Abstract
The exercise and experience of agency—the process of using one's resources to intentionally determine and pursue goal-directed actions amidst constraints—are critical for health professions trainees. Agency in health professions education (HPE) has been linked to feedback, assessment, and learner growth and development. One threat to trainee agency receiving increasing scholarly attention is moral injury: guilt, shame, or profound distress caused by violating one's values under stress. In this chapter we illustrate how theories of agency can powerfully support examination and prevention of HPE learners' moral injury. We begin by setting out the problem of moral injury with a case drawn from critical care medicine. We then address the problem of moral injury by drawing on two philosophical approaches to agency: (a) what moral and postmodern philosophers have said about what it means to exercise agency amidst the potential constraints of other agents of social and institutional structures and (b) what phenomenological philosophers have said about what it means to have a sense of agency amidst these constraints. We conclude by offering suggestions for how instructors can better support learners' agency to prevent moral injury and how a nuanced view of agency can shape HPE research and practice.
| Original language | English |
|---|---|
| Title of host publication | Applied Philosophy for Health Professions Education |
| Subtitle of host publication | A Journey Towards Mutual Understanding |
| Publisher | Springer Nature |
| Pages | 157-171 |
| Number of pages | 15 |
| ISBN (Electronic) | 9789811915123 |
| ISBN (Print) | 9789811915116 |
| DOIs | |
| State | Published - 1 Jan 2022 |
| Externally published | Yes |