Professional Identity Formation Research Articles

Influence of a rural Longitudinal Integrated Clerkship on medical graduates’ geographic and specialty decisions: a constructivist grounded theory study

BackgroundLike many countries, Australia is suffering from a longstanding and persistent medical workforce maldistribution with fewer doctors per capita in rural locations and a trend towards sub-specialisation. Longitudinal Integrated Clerkships (LIC), a medical education model, are more likely than other clerkship models to produce graduates who work rurally, in communities of increasing remoteness and in primary care. While this quantitative data is essential, there has been a dearth of program-specific evidence explaining this phenomenon.MethodsTo address this knowledge gap, a constructivist qualitative grounded theory approach was employed to identify how the Deakin University comprehensive rural LIC influences graduates’ (2011–2020) career decisions in terms of both medical specialty and geographic practice location.ResultsThirty-nine graduates participated in qualitative interviews. The Rural LIC Career Decision Making Framework was developed, postulating that an alignment of personal and program factors under the central concept of ‘choosing to participate’ can influence graduates’ geographic and specialist career decisions, both individually and symbiotically. Once embedded in the clerkship, participation was augmented by the concepts of learning design affordance and learning in place, providing the participants with longitudinal opportunities to experience and compare medical disciplines in an integrated manner.ConclusionsThe developed framework presents contextual elements of the program that were deemed influential on graduates’ subsequent career decisions. The alignment of these elements with the program’s mission statement has the capacity to enhance the program’s rural workforce goals. Regardless of graduates’ willingness to participate in the program, a transformation occurred. Transformation occurs through reflection, either challenging or confirming the graduate’s pre-conceived ideas about career decisions and in turn influencing professional identity formation.

Only a cog in a machine?: Reappraising institutionalized EAP teacher identities in a transnational context

Language teacher identity (LTI) research, critical approaches to language education, and English for Academic Purposes (EAP), have each grown into considerable areas of scholarship. However, not many studies have addressed topics at the intersection of these triple areas. Therefore, adopting a critical perspective on LTI construction within predominant language ideologies, this study aimed to investigate EAP teachers' professional identity formation in response to institutional policies in a Sino-British university in China. As part of a larger project, data bodies were collected through a narrative survey completed by 77 faculty members and semi-structured interviews with 36 of them at this transnational English-medium university. The analysis of narratives and interview transcripts through qualitative coding procedures revealed three major aspects of the participants' institutionalized identities: ‘The EAP teacher’ (comprising three roles: a cog in a machine, a British acculturation agent, and a mock monolingual role model); ‘The safe researcher’ of trendy topics; and ‘The service provider’ seeking promotion. The findings contribute insights into EAP LTI from a critical perspective by documenting how EAP teachers (are obliged to) construct institutionalized identities in relation to language ideologies and educational policies in a transnational higher education context.

Self, Physician, and Specialty: A Qualitative Exploration of Medical Students' Specialty Identity Formation During Undergraduate Medical Training.

A physician's specialty is an integral part of their professional identity formation (PIF), not only determining the role they play in patient care but also shaping group interactions in the workplace. Prior work on PIF in medical students has focused on the development of a physician identity. However, little is known about how medical students might begin to develop divergent specialty-specific identities during medical school. Consequently, the authors aimed to explore how the process of specialty selection shapes PIF during undergraduate medical training and to develop a construct of specialty identity formation (SIF) as an important aspect of PIF. The authors used a constructivist grounded theory approach to explore SIF in senior medical students at the University of Washington between August 2022 and January 2023. The author team consisted of 6 attending physicians. Two investigators conducted hour-long, semistructured interviews, which were audio recorded, transcribed, and deidentified. After analysis, member checking was completed with 2 participants. The authors interviewed 14 students and categorized the data into 3 phases: nascent understanding, experiential grounding, and projecting forward. Participants reflected on considering their personal values, while simultaneously exploring the values and defining features of various specialty groups. Early impressions were formed based on ideas influenced by peers and mentors and later integrated with experiences on clinical rotations. Finally, participants noted engaging in a process projecting forward as they attempted to envision their potential futures as both physicians and members of a specialty group. As students explore their specialty identity, they use self-anchoring and self-stereotyping to integrate components of their evolving specialty identity into their professional identity. However, uncertainty regarding their fit with a specialty persists for many. Many sociocultural aspects of the learning environment affect SIF, including threats to psychological and identity safety.

Extending Professional Identity Formation to develop academic faculty for a new medical school.

