A Scoping Review of Professional Identity Formation in Undergraduate Medical Education

Abstract

Background Professional identity formation (PIF) in medical students is a multifactorial phenomenon, shaped by ways that clinical and non-clinical experiences, expectations and environmental factors merge with individual values, beliefs and obligations. The relationship between students’ evolving professional identity and self-identity or personhood remains ill-defined, making it challenging for medical schools to support PIF systematically and strategically. Primarily, to capture prevailing literature on PIF in medical school education, and secondarily, to ascertain how PIF influences on medical students may be viewed through the lens of the ring theory of personhood (RToP) and to identify ways that medical schools support PIF. Methods A systematic scoping review was conducted using the systematic evidence-based approach. Articles published between 1 January 2000 and 1 July 2020 related to PIF in medical students were searched using PubMed, Embase, PsycINFO, ERIC and Scopus. Articles of all study designs (quantitative and qualitative), published or translated into English, were included. Concurrent thematic and directed content analyses were used to evaluate the data. Results A total of 10443 abstracts were identified, 272 full-text articles evaluated, and 76 articles included. Thematic and directed content analyses revealed similar themes and categories as follows: characteristics of PIF in relation to professionalism, role of socialization in PIF, PIF enablers and barriers, and medical school approaches to supporting PIF. Discussion PIF involves iterative construction, deconstruction and inculcation of professional beliefs, values and behaviours into a pre-existent identity. Through the lens of RToP, factors were elucidated that promote or hinder students’ identity development on individual, relational or societal levels. If inadequately or inappropriately supported, enabling factors become barriers to PIF. Medical schools employ an all-encompassing approach to support PIF, illuminating the need for distinct and deliberate longitudinal monitoring and mentoring to foster students’ balanced integration of personal and professional identities over time.

The toll of staying dry in a sea of context

“…17 For individuals navigating the novice-expert continuum, '[d]econstructing the self to pursue congruence among multiple existing identities can be disorienting or disconcerting'. 14 What if the same discomfort were expected of the very communities that influence these factors, aiming to do better? Well … it depends.…”

“…Depending on context, teaching by the same expert can become a political process that empowers or oppresses the learner, as learning does not occur solely within intended teaching confines. We have come to accept that gaps between espoused and enacted values within hidden curricula can undermine one's view, voice, value, place and professional identity formation, by impacting how personal and professional tensions come to collide or harmonise along the way 14 . Similar tensions abound even within HPE in our lived experiences, from the definition of duties and codes of practice, to the organisational structures in place, to our educational approaches, to our choice of educational research and to the root of our educational missions.…”

“…What if instead we could enrich our work by prioritising synthesis of knowledge, built on logical theories and context‐driven conceptual frameworks that inform and improve study design, as exemplified in these four papers? What if we aimed to advance the field through collaborative, multidisciplinary communities of research and scholarship representing expertise from HPE, health care institutions, diverse disciplines, journals and relevant regulatory bodies? 17 For individuals navigating the novice‐expert continuum, ‘[d]econstructing the self to pursue congruence among multiple existing identities can be disorienting or disconcerting’ 14 . What if the same discomfort were expected of the very communities that influence these factors, aiming to do better?…”

Professional Identity Formation in Health Promotion Practitioners: Students’ Perspectives during an Undergraduate Program in Switzerland

“…Practical experiences in the profession are essential for PI formation in educational programs [9,12]. More established professions investigate the PI formation of their workforce, such as medicine [42][43][44], physiotherapists [45,46] or social work [47][48][49][50]. To the authors' knowledge, literature on the PI of the HP workforce is scarce, especially there is a lack of empirical studies [51][52][53].…”

A Synchronous Hybrid Team-Based Learning Class: Why and How to Do It?

“…Professional identity formation is also an important part of physicians’ development. Professional identity is a highly dynamic and multi-faceted process achieved through socialisation with peers and mentors, and influenced by interactions with patients in the clinical setting [ 26 – 29 ]. Given that being part of the community of practice is fundamental for professional identity formation [ 30 , 31 ], concerns were raised when medical students were temporarily removed from the clinical training environment during the COVID-19 pandemic [ 32 ].…”