scholarly journals Balancing Forces: Medical Students’ Reflections on Professionalism Challenges and Professional Identity Formation

2021 ◽  
Vol 53 (3) ◽  
pp. 200-206
Author(s):  
Amrapali Maitra ◽  
Steven Lin ◽  
Tracy A. Rydel ◽  
Erika Schillinger
Keyword(s):  
Medical Students ◽  
Professional Identity ◽  
Identity Formation ◽  
Medical Training ◽  
Health Care Team ◽  
Free Text ◽  
Self Awareness ◽  
Theory Approach ◽  
Professional Identity Formation ◽  
Medicine Clerkship

Background and Objectives: Professionalism is essential in medical education, yet how it is embodied through medical students’ lived experiences remains elusive. Little research exists on how students perceive professionalism and the barriers they encounter. This study examines attitudes toward professionalism through students’ written reflections. Methods: Family medicine clerkship students at Stanford University School of Medicine answered the following prompt: “Log a patient encounter in which you experienced a professionalism challenge or improvement opportunity.” We collected and analyzed free-text responses for content and themes using a grounded theory approach. Results: One hundred responses from 106 students generated a total of 168 codes; 13 themes emerged across four domains: challenging patients, interpersonal interactions, self-awareness, and health care team dynamics. The three most frequently occurring themes were interacting with emotional patients, managing expectations in the encounter, and navigating the trainee role. Conclusions: Medical students view professionalism as a balance of forces. While many students conceived of professionalism in relation to patient encounters, they also described how professionalism manifests in inner qualities as well as in health systems. Interpersonal challenges related to communication and agenda-setting are predominant. Systems challenges include not being seen as the “real doctor” and being shaped by team behaviors through the hidden curriculum. Our findings highlight salient professionalism challenges and identity conflicts for medical students and suggest potential educational strategies such as intentional coaching and role-modeling by faculty. Overall, students’ reflections broaden our understanding of professional identity formation in medical training.

scholarly journals On Teaching the Sum While Paying Attention to the Parts: Whole Person Care through Ethnography in Medical Education

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Vasiliki Nataly Rahimzadeh ◽  
David Lessard ◽  
Peter Nugus
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
Professional Identity ◽  
Identity Formation ◽  
Medical Training ◽  
Academic Discipline ◽  
Professional Identity Formation ◽  
Patient Centered ◽  
Whole Person

Objective—This article provides a reflection on medical teaching opportunities for whole person care based on our experiences mentoring 2nd-year medical students through an Ethnography Practicum at a Canadian university.                                                                  Background—The Ethnography Practicum is a new addition to the Family Medicine Transition to Clinical Practice (TCP) curriculum introduced in the second year of medical school at McGill University. It involves 30 hours of instruction (6 hours in lectures with an instructor, and 24 hours in small-group tutorials with the authors), and 9 hours of fieldwork observations in various community health settings across Montreal, QC. The primary aims of the Practicum converge with those of the TCP generally in two important ways: to inculcate in students the concepts of patient centered care, and to promote family medicine as both an academic discipline and career option.                    Results and Discussion— Our experiences illustrate two tensions that shape students’ expectations and experiences throughout their involvement in the Practicum and, in turn, highlight the implications for teaching whole-person care. First, ethnography as a combination of different methods has itself been the locus of tensions between positivist and critical traditions in the three last decades. Second, the Practicum is situated precisely at the crossroads of key moments on the professional identity formation continuum for our students. Such a crossroads is disruptive to the status quo of medical traineeship characteristic of the first two years in medical school, and thus reorients professional identity formation. The above tensions reveal how ethnography is not only a revered research tradition in the humanities, but can also be a conduit to whole person care-inspired clinical practice.Conclusion—As instructors and mentors involved in this Ethnography Practicum, we are continually forging a new relevance for organizational ethnography in medical training, where medical students can reflect and act on competencies beyond clinical ones. The Practicum provides a space for students to wrestle with alternative epistemologies to understanding the social world in which medicine is embedded. We lastly provide pragmatic ways to better address these tensions in an effort to support students as they proceed through the (multifaceted) development of their professional identities as future physicians.

scholarly journals 729 “I Don’t Feel Like I’m Learning How to Be A Doctor:” The Impact of Disruptions Due to Covid-19 On Professional Identity Formation in UK Medical Students

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Harvey ◽  
M E L Brown ◽  
M H V Byrne ◽  
J Ashcroft ◽  
J C M Wan ◽  
...  
Keyword(s):  
Medical Students ◽  
Professional Identity ◽  
Identity Formation ◽  
Medical Training ◽  
Professional Identity Formation ◽  
Clinical Environment ◽  
Clinical Exposure ◽  
Open Questions ◽  
Qualitative Responses ◽  
The Impact

