Fiktion används i utbildningssyften inom flera fält så som ingenjörsutbildningen och juristutbildningen, samt inom högre utbildning. Skönlitteraturanvändande på läkarutbildningen utgår ofta från teorier från medicinsk humaniora och narrativ medicin som menar att fiktion kan ge läkarstudenter och läkare möjlighet att utveckla viktiga professionsförmågor som emotionell medvetenhet och empati, vilket kan hjälpa till att motverka den nedgång i empati som enligt forskning sker hos läkarstudenter under sin utbildning. Trots omfattande forskning om fiktion på läkarutbildningen, finns det mycket lite forskning som detaljerar de praktiker när skönlitteratur används, och hur de emotionella aspekterna av läkaryrket kan begreppsliggöras i fiktionssamtal. Denna avhandling undersöker skärningspunkten mellan fiktion, interaktion och emotion i läkarutbildningen. Syftet med studien är att bidra till kunskap om hur känslor kan konstrueras inom läkarutbildningen som två emotionella aspekter - affektiv positionering och professionella känslor - som erfarenheter och förmågor som läkarstudenter behöver lära sig. Diskursiv psykologi (DP) formar det teoretiska och metodologiska ramverket för att analysera 58 timmar av video- och ljudinspelade fiktionsseminarier från två svenska läkarutbildningar. Känslor kan ur ett DP-perspektiv förstås inte som en reflektion av inre upplevelser, utan som ett fenomen som skapas genom interaktion, och som kan användas för att åstadkomma social handling. Resultaten visar att reflektion och reflektiva praktiker är en del av fiktionssamtal, och att affektiva positioneringar kan konstrueras som en studentresurs för att hantera intensitet, kontroll, bedömning och ansvarsutkrävande. Vidare kan läkares professionella känslor konstrueras som emotionellt arbete som studenter behöver förberedas för, där känslomässiga regler konstrueras som flytande och föränderliga kalibreringar av känslor. Uppgiften att lära sig professionella känslor som ett verktyg, konstrueras som problematisk av läkarstudenterna eftersom uppvisandet av kunskap inför andra studenter kan störa konstruktionen av deras studentidentitet.

Although there is a large body of research about emotional labour in workplace settings, such as the health professions and the service industry, less is known about the empirical processes through which emotional labour is taught in higher education and professional education. Using medical education as an example, a discursive psychological (DP) approach is used in this paper to detail how the feeling rules of the physicians profession are constructed by students and tutors in fiction, film, and poetry seminars. From a data set of 36 video- and audio-recorded fiction seminars from two medical schools, 29 sequences of discussions about emotional challenges for physicians were found. These examples have been transcribed in detail and analysed using DP. Analysis shows that students and tutors construct feeling rules as fluid, negotiable and changeable. Feeling rules are defined as the calibration of emotion to suit different situations as well as different physicians with different levels of emotionality. Students deploy constructions of feeling rules to manage student identities, and students and tutors construct emotion as a separation between subjective experience and observable behaviours, where the subject-side experience should be managed or controlled in the way it manifests externally.

In medical education, reflection is widely considered to be an important skill for physicians, and thus an important skill for medical students to learn. There is however no consensus on how reflection should be taught, and empirical research on in-situ reflective practices in medical education is fairly uncommon. This paper uses discursive psychology (DP) as theoretical and methodological framework to uncover how reflection is interactionally achieved in fiction sem-inars, which are used in medical education as a means to teach professional skills such as reflection and emotional awareness. In the data set of 58 h of video-and audio recordings from fiction seminars in two medical schools, 24 examples were found where students reflect on the possible learning outcomes of discussing fiction. Analysis shows that reflective practices are imbedded in fiction seminars, and that reflection is collectively achieved by students listening to each other, building on each others reflections and challenging each others viewpoints. These practices allow students to construct both resistance and learning while still adhering to the aims of the seminars of doing reflection.

Fiction is understood to have unique qualities that emotionally engage the reader, making it suitable as a didactic tool in medical education to help students prepare for the emotional aspects of their future profession. To date, however, little is known about the processes through which talking about fiction, film or poetry can help medical students to co-construct emotional reactions as affective stances and how that might contribute to their professional development.

Using a discursive psychology approach, video recordings from 36 fiction seminars collected from 2016 to 2018 were analysed regarding how affective stances related to reading were constructed by medical students. The findings illustrate how students use subject–object relations to account for affective stances, meaning that they attribute their emotional reaction either to an aspect of the book (object-side explanations), or to personal characteristics (subject-side explanations). The way students enact and account for their affective stances can provide opportunities for tutors to create teachable moments for the students. This study contributes to discursive psychology and reader-response research, as well as medical education research.

Vocational training programmes in higher education encompass, as learning objectives, the development of relational skills and professional judgement, especially in welfare professions such as policing, teaching and healthcare, where know-how about managing close contact with people is a prerequisite. Based on a cross-professional analysis, the current article explores how students from three different professional education programmes – teacher education, police training and medical education – construct professional judgement in group discussions and interviews. The results show that participants construct professional judgement as relationships between three different dimensions: personal ethics, educational standards, and professional practice. When discussing professional dilemmas, students utilise these three different dimensions to argue for the moral or ethical soundness of their choices. The results of the study shed light on the importance of providing students with opportunities to reflect openly on professional judgement in different ways, even though such reflections may not always be formally assessed. Furthermore, the analysis demonstrates similarities between the three programmes that we analysed, as well as similarities in students’ reflections regarding essential aspects of the professions.