A mixed-methods study on the course of professional identity formation in undergraduate medical students

BACKGROUND

This study explored the development of professional identity formation (PIF) in medical students during clinical rotations, focusing on the relationship between self-perceived development and actual development. It examined feedback and evaluations within the entrustable professional activities (EPA) framework, emphasizing the role of formative feedback in fostering professional growth. By analysing students' perceptions of their professional identity and feedback from online portfolios, this study aimed to enhance understanding of the trajectory of PIF.

METHODS

Conducted at the Radboud University, this study focused on medical students in the Master's programme. Sub-study 1 involved administering the extended Professional Self Identity Questionnaire (PSIQ) to 2,095 students from September 2020 to September 2022. Sub-study 2 analysed data from 240 students, integrating PSIQ responses with feedback from their online portfolios, including assessments and supervisor feedback. Data were analysed using SPSS (sub-study 1) and content analysis (sub-study 2) to explore the relationship between self-perceived PIF and actual performance.

RESULTS

A total of 1,519 students completed the extended PSIQ, with exploratory factor analysis confirming the questionnaire's unidimensional structure and improved reliability after adding three items. A one-way ANOVA showed a significant increase in PSIQ scores across different medical programme episodes. In sub-study 2, data of 240 students from three clerkships were analysed for the correlation between self-perceived PIF and actual performance, with no significant differences in their performance on national tests, assessments, or supervisor ratings. Portfolio analysis revealed that supervisors' feedback centred on collaboration, attitude, self-confidence, and growth toward becoming a physician, with students in later clerkships receiving more detailed feedback.

CONCLUSIONS

The extended PSIQ, which includes questions about EPAs and clerkship transitions, maintains reliability and construct validity, making it suitable for studying PIF within an EPA-based curriculum. Although no significant differences in performance were found, assertiveness emerged as a key factor in the quality and quantity of feedback, with more assertive students receiving better feedback. Narrative feedback, especially process-oriented, is crucial for supporting professional identity formation in medical students.

Caring for terminally Ill patients: the impact on oncologists

BACKGROUND

Journeying with patients throughout their cancer trajectory and caring for them at the end of life can lead to emotional and moral distress in oncologists, negatively impacting their personal and professional identities. A better understanding of how transitions in care goals affect oncologists can shed light on the challenges faced and the support required. This study explored the impact of care transitions on oncologists' professional identity formation (PIF).

METHODS

From September to December 2023, semi-structured interviews were conducted with oncologists in a palliative care center in Singapore. The Ring Theory of Personhood (RToP) was used as a framework to capture the effects of experiences with patients transitioning from curative to palliative care on the oncologists' sense of self and identity. Data were analyzed using both inductive and deductive qualitative analysis.

RESULTS

Participants included six female and six male physicians, aged 30 to 53 years (mean 38 years), with an average of 9.75 years of experience as oncologists. The main domains identified were 1) challenges faced in transitioning patients to palliative care, 2) the impact of dealing with dying patients on oncologists, and 3) coping mechanisms.

CONCLUSION

Oncologists experience self-doubt and moral distress as they manage transitions in care. The PIF of oncologists can be supported through reflection and introspection, peer support, and interventions to promote self-care - ultimately enabling them to make meaning of their experiences, renew family ties, and reaffirm their commitment to the profession.

"Today, I Say It's Mine!": Professional Identity Construction among Jewish and Arab School Counselors Coping with CSA Disclosure in Israel

School counselors play a crucial role in preventing, disclosing, and intervening in child sexual abuse cases (CSA) and in maintaining safe and protected school environments. However, research on their experiences coping with CSA remains limited. The purpose of the present study was to describe and analyze the coping experiences of Israeli Jewish and Arab school counselors with CSA disclosure, particularly the consequences for their processes of professional identity construction (the ongoing process through which they develop and refine their sense of self in their profession). Semi-structured interviews were conducted with 21 Israeli Jewish and Arab school counselors working in elementary schools (grades 1-6) with significant experience in coping with CSA. Two themes surfaced, reflecting the counselors' professional identity construction: (1) Counselors' professional identity transformation following encounters with CSA among their students; (2) Integrating professional knowledge, attitudes, and engagement behaviors into professional identity. The findings describe a trajectory of transformation and professional development among the counselors, beginning with defining and refining their professional roles and followed by the integration of professional knowledge, attitudes, and behaviors into their professional routines. Arab counselors also highlighted specific sociocultural challenges within this process, relating to the gap between cultural values and role expectations. Implications for future research, policy, and practice are discussed.

