Factors associated with professional identity formation within psychiatry residency training: Alongitudinal study.

Qian Hui Chew,Yvonne Steinert,Kang Sim

doi:10.1007/s40037-021-00673-w

Abstract

IntroductionConceptual frameworks for professional identity (PI) formation highlight the importance of developmental stages and socialization as the learner progresses from legitimate peripheral to full participation. Based on extant literature and clinical impressions, the authors aimed to explore factors associated with PI formation in psychiatry residents over time, and hypothesized that time in training, seniority status, and duration of exposure to psychiatry prior to residency would be associated with PI formation.MethodsEighty out of 96 psychiatry residents (response rate, 83.3%) from the National Psychiatry Residency Program in Singapore participated and rated their PI development using the Professional Self Identity Questionnaire (PSIQ) across four timepoints from January 2016–December 2019. The residents were classified as junior (first 3 years) or senior residents (years 4–5). Linear mixed model analyses were conducted, with time in training, seniority status (junior versus senior residents), duration of psychiatry postings prior to residency, and their interaction as associated factors with PI over time.ResultsTime in training, seniority, and duration of psychiatry postings before residency (all p < 0.01) were significantly associated with higher PSIQ scores at baseline. Over time, although all residents had increases in PSIQ scores, this rate of change did not differ significantly between junior and senior residents.DiscussionExposure to psychiatry postings before residency, time in learning, and seniority are factors which influence PI development in residents. This has implications for psychiatry residency selection and training, adequate clinical exposure during training rotations, and continual support for new and senior residents to foster PI formation over time.Supplementary InformationThe online version of this article (10.1007/s40037-021-00673-w) contains supplementary material, which is available to authorized users.

Highlights

Conceptual frameworks for professional identity (PI) formation highlight the importance of developmental stages and socialization as the learner progresses from legitimate peripheral to full participation
All psychiatry residents from the National Psychiatry Residency Program in Singapore were invited to participate in this longitudinal study from January 2016–December 2017, and we followed up recruited participants until December 2019
The National Psychiatry Residency Program is a five-year training program which is accredited by the Accreditation Council of Graduate Medical Education–International (ACGME–I) and is the only psychiatry residency program in Singapore

Summary

Introduction

Conceptual frameworks for professional identity (PI) formation highlight the importance of developmental stages and socialization as the learner progresses from legitimate peripheral to full participation. Professional identity (PI) formation, defined as the development of professional values, actions, and aspirations, has been deemed as the backbone of medical education [1]. As residents prepare for the transition to full-fledged physicians throughout the course of residency, one determinant of their competence and success is the formation of a PI [2]. When a physician’s personal and professional identities are incongruent, problems may arise for the clinician, the patient, and the profession. The clinician may experience identity dissonance when their personal and professional identities are perceived to be poorly aligned with each other [2,3,4,5]. The inability to reconcile these identities could result in emotional difficulties, and uncertainty about values, competence, and even selfworth [2]. Abedini and colleagues [6]

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