Challenges to assessing professional identity in medical students: a tale of two measures

Era Buck,Courtney West,Lori Graham,Ann W Frye,Cayla R Teal

doi:10.1080/10872981.2019.1649571

Abstract

ABSTRACTBackground: Professional identity formation (PIF), a foundational process in becoming a physician, includes establishment of values, moral principles, and self-awareness. The purpose of this report is to examine challenges in establishing the validity of measures of identity fusion as one facet of PIF.Method: Utilizing the modern approach of validity as a unitary concept, the authors generated six hypotheses to examine the evidence for the construct validity of the scores of Physician Professional Identity (PPI) and Identity Integration (IdIn), considering relationships of these measures with each other, year of training and data from a larger survey.Results: Responses from 3473 students at 8 medical schools revealed a weak association between the measures with distributions varying by cohort. PPI had a stronger relationship to cohort and IdIn was moderately associated with students’ attitudes relevant to social media use. Responses were independent of response format and evidence supported the interpretation of scores for IdIn as indications of integration of identity.Discussion: Sufficient evidence was found to suggest that these measures assess aspects of PIF. Use of these measures as part of a multidimensional, longitudinal approach to refining understanding of the construct of PIF and developing effective assessment strategies.

Highlights

Professional identity formation (PIF) in medicine is a foundational process experienced during the transformation from college student to physician [1,2]
The results (Table 4) indicated that Physician Professional Identity (PPI) scores had no or very weak association with responses for this question; Identity Integration (IdIn) scores had a larger but still small positive association with the yes/no responses across all four cohorts of students. These analyses provide some weak support for interpreting IdIn scores in the context of PIF but none for PPI scores
First and second-year students’ ability to integrate what is likely a largely yet-unformed professional identity may have been difficult to measure. Both constructs may be important in the process of PIF, but in this study, the associated scores did not vary together in a linear fashion; this suggests the constructs represented by PPI and IdIn may not be the same

Summary

Introduction

Professional identity formation (PIF) in medicine is a foundational process experienced during the transformation from college student to physician [1,2]. This integrative, developmental process involves the establishment of core values, moral principles, and self-awareness. Stern [9] outlined strategies that have been used to assess professionalism components Many of these measurements depend on relatively brief observable behaviors and have limited utility for assessing the formation process. Method: Utilizing the modern approach of validity as a unitary concept, the authors generated six hypotheses to examine the evidence for the construct validity of the scores of Physician Professional Identity (PPI) and Identity Integration (IdIn), considering relationships of these measures with each other, year of training and data from a larger survey. Use of these measures as part of a multidimensional, longitudinal approach to refining understanding of the construct of PIF and developing effective assessment strategies

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Methods

Discussion

Conclusion