Practitioners in search of an identity: A Delphi study of sport psychology professional identity

The existence of a professional identity among sport psychology practitioners (SPPs) can increase ethical and effective practice while also leading to more satisfactory careers and advancing awareness of professional roles. There is currently no consensus regarding a sport psychology professional identity (SPPI), a definition of this construct, and the factors influencing it. As such, in the present study, we sought consensus on a definition of SPPI and aimed to identify associated factors. A multinational panel of 39 SPPs from 6 different continents participated in a 3-round Delphi study. The panelists in this study, who were recruited based on their applied and scholarly experiences, constructed a shared definition of SPPI as an individual's professional self-concept concerning their sense of belonging and fit within the sport psychology profession. Further, the panelists also constructed a list of factors supporting (n = 13; e.g., knowledge and philosophy of the profession, personal meaning) and hindering (n = 10; e.g., isolation, non-traditional roles, lack of practitioner-environment fit) the development of SPPI. Professional organizations might use these results to advance professional development and training by integrating them into curricula for qualification processes. A clear understanding of what SPPI is and the factors that foster and hinder its development can support practitioners' wellbeing and practice as well as raise public awareness of what is the sport psychology profession.

Rethinking professional identity formation amidst protests and social upheaval: a journey in Africa

The under-representation of minoritized or previously oppressed groups in research challenges the current universal understanding of professional identity formation (PIF). To date, there has been no recognition of an African influence on PIF, which is crucial for understanding this phenomenon in places like South Africa, a society in which the inequity of the apartheid era still prevails. In addition, there is little data examining how social upheaval could impact PIF. This study uses interviews with medical students to explore PIF within the context of social upheaval during the 2015-2016 protests that rocked South Africa when students challenged asymmetries of power and privilege that persisted long after the country's democratic transition. The combination of the primary author's autoethnographic story, weaved into the South African sociohistorical context and ubuntu philosophy, contributes to this study of PIF in the South African context. The use of an African metaphor allowed the reorientation of PIF to reflect the influence of an ubuntu-based value system. Using the calabash as a metaphor, participants' experiences were framed and organized in two ways: a calabash worldview and the campus calabash. The calabash worldview is a multidimensional mixture of values that include ubuntu, reflections of traditional childhoods, and the image of women as igneous rocks, which recognizes the power and influence on PIF of the women who raised the participants. Introducing an African ubuntu-based perspective into the PIF discourse may redirect the acknowledgement of context and local reality in developing professional identity.

Development of professional identity among dental students - A qualitative study

PURPOSE

The study explored dental students' perception of their professional identity (PI) development at a newly established dental college with a problem-based learning (PBL) curriculum.

METHODS

Qualitative methods based on focus groups were used for data collection. The conceptual framework of the study was informed by a subject-centered sociocultural approach to PI development. Purposive sampling was used to collect data from five focus groups of undergraduate dental students to gain a deeper understanding of their PI development in a PBL environment.

RESULTS

Out of a total of 38 dental students in years 2 and 3, 34 students (89.47%) participated in the focus groups. A theory-driven thematic analysis was used to dissect the views and experiences of the participants to explore factors contributing to PI development in the early years of the program. At an individual level, PBL was seen to be appropriate for PI development. However, some participants placed more emphasis on practical training in operative dental skills. Relational sources especially role modeling by the PBL facilitators and faculty staff were identified as a key factor to nurture PI development. Mixed views were observed on the value of PBL to enhance team-working skills. The participants also identified challenges of PBL and provided recommendations on further improvements to enhance the learning experiences of the students.

CONCLUSIONS

This study provided useful insights into a PBL curriculum at a newly established dental institution. The findings underscore the value of PBL in developing PI and also highlight the challenges of implementing PBL in a socio-cultural context and pedagogical implications for further program improvement.