Academic health centers have a responsibility to foster professional development approaches and engagement environments for faculty to elevate both knowledge and sense of belonging as medical educators. This new educational methods submission depicts faculty development and engagement initiatives implemented at a single institution that were created and influenced by the psychological framework of Professional Identity Formation. The authors suggest ways that academic medical centers can draw upon the formation of these programs to best serve their faculty for cultivating development and engagement for professional growth.

Each One, Teach One

Fully anonymous peer review enhances students’ writing and feedback abilities, encourages professionalism and kindness, and transforms the teaching dynamic. This essay describes the use of the Peerceptiv platform for fully anonymous peer review assignments in law school courses. This platform is uniquely helpful in fostering professional identity formation while helping students improve their analytical writing skills. However, implementing this peer review platform comes with challenges such as student reluctance and discomfort. With strategic communication and investment of time, these challenges can be overcome to realize the potential of this innovative approach and provide formative assessment, regardless of class size. Ultimately, scalable peer review helps students strengthen skills while developing collaborative professional identities throughout the law school curriculum.

Latent profiles of narrative competence and professional identity among nursing students: A cross-sectional analytic study based on the Ring theory of personhood

AimTo identify latent profiles of narrative competence in nursing students and examine the association between the potential competence profiles and professional identity from a person-centred perspective. BackgroundAccording to the Ring theory of personhood, nursing students can develop their professional identities from individual, relational and social aspects through interaction with patients, as well as listening to, understanding and responding to patients' disease narratives. However, few studies have examined the relationship between narrative competence and professional identity through the quantitative method. DesignA cross-sectional analytic study. MethodsA total of 472 nursing students responded to the survey between March and May 2023. The Professional Identity Questionnaire for Nurse Students and the Narrative Competence Scale were given to participants. Latent profile analysis was conducted to identify narrative competence profiles. The Bolck-Croon-Hagenaars method was used to analyse whether these latent profiles for narrative competence affected nursing students’ general, individual, interpersonal and social professional identities. ResultsLatent profiles were identified as “low narrative competence” (12.1 %), “relatively low narrative competence” (39.9 %), “moderate narrative competence” (40.1 %) and “high narrative competence” (7.9 %). The profiles only show level differences rather than combinations of competence areas. These profiles had varying effects on the nursing students’ general professional identities, as well as their individual, relational and social professional identities. ConclusionThis study highlights the significance of providing tailored guidance and support to nursing students, taking into account their unique narrative competency profile, to promote the formation of professional identity from individual, relational and social aspects. Nursing educators should effectively distinguish nursing students with inadequate narrative competence and value patients’ disease narratives to promote narrative competence and professional identity.

A scoping review and theory-informed conceptual model of professional identity formation in medical education: Commentary from a clinical psychology perspective.

A scoping review and theory-informed conceptual model of professional identity formation in medical education: Commentary from a clinical psychology perspective.

The Influence of Academic Affairs on PIF

Referencing literature and professional experiences of multiple academic affairs deans in Doctor of Pharmacy degree granting programs, this commentary examines the ways offices of academic affairs (OAAs) play an integral part in the professional identity formation (PIF) of students, faculty, preceptors, and staff. The overlapping roles of academic affairs and other program and university offices are examined with a focus on approaches that impact student PIF. Although size, organizational structure, and roles or responsibilities can vary among OAAs within pharmacy education, 5 focus areas are identified as opportunities where most, if not all, OAAs can positively impact PIF for students. These 5 areas include curriculum design, delivery, and operations; leadership; professional development; student support and progression; and accreditation. OAAs can help to shape PIF within pharmacy education in a variety of ways. Identifying and reflecting upon the 5 focus areas described in this paper may help individuals within OAA units to recognize where PIF efforts may be developed, refined, or assessed within their program. By intentionally layering PIF strategies across these 5 focus areas, OAA personnel and those from other units within and outside of the university system may thoughtfully work together to develop graduates who have increased self-awareness, confidence, and the ability to lead within the profession of pharmacy.

Mentoring: Shaping the professional identity of the academic internal medicine hospitalist.

