"You're a trainee telling your consultant to hold their question until later": Using a resident-led faculty development workshop to explore trainee-consultant expertise role-reversal.

Background: Medical education traditionally involves directional flow of knowledge/skills/attitudes from a senior to junior individual. However, medical training also provides opportunities for expertise role-reversal, where the direction of flow is reversed. Unlike fields such as aviation, medicine has not yet begun to fully realise the educational potential of this approach. Objective: To better understand how role-reversal is viewed by medical education participants, necessary for its use as a tool to advance both education and patient care. Methods: A senior resident designed and led a feedback-writing workshop for her own consultants (conducted 2022). After the session, eight consultants were interviewed in a semi-structured format. Analysis was conducted using the Stenfors-Hayes phenomenographical approach. Results: A multiplicity of experiential perspectives was identified by both consultants (teacher/participant/supporter/hierarchy member/colleague/holder of multiple perspectives) and trainee (presenter/subordinate/learner/researcher). The exercise increased appreciation and awareness of the complexity of the trainee-consultant educational-power relationship, though both parties maintained traditional hierarchy despite altered informational flow. Participants often held multiple articulated experiential perspectives simultaneously. Conclusions: Consultants were able to assume a learning mindset while simultaneously maintaining awareness of their existing hierarchical relationship to the trainee-presenter; the trainee, conversely, struggled to adopt the teacher mindset. Deliberately viewing moments where trainees present new information to consultants as expertise role-reversal may provide a starting point for more equitable knowledge exchange between both parties in the clinical routine, and a foil for epistemic injustice. Increasing recognition and use of expertise role reversal can play a critical role in improving educational culture.