Why do master's students of humanities and social sciences publish papers in Chinese-language predatory journals? A qualitative study based on Grounded Theory

In China, master's students in humanities and social sciences (HSS) are becoming the main target of Chinese-language predatory journals. Existing research has not paid enough attention to why these students publish papers in Chinese-language predatory journals. This research interviewed 30 HSS master's students with different majors using semi-structured interviews and Grounded Theory to analyze the data; it found that research discrimination, research context, self-awareness, and individual demand are the main reasons why students publish papers in Chinese-language predatory journals. This study provides the following suggestions in an effort to solve the problem of Chinese-language predatory journals. First, the Chinese government should draw up a blacklist of Chinese-language predatory journals. Second, the research evaluation departments of Chinese universities and research institutions should evaluate the research results of HSS master's students based on this list. Third, Chinese universities or scientific research institutions should strengthen the training of HSS master tutors and increase their awareness of Chinese-language predatory journals. And finally, Chinese HSS master's students should be taught about the hazards of Chinese-language predatory journals in research integrity and ethics courses, and refuse to publish papers in Chinese-language predatory journals.

Mechanisms involved in the formation of professional identity by medical students

BACKGROUND

Despite in-depth discussions regarding professional identity of doctors, there is still a gap in our understanding of how this professional identity actually evolves.

OBJECTIVE

To outline some major mechanisms involved in formation of medical students' professional identity.

METHODS

A qualitative study based on thematic analysis. 296 diary entries, written by eight medical students as part of the three-year course 'Becoming a Physician,' were reviewed. The course, conducted in small groups, gradually exposes students to the clinical field, and emphasizes awareness to marginalized populations, and interpersonal communication skills.

RESULTS

Following the social constructivist learning theory, where learners individually and socially construct meaning attributed to their experiences, we identified three major mechanisms based on students' written reflections. These include linking current experiences to past; comparing different types or aspects of knowledge, doctors or medicine; and future perspective taking.

CONCLUSIONS

This study sheds light on the possible mechanisms used by medical students in forming their professional identity prior to their clinical training. Knowing these mechanisms can help medical educators better understand and support their students in formation of their professional identities. Conducting reflective writing could serve as an effective tool for learners to comprehend the meanings of their experiences.

Group Mentoring for Junior Medical Students-the Mentor in the Reflection Cycle

PURPOSE

To describe the experience and perceptions of physicians involved in group mentoring of undergraduate pre-clinical medical students.

METHOD

We conducted a cross-sectional questionnaire-based survey on perceptions of mentors regarding their motivation, personal development, reflective experience, and burnout. All the participants were mentors to undergraduate pre-clinical medical students in the course "Becoming a Physician." This unique course focuses on various aspects of medical professionalism and aims to increase awareness and sensitivity to patients, especially of disadvantaged populations, and to promote sensitive effective communication skills. Mentors in the course are expected to serve as role models to their students.

RESULTS

Of 36 mentors, 33 (91.7%) responded. The most frequent motivations to join the course were to contribute to students' personal, social, and professional development and to contribute to educating more compassionate physicians. The topics discussed most in the groups were the meaning of being a physician and ethical dilemmas. Mentors expressed that they gained professional growth and opportunities to reflect on the complexity of physicians' training and work. They perceived their highest success as being able to serve as role models for their students and provide them broad perspectives. Mentors stated that they failed in trying to facilitate content learning, and were disturbed by students' lack of punctuality. Group mentors scored relatively low on the Maslach Burnout Inventory for Physicians.

DISCUSSION

This study provides insights on the experience of mentorship of medical school students, and on mentors' perceptions regarding their teaching experience and personal and professional development.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-020-01146-1.

Professional self-concept and burnout among medical school faculty in South Korea: a cross-sectional study

BACKGROUND

Medical school faculty members have been reported to be highly likely to suffer burnout. Research is being conducted on professional self-concepts as a factor that relieves burnout in many professions. However, there is a paucity of data on the relationship between professional self-concept and burnout among medical school faculty. Professional self-concept means a perception of oneself as a member of the profession. It influences an individual's thoughts, actions, and emotions. The more positive the professional self-concept, the higher is the self-esteem in the profession, which can contribute to reducing burnout. This study aimed to investigate the professional self-concept and incidence of burnout among medical school clinical faculty members, and to ascertain the factors that affect professional self-concept with respect to burnout.