Abstract Introduction Professional identity formation (PIF) is a priority of medical training. Covid-19 caused disruption to medical education. We ask how this disruption impacted PIF through the lens of the activities performed – or not performed – by medical students during the first wave of the covid-19 pandemic, and perceptions of conflicts between activities. Method A pragmatic survey was distributed in spring 2020. Thematic analysis was performed of qualitative responses to two open questions. A social constructivist approach linked participants’ comments to PIF theory. Results We analysed 928 responses. Three themes surrounding students’ activities during covid-19 and their impact on identity were constructed: Conflict arose at the intersections between these themes. Students noted lack of clinical exposure was detrimental, implicitly recognising that aspects of PIF require the clinical environment. Participants were keen to volunteer but struggled with balancing academic work. Participants worried about risk to their households and the wider community and wanted their skills to add value in the clinical environment. Volunteers felt frustrated when they were unable to perform tasks aligning with their identity as a future doctor. An exception was participants who worked as interim FY1s, aligned with the role of an FY1. Conclusions Medical students feel a duty to help during crises. Conflict arises when different aspects of their identity demand different actions. Care must be taken to nurture PIF during periods of disruption.

scholarly journals A Scoping Review of Professional Identity Formation in Undergraduate Medical Education

2021 ◽  
Author(s):  
Shiva Sarraf-Yazdi ◽  
Yao Neng Teo ◽  
Ashley Ern Hui How ◽  
Yao Hao Teo ◽  
Sherill Goh ◽  
...  
Keyword(s):  
Medical Students ◽  
Identity Development ◽  
Medical School ◽  
Professional Identity ◽  
Identity Formation ◽  
Scoping Review ◽  
Medical Schools ◽  
Professional Identity Formation ◽  
Enabling Factors ◽  
Content Analyses

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.

scholarly journals Community Engagement Leads to Professional Identity Formation of Nursing Students

2020 ◽  
Vol 5 (3) ◽  
pp. 181-184
Author(s):  
Edna R. Magpantay-Monroe ◽  
Ofa-Helotu Koka ◽  
Kamaile Aipa
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Professional Identity ◽  
Identity Formation ◽  
Community Engagement ◽  
Research Literature ◽  
Self Awareness ◽  
Clinical Learning ◽  
Professional Identity Formation ◽  
Nursing Leaders

Professional identity formation is essential to nursing education. Knowledge, skills, attitudes, and values help form nursing students’ identity. Professional identity is a process of becoming independent and having self-awareness of one’s educational journey (All Answers Ltd., 2018). Maranon and Pera (2015) described that the contrast between didactic and clinical learning may play a role in the ambiguity that initiates nursing students about professional identity. There is a gap in the current research literature and has been underexplored with no intentional plan to address new areas (Godfrey, 2020; Haghighat, Borhani, & Ranjbar, 2020). The goal of professional identity formation is to develop well-rounded students with moral competencies who will blossom into future nursing leaders (Haghighat et al., 2020). The benefit to the community of producing well-rounded nursing students is safety and quality in their actions. This descriptive paper will address examples of how professional identity may be achieved by nursing students’ participation in community engagement such as attendance to professional conferences and intentional mentoring.

scholarly journals Unmasking identity dissonance: exploring medical students’ professional identity formation through mask making

2017 ◽  
Vol 6 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Kimera Joseph ◽  
Karlen Bader ◽  
Sara Wilson ◽  
Melissa Walker ◽  
Mark Stephens ◽  
...  
Keyword(s):  
Medical Students ◽  
Professional Identity ◽  
Identity Formation ◽  
Professional Identity Formation ◽  
Mask Making

scholarly journals Simulated medical consultations with standardized patients: In-depth debriefing based on dealing with emotions

2018 ◽  
Vol 42 (1) ◽  
pp. 84-93 ◽  
Author(s):  
Marcelo Schweller ◽  
Diego L. Ribeiro ◽  
Sílvia R. Passeri ◽  
Jamiro S. Wanderley ◽  
Marco Antonio Carvalho-Filho
Keyword(s):  
Medical Students ◽  
Professional Identity ◽  
Identity Formation ◽  
Defense Mechanisms ◽  
Medical Curriculum ◽  
Medical Profession ◽  
Standardized Patients ◽  
Simulated Patients ◽  
Professional Identity Formation ◽  
Emotional Detachment

ABSTRACT In general, students have few opportunities to address their emotions under the guidance of an experienced physician, which can undermine their self-confidence to deal with real patients in stressful situations. Emotional detachment and cynicism are defense mechanisms, which can emerge as a consequence. The consolidation of a professional identity committed to patients’ interests can become a challenge when medical students are not comfortable in their role as caregivers. In general, we consider that the undergraduate medical curriculum has been insufficient in providing appropriate environments for students to reflect on professional identity formation and on the future challenges of their profession. Objective: To develop an in-depth debriefing to address students’ emotions and professional identity formation in the context of a simulation activity with simulated patients at a medical school in Brazil. Methods: The authors conducted a simulated medical consultation activity using standardized patients (SPs) with an in-depth debriefing based on the feelings of the patient and the student. During each encounter the