Burnout and lagging academic productivity are pressing challenges in hospital medicine, leading to stagnation and attrition. Mentoring shapes professional identity formation and enhances faculty vitality and retention, but has not been optimized among academic hospitalists. We sought to explore how mentoring impacts academic hospitalist professional identity and to elucidate barriers to mentoring in the field. We conducted focus groups at three academic medical centers. Informed by social-constructivist theory of identity development, we coded deidentified data and performed thematic analysis. Thirty-one academic hospitalists participated with 1 to >20 years experience. Mentoring shaped professional identity formation in six core domains: choosing academic hospital medicine, identifying and focusing on an area of interest, progressing career, navigating work-life integration, staying in academic medicine, and becoming a mentor. Distinct models included dyadic mentoring, peer mentoring, organic mentoring, and mentoring teams, each with benefits and limitations. We identified nine key mentoring actions that influenced hospitalist professional identity formation and career development. Mentoring barriers included lack of time, awareness, and access to experienced mentors, as well as poor quality mentoring and mentor-mentee malalignment. Aspects of hospitalists' professional identity also posed barriers, including ambivalence around academic identity. Mentoring fosters academic thriving and retention in academic hospitalists. Access to effective mentoring remains lacking due to few senior mentors in the relatively new field of hospital medicine and reticence in academic identity, among other factors. Mentoring training, impact on underrepresented minority hospitalists, and integration into institutional culture should be considered for enhancing the career development of academic hospitalists.

Physicians' Perceptions and Experiences Regarding Leadership: A Link Between Beliefs and Identity Formation.

Despite the development of national recommendations and training programs for effective leadership, junior and senior medical leaders often find themselves ill-prepared to take on these new responsibilities. This study aimed to explore physicians' perceptions, feelings, and beliefs regarding leadership and to provide recommendations regarding appropriate training and institutional post-training support. We conducted a qualitative study at the Geneva University Hospitals. A purposeful sample of residents (R), fellows (F), attending physicians (A), and chairpersons (CP) were invited to participate in focus groups (or semi-structured interviews) between April and June 2021. We investigated their understanding of leadership, self-perception as leaders, difficulties, and paths to improvement in their leadership skills. Focus groups were transcribed verbatim and analyzed both inductively and deductively using Fishbein's model of behavior prediction and Irby's professional identity formation framework. We conducted ten focus groups (R=3; F=4, A=2, and CP=1) and one interview (CP). Physicians expressed poor self-efficacy at all hierarchical levels: feelings of insecurity and confusion (R and F), frustration (A), and feeling stuck between divisional and institutional governance (CP). Such negative feelings were nurtured by personal beliefs with an intuitive and idealized representation of leadership. Beliefs focused more on personal characteristics rather than on skills, processes, or perceived institutional norms. Unclear expectations regarding physicians' role as leaders, overemphasis on academic achievement, and silo professional organizations fueled their feelings. Participants reported developing their leadership through trial and error, observing role models, and turning to personal resources rather than formal training. Our results show that physicians' leadership skills are still mainly acquired intuitively and that institutional norms do not encourage clarification of leadership roles and processes. Physician training in leadership skills, together with more explicit and clear institutional processes, may help to improve physicians' self-efficacy and develop their identity as leaders.

Who am I? Professional Identity Formation in Pharmacy Education Among Learners Underrepresented in Pharmacy

Professional identity formation (PIF) throughout the pharmacy curriculum is important for learners to transform from layperson to pharmacist. To be effective, PIF activities need intentional development and support. Professional identity is often seen as the core component of PIF; however, there must be an emphasis on integrating and aligning an individual’s personal identity through this process. Moreover, there has been an emphasis on upholding diversity, equity, inclusion, and antiracism efforts in pharmacy practice and education. There is a need to explore experiences of PIF among diverse populations, including learners underrepresented in pharmacy. This commentary explores the differences in PIF among underrepresented learners in health care disciplines and is a call to action to explore evidence-based interventions that are inclusive and tailored to individual learners. This commentary sets a foundation for additional scholarly work and recommendations regarding PIF among underrepresented learners.

Developing Confidence in Engaging in Diversity, Equity, and Inclusion and Social Determinants of Health Topics Through Self-Authorship

ObjectiveThis study used a self-authorship framework to explore if diversity, equity, and inclusion (DEI) and social determinants of health (SDoH)–focused laboratories and learning activities increase student confidence in understanding aspects of implicit bias and SDoH, and how these activities impact student comfort in discussing and confidence in initiating conversations on DEI/SDoH topics with colleagues, faculty, supervisors, and patients. MethodsFirst-year PharmD students engaged in 3 learning activities across 2 courses. Students were challenged to evaluate their biases and incorporate DEI/SDoH into their professional identity formation. This study used a mixed-methods, embedded approach to analyze assessment data collected via a questionnaire and assignments administered at 3 points during the fall semester. Quantitative analysis used a quasi-experimental, between-participants, pretest-posttest design. The qualitative component used open-ended questions to gain additional insight into participant experiences, gathered detail on perceptions, and provided context. ResultsA 1-way analysis of variance showed statistically significant increases between assessment points for all items related to confidence in understanding implicit bias and SDoH. Comfort in discussing DEI/SDoH topics with supervisors/faculty and patients increased over time. Comfort in discussing DEI/SDoH topics with colleagues did not increase. Three salient themes emerged from qualitative analyses: bias and privilege awareness, education, and professionalism. ConclusionThis study found that students started evaluating their own knowledge, beliefs, and claims in social and professional settings as defined by the self-authorship framework. Student comfort and confidence in discussing DEI/SDoH topics increased over time. Findings support that engaging students in multimodal programming may support incorporation of DEI/SDoH into professional identity formation.

