Assessing professional identity formation (PIF) amongst medical students in Oncology and Palliative Medicine postings: a SEBA guided scoping review

Abstract

Background Introduction to a multi-professional team who are working and caring for the dying, and facing complex moral and ethical dilemmas during Oncology and Palliative Medicine postings influence a medical student’s professional identity formation (PIF). However, limited appreciation of PIF, inadequate assessments and insufficient support jeopardise this opportunity to shape how medical students think, feel and act as future physicians. To address this gap, a systematic scoping review (SSR) of PIF assessment methods is proposed. Methods A Systematic Evidence-based Approach (SEBA) guided SSR of assessments of PIF in medical schools published between 1st January 2000 and 31st December 2021 in PubMed, Embase, ERIC and Scopus databases was carried out. Included articles were concurrently content and thematically analysed using SEBA’s Split Approach and the themes and categories identified were combined using SEBA’s Jigsaw Perspective. The review hinged on the following questions: “what is known about the assessment of professional identity formation amongst medical students?”, “what are the theories and principles guiding the assessment of professional identity formation amongst medical students?”, “what factors influence PIF in medical students?”, “what are the tools used to assess PIF in medical students?”, and “what considerations impact the implementation of PIF assessment tools amongst medical students?”. Results Two thousand four hundred thirty six abstracts were reviewed, 602 full-text articles were evaluated, and 88 articles were included. The 3 domains identified were 1) theories, 2) assessment, and 3) implementation in assessing PIF. Differing attention to the different aspects of the PIF process impairs evaluations, jeopardise timely and appropriate support of medical students and hinder effective implementation of PIF assessments. Conclusion The Krishna-Pisupati model combines current theories and concepts of PIF to provide a more holistic perspective of the PIF process. Under the aegis of this model, Palliative Care and Oncology postings are envisaged as Communities of Practice influencing self-concepts of personhood and identity and shaping how medical students see their roles and responsibilities as future physicians. These insights allow the forwarding of nine recommendations to improve assessments of PIF and shape the design of a PIF-specific tool that can direct timely and personalized support of medical students.

A systematic scoping review of reflective writing in medical education

“…To begin, the Krishna Model of Reflective Writing (Fig. 3 ) builds on the Krishna-Pisupati Model [ 10 ] used to describe evaluations of professional identity formation (PIF) [ 8 , 10 , 24 , 251 ]. Evidenced in studies of how physicians cope with death and dying patients, moral distress and dignity-centered care [ 46 , 54 ], the Krishna-Pisupati Model suggests that the physician’s belief system is informed by their self-concepts of personhood and identity.…”

“…To synthesise a coherent narrative from the multiple accounts of reflective writing, we adopt Krishna’s Systematic Evidence-Based Approach (SEBA) [ 10 , 15 , 21 , 46 – 53 ]. A SEBA-guided Systematic Scoping Review (SSR in SEBA) [ 13 – 24 , 50 , 53 – 55 ] facilitates reproducible, accountable and transparent analysis of patterns, relationships and disagreements from multiple angles [ 56 ].…”

“…The SEBA process (Fig. 1 ) comprises the following elements: 1) Systematic Approach, 2) Split Approach, 3) Jigsaw Perspective, 4) Funnelling Process, 5) Analysis of data and non-data driven literature, and 6) Synthesis of SSR in SEBA [ 10 , 15 , 21 , 46 – 53 , 57 – 60 ] . Every stage was overseen by a team of experts that included medical librarians from the Yong Loo Lin School of Medicine (YLLSoM) at the National University of Singapore, and local educational experts and clinicians at YLLSoM, Duke-NUS Medical School, Assisi Hospice, Singapore General Hospital, National Cancer Centre Singapore and Palliative Care Institute Liverpool.…”

“…Teo et al [ 10 ] build on this concept of reflective practice. The authors suggest that the physician’s belief system informs and is informed by their self-concepts of identity which are in turn rooted in their self-concepts of personhood - how they conceive what makes them who they are [ 11 ].…”

Correction: Assessing professional identity formation (PIF) amongst medical students in Oncology and Palliative Medicine postings: a SEBA guided scoping review

“…Following the publication of the original article [ 1 ], the authors became aware that there has been a transposition of the references as changes were made to the tables. This meant that the citations produced and the references in the published manuscript including those displayed in Tables Two to Seven (Table 2, Table, 3, Table 4, Table 5, Table 6, Table 7) does not match.…”