Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Kinsella, Elizabeth Anne

Abstract

It has become increasingly popular in health professional education to solicit the contributions and involvement of people who have firsthand or ‘lived’ experiences of using mental health services – a practice hereafter referred to as service user involvement (SUI). SUI is founded on the premise that service users ought to be involved in the development and evaluation of services and systems they experience, which includes the education of future health professionals. Despite the momentum this practice has gained in a range of international contexts, SUI is often conceptualized, organized, and implemented uncritically, and with tremendous inconsistency across health professional education contexts. This research adopts a postcritical ethnographic methodology to: (i) deepen understandings of stakeholders’ diverse experiences of SUI, and to (ii) critically examine whether current approaches to SUI support service user educators’ meaningful involvement as knowers in health professional education.

The body of this dissertation is comprised of four integrated manuscripts, which aim to deepen and complicate understandings of the ways SUI is approached and experienced. The first manuscript is a theoretical chapter that elucidates the links between epistemic injustice and sanism in considerations of the marginalization of service user (or Mad) knowledge. The second manuscript reports on findings related to the practice of storytelling in SUI, which was identified as a central theme in how service user educators’ knowledge is conceptualized and shared within health professional education. The third manuscript explores one of the most common risks or concerns related to engaging in SUI: tokenism. This chapter draws on the ethnographic data to consider service user- and health professional- educators’ perspectives on tokenism (or lack thereof) in SUI. The fourth manuscript offers a reflexive examination grounded in my firsthand experiences as a service user- and sessional health professional- educator, in conversation with the ethnographic data.

This work contributes to important ongoing conversations around experiential or service user-produced knowledge and its uptake by/within the health professions and stands to inform a range of stakeholders (e.g., service user- and health professional- educators, curriculum committees, administration, policy makers, researchers, etc.) who may be interested in critically engaging in the practice of SUI.

Summary for Lay Audience

It has become increasingly popular in health professional education to solicit the contributions and involvement of people who have firsthand or ‘lived’ experiences of using mental health services – a practice hereafter referred to as service user involvement (SUI). SUI recognizes that service users ought to be involved in the development and evaluation of the services and systems they experience, which includes the education of future health professionals. Despite the momentum this practice has gained in a range of international contexts, SUI is often understood and approached uncritically and carried out with tremendous inconsistency across health professional education contexts. Presented in an integrated article format, this research draws from a variety of stakeholder perspectives (collected through in-depth interviews, participant observation, and reflexive writing) to: (i) deepen understandings of the ways SUI is experienced, and to (ii) critically examine current approaches to its practice. This work contributes to important ongoing conversations around experiential or service user-produced knowledge and its uptake by/within the health professions, and stands to inform a range of stakeholders (e.g., service user and health professional educators, curriculum committees, administration, policy makers, researchers, etc.) who may be interested in critically engaging in the practice of SUI.

Available for download on Saturday, December 31, 2022

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