METHODS

A total of 68 clinical faculty members at the Ajou University School of Medicine completed a modified form of the professional self-concept scale and the Maslach Burnout Inventory. We undertook the following statistical analyses: a descriptive analysis to understand the distribution of participants, correlation analysis to indicate associations between variables and a multiple regression analysis to examine the influence of gender, position, and specialty on professional self-concept and burnout, and the effect of each subscale of professional self-concept on burnout.

RESULTS

As professional self-concept increases, burnout decreases. There was no significant difference between professional self-concept and burnout with respect to gender or field of medical specialty, while a significant difference was observed across faculty position levels. Additionally, the professional self-concept subscale, which included satisfaction and communication skill, was found to significantly affect burnout.

CONCLUSIONS

This study shows that professional self-concept affects burnout. Through these results, we can infer that professional self-concept functioned to protect medical school faculty from burnout. This may be a strategy that fortifies the professional identity of medical school faculty, and it is suggested that educational programs that are directed toward this goal be established.

Integrating Pastoral and Clinical Identities: A Narrative Inquiry of Pastoral Counselors

Narrative inquiry methodology was used to understand the lived experiences of two ordained pastoral counselors who obtained licensure as clinical mental health professionals, particularly in terms of their identity development and integration of pastoral and clinical identities. Data analysis from semi-structured interviews revealed rich experiences with five themes: the journey; God's call; self and identity; the role of mentors; and relationships. Implications for research and practice associated with pastoral counseling and counselor education are discussed.

Liminality in the occupational identity of mental health peer support workers: A qualitative study

Peer support is increasingly provided as a component of mental health care, where people in recovery from mental health problems use their lived experiences to provide support to those experiencing similar difficulties. In the present study, we explored the evolution of peer support workers' (PSW) occupational identities. A qualitative study was undertaken alongside a pilot randomized, controlled trial of peer support for service users discharged from a mental hospital in London, UK. Two focus groups were conducted with eight PSW. Semistructured interviews were conducted with 13 service users receiving peer support and on two occasions with a peer support coordinator. The data were analysed using theoretical thematic analysis, focussing on occupational identity formation. We discuss how the occupational identity of PSW evolved through the interplay between their lived experience, their training, and their engagement in the practice environment in such a way as to construct a liminal identity, with positive and negative outcomes. While the difficulties associated with the liminality of PSW could be eased through the formalization and professionalization of the PSW role, there are concerns that this could lead to an undermining of the value of PSW in providing a service by peers for peers that is separate from formal mental health care and relationships. Skilled support is essential in helping PSW negotiate the potential stressors and difficulties of a liminal PSW identity.

The Implications of Doctoral Students’ Professional Socialization Experiences in Graduate Training

Using survey data from 278 counseling psychology doctoral students, we explored the concept of professional socialization in graduate training and investigated the degree to which a combination of student training factors accounted for (a) greater professional involvement in the Society of Counseling Psychology, (b) endorsement of counseling psychology values, and (c) affiliation with the Society. Results revealed that training programs fostered students’ professional connection to the field by providing faculty models, emphasizing counseling psychology identity, and encouraging student involvement in the Society. Together, these three professional socialization variables accounted for students’ professional activity, counseling psychology values, and Society membership status above and beyond years of enrollment, degree at admission, and membership status in other professional organizations. Implications regarding the influence of early professional socialization in graduate training within the context of establishing a long-term professional pipeline for the Society are discussed.

Validation of the Professional Identity and Values Scale Among an Athletic Trainer Population

CONTEXT

  Forming a professional identity is a process by which an individual achieves an awareness of his or her own self-concept in the context of the profession. Identity in relation to an individual's profession includes the ability to articulate one's role as a professional and professional philosophy. Professional identity has been studied extensively in other fields, but currently no professional identity scales have been validated within the athletic training profession.

OBJECTIVE

  To validate the Professional Identity and Values Scale (PIVS) among an athletic trainer population.

DESIGN

  Cross-sectional study.

