doctoral advice – “don’t forget to write this up for your reflective portfolio”.  Not having one of those, I decided to blog it. I’ve been reading and writing (and presenting) on LGBTQ issues in healthcare for what seems forever (although realistically it can only be a year or so) – and overall had a good response. Often LGBTQ people will come up afterwards and tell me about their experiences in healthcare (some funny, some just WTAF). Many straight people will comment that it has “made them think” or the talk “opened their eyes” – which is also gratifying.  The UKRCO post-talk activity was definitely the most positive/funnest/most affirming so far.

The best part was afterwards (on Twitter as well as IRL) talking with a diverse group of people, gay, straight, differently gendered – medical imaging people, radiation therapists, managers and leaders . For example, I met a brilliant undergrad student who was volunteering at the conference and doing research on examining radiographers’ knowledge of care for trans patients. Her impetus was listening (as a first year) to how staff around her had talked about a trans woman who was being treated for prostate cancer. She wanted to change that conversation.  I think what struck me about all the interactions with LGBTQ colleagues were the things we have in common. Coming out stories were shared, some were easy – some painful to talk about even now. There was a lot of discussion about how we manage our identity at work, who knows, who doesn’t – who is cool with it and the inevitable horror stories of the times it didn’t go well (for us as well as for patients).  Most of us remembered patients who were LGBTQ that we clicked with – some of us wore rainbow lanyards, lapel pins or just gave off a strong gay vibe!  We talked about gender – and being gendered – and the difficulty of finding a sweet tailored suit (and not a cocktail dress) to rock up in for the inevitable conference gala dinner.  It was so great to be in the gay-zone and get that sense of support and affirmation – most importantly that my research is on the right track, the stuff I experienced at work hasn’t gone away, and that people are really receptive and keen to learn how to improve care for patients.

In my talk I used a clip from the fabulous Macmillan* “LGBTQ experiences of cancer care” video series where Lesley (a lesbian living with ovarian cancer) talks about her discomfort with knowing some of her nurses were lesbian but closeted. She says “it’s about equality really….” – she is out, why are they hiding that same thing from her? This prompted an interesting side discussion about “should LGBTQ staff HAVE to come out” – where I think (fairly obviously) the answer is “of course not”.  Issues ranged from legislative concerns (where we can’t discriminate against anyone based on sexual orientation etc.) to colleagues saying “well, should I wear a badge that says I am a Christian, Muslim?” One person said that “it’s about being professional” (not talking about their sexual orientation at work) – which ties into a lot of the research that shows it’s often homo, not hetero-sexuality seen as “unprofessional”.

Next week is my comprehensive exam that will assess whether I am ready for candidacy and the research part of my EdD. This week has been a gift in terms of giving me insight into what it is like “out there” and validating my topic as one that is important, relevant and likely to make a change in practice.   Now onward!

*Macmillan have some really good resources, including the recent “Supporting LGBT people affected by cancer” article and the “No one overlooked- experiences of LGBT people affected by cancer” report