How Preceptors Support Pharmacy Learner Professional Identity Formation

ObjectivePharmacy preceptors play a role in helping learners form professional identities during experiential education. However, it is not clear what specific roles and precepting strategies best foster professional identity formation (PIF). The objective of this study was to explore how preceptors support pharmacy learner PIF. MethodsThis qualitative study used an interpretative descriptive approach. Preceptors from 5 experiential education programs were recruited using purposive sampling for individual semistructured interviews. Interviews were recorded, transcribed, coded, and analyzed by thematic analysis. Team members used a reflective and iterative approach for data analysis and generation of themes. ResultsA total of 22 participants were interviewed from various pharmacy practice settings and precept a range of learners, including introductory pharmacy practice experiences, advanced pharmacy practice experiences, and residents. Four main themes were identified to support pharmacy leaner PIF: making learners part of the practice and team, preparing learners to assume the role of a pharmacist, helping learners navigate emotions during practice experiences, and supporting learners in finding the right fit within the profession. Specific precepting strategies associated with each theme were identified. ConclusionPreceptors play an important role in supporting learners in thinking and acting as professionals while also helping navigate emotional experiences that may impact PIF and having conversations to help define learner’s future aspirations of the pharmacist they want to become. Strategies identified can inform curricular approaches and preceptor development that intentionally supports PIF.

Safely gaining experience in death and dying: Simulation in palliative care and end-of-life education

BackgroundTraining in palliative and end-of-life (EOL) care provision represents a critical topic in health professional curricula for ensuring a workforce prepared to provide safe and person-center care at the end of one's life. This manuscript describes the incorporation of a simulation-based learning experience (SBLE) and the evolution of a professional elective course for student pharmacists related to palliative and EOL care. Educational activityA SBLE was incorporated into a long-standing professional pharmacy elective course in palliative and EOL care. The decision to incorporate and utilize SBLE to introduce topics of deprescribing, communication, prioritization of quality of life, and establishing goals of care was utilized in recognition of a need to establish a psychologically safer environment to allow students to explore these topics prior to the advanced pharmacy practice experiences. DiscussionIncorporation of SBLE in this professional elective course resulted in a favorable effect on course enrollment. Observations from structured debriefing and anecdotal student feedback suggest that students had trouble tailoring care plans to the circumstances, particularly in focusing on de-escalating medication treatments, emphasizing the need for training in the care for this patient population which incorporate considerations for goals of care. Lessons related to the influence of environmental distractions, expressions of discomfort conveyed by body language, and challenges in prioritizing and focusing on tailoring care plans given evolving information at hand were identified. ImplicationsWe describe the effective implementation and utilization of SBLE in a professional elective focused on palliative and EOL care for student pharmacists. Future directions include research initiatives designed to evaluate the impact of simulation on key competencies and areas developed through participation in such exercises. Systematic evaluation of outcomes and competencies related to team dynamics, sympathetic communication, professional identity formation and resiliency and preparation for dealing with death and dying in experiential learning are planned.

Do professionalism, leadership, and resilience combine for professional identity formation? Evidence from confirmatory factor analysis

Do professionalism, leadership, and resilience combine for professional identity formation? Evidence from confirmatory factor analysis

Factors affecting professional identity formation of basic medical sciences teachers in Pakistan: a phenomenological analysis of interviews

IntroductionTeachers can perceive themselves as a true teacher and act as one only if they have a strong professional identity. This study aimed to identify factors that shape the unique professional identity of basic medical sciences teachers in Pakistan.MethodsA qualitative study was performed using the concepts of phenomenology and purposive sampling. A 20-item text-based interview was conducted by sharing a Google Form link with basic medical sciences teachers from select institutions. Iterative data collection and analysis were performed until data saturation was attained.ResultsA total of 40 participants took part in the study. Nine categories were identified and grouped into two major themes: four personal and five environmental factors. Personal factors included characteristics, preferences, religious values, and professional development. Environmental factors included community of practice, students' feedback, administrative support, work environment, and societal apathy. Among these factors, aptitude, family preference or work-life balance, hard work, dedication, and effect on parenting were more evident in women. By contrast, passion, experience, complacency, and unique identity were the prominent factors.DiscussionCommunity of practice [31 (77%)], passion for teaching [21 (52%)], students' feedback [18 (45%)], work-life balance [16 (40%)], and religious values [13 (32%)] were the primary positive contributors to the identity of basic medical sciences teachers. By contrast, poor administrative support [8 (20%)], negative work environment [11 (27%)], job dissatisfaction [7 (17%)], societal apathy [4 (10%)], and lack of opportunities for professional growth [6 (15%)] negatively impact the professional identity of basic medical sciences teachers.