SETTING

  Web-based questionnaire.

PATIENTS OR OTHER PARTICIPANTS

  Athletic trainers employed in National Collegiate Athletic Association Division I, II, III, or National Association of Intercollegiate Athletics colleges or universities (n = 299, 56.5% female, 43.5% male). The average age of the participants was 33.6 ± 8.3 years, and they had 10.3 ± 7.6 years of experience.

MAIN OUTCOME MEASURE(S)

  Participants were asked to complete a demographic questionnaire and the 32-item PIVS. The variables included demographics and the PIVS (Professional Orientation and Values subscale [18 items] and the Professional Development subscale [14 items]).

RESULTS

  Exploratory factor analysis reduced the survey from 32 to 20 items and revealed 6 factors. Three factors emerged from the Professional Development subscale and emphasized professional insecurities during the early career stages, the importance of mentors during the intermediate stages, and self-confidence and awareness during the later stages of professional development. An additional 3 factors emerged from the Professional Orientation and Values subscale: (1) patient care and advocacy, (2) professional engagement and collaboration, and (3) personal wellness and values. A Cronbach α of 0.80 indicated good internal consistency.

CONCLUSIONS

  A modified PIVS is a valid and reliable measure of professional identity among athletic trainers employed in the collegiate setting.

Reforms and identities

Purpose

The purpose of this paper is to show how the identities of the employees of Polish public administration are shaped in the process of public system reforms.

Design/methodology/approach

The findings are based on interviews with 40 employees of the Polish public administration. The authors have used open interviews as well as projective methods to discover and explore beliefs and attitudes of bureaucrats towards their work and the system of public administration. The selected sample was diversified both spatially and systematically to reflect the diversity of organisations that constitute the Polish public administration system. Grounded theory was used for data coding and interpretation.

Findings

The study indicates that organisational change initiatives designed to enhance the quality and efficiency of public administration may have negative impacts on the identities of public servants and may lead to their increased incapacity. Rather than sparking entrepreneurial behaviours and transforming bureaucrats into managers, introduction of the rhetoric of New Public Management and New Public Governance in the Polish public administration has contributed to strengthening of classical dysfunctions of bureaucracy.

Research limitations/implications

The results imply that the understanding of organisational changes in the Eastern European public sector – which are usually studied through the lenses of regulation and economy – would benefit from more sociologically and historically oriented studies. The limitations of our results are associated with the adopted qualitative subjective methodology.

Practical implications

Foreign-born templates of reforms may appear to be logical and coherent but they rest on certain assumptions about identities and value structures that are not necessarily congruent with the identities at the adoption site. For that reason, successful reform projects need to consider and problematise the content and shape of culturally conditioned identities.

Social implications

Understanding of public sector reforms’ implication should lead to the improvement of change programmes as well as to the evolution of public administration towards a form more desired by the society. It is especially important as Polish society considers public administration as one of factors influencing (in a negative way) the quality of life.

Originality/value

The paper provides insight into public administration reforms in Poland and their impact on public servants’ identities.

The emotional wellbeing of lay HIV counselling and testing counsellors

The HIV testing, treatment and care programme of the South African public healthcare system depends on HIV counselling and testing (HCT) that is primarily delivered by lay counsellors. Lay counsellors are expected to educate clients about HIV/AIDS, advocate behaviour change, convey test results and support those infected and affected to cope with the emotional and social challenges associated with HIV/AIDS. This research focuses on the emotional wellbeing of lay HCT counsellors because this influences the quality of services they provide. A mixed methods approach was used. The emotional wellbeing, level of burnout, depression and coping style of 50 lay HCT counsellors working at the City of Tshwane clinics were assessed. Additionally, five focus group discussions were conducted. The results showed that HCT counsellors reported average emotional wellbeing, high levels of emotional exhaustion and depression. They had a sense of personal accomplishment and positive coping skills. The results revealed that they may have difficulty dealing with clients' emotional distress without adequate training and supervision. This creates a dilemma for service delivery. In the light of the important role they play in service delivery, the role of the lay HCT counsellor needs to be reconsidered. HCT should develop as a profession with specific training and supervision to develop their emotional competencies to conduct effective counselling sessions.