Transformative Peer Connections: Early Experiences From the ASCO Palliative Care Community of Practice.

The integration of palliative care into routine oncology practice is the standard of care by most leading cancer organizations. Palliative medicine helps to deliver higher quality of care at a lower cost. However, there are barriers to implementing palliative oncology at many institutions for myriad reasons. In this article, we discuss an innovative strategy that ASCO implemented called the Communities of Practice (CoP). We share our experiences as the Palliative Care CoP and how our group seeks to develop processes and structures to collectively promote systemic change and enhance palliative care delivery for people with cancer. Our Palliative Care CoP engages with senior leaders, administrators, and those in power to achieve a shared vision of delivering holistic health care for people with serious illness. We continue to evolve to meet our members' growing needs by addressing eight main domains: (1) increasing palliative care education and resources; (2) creating opportunities for global palliative care research; (3) providing peer mentorship and community building; (4) engaging with patient advocates; (5) supporting and developing interdisciplinary teams; (6) assisting with professional development and identity formation, especially for trainees and early career faculty; (7) extending our outreach through social media; and (8) enhancing the clinical practice of palliative oncology. The ASCO CoP has been a vital forum to realize ASCO's mission of conquering cancer and advancing the Art and Science of Cancer Care: From Comfort to Cure.

Medical students' and GP tutors' experiences of near peer teaching in primary care: a qualitative study.

There exists a significant body of literature on the benefits of Peer Assisted Learning (PAL). Near-peer (NP) teaching can be defined as teaching delivered by senior students to younger year students. There are numerous examples in the literature of PAL projects in a non-clinical setting but little research in a clinical setting and even less in primary care. Postgraduate literature suggests that potential benefits include promotion of general practice as a career as well as increasing teaching capacity.A successful pilot led to the development of a new undergraduate NP teaching Student Selected Component (SSC) in a primary care setting. To explore the experiences of medical students and GP tutors who participated in this SSC. Semi-structured interviews were carried out with year 5 NP student teachers, GP tutors, and year 3 students. Thematic analysis was used to analyse the qualitative data generated. As well as increasing teaching capacity and consolidating their own knowledge, the findings suggest an impact on the professional identity formation of NP student teachers helping them to prepare to be future doctors. The NP teaching fostered an environment of psychological safety for all students, although there was an additional element of risk management and supervision when teaching with patients. Undergraduate NP teaching has advantages for student learners, NP student teachers, GP tutors, and practices. The increased teaching capacity has implications for recruitment of practices for teaching and may promote general practice as a future career.

Professional identity formation of clinical medical students during and beyond the pandemic: exploring the implementation gap through personal reflection.

Professional identity formation of clinical medical students during and beyond the pandemic: exploring the implementation gap through personal reflection.

Role perception and professional identity development of municipal police recruits in British Columbia

PurposeThe study aimed to address how recruits perceive their roles and develop professional identities during in-classroom and in-field training.Design/methodology/approachThis study explored the professional identity formation process by analysing asynchronous surveys with recruits from 13 municipal police departments in British Columbia, Canada. The participants were surveyed twice: after classroom-based training following Block I at the British Columbia Police Academy (BCPA) and after their departmental field training following Block II.FindingsThe analysis revealed that police recruits lacking public safety experience transformed their occupation and lifestyle. The training at the police academy helped develop recruits' muscle memory as they applied their knowledge to the situation through hands-on practice. Moreover, teamwork at the police academy and during field training allowed recruits to form their police identity. The study was conducted between 2020 and 2021 during the COVID-19 pandemic, thus revealing how the recruits learnt effectively whilst facing continuous challenges and adjusting.Research limitations/implicationsThis study relied solely on the respondents' language in text-based answers; therefore, it was not possible to ask follow-up questions or seek clarification. Consequently, several inputs were excluded from the analysis. This would not have been the case if a quantitative method, where answers can be selected accurately, had been used.Originality/valueThis study demonstrates that police recruits acquire diverse competencies and skill sets through rigorous formal requirements, nuanced informal aspects and comprehensive training at the BCPA and during field training, all of which pivotal in shaping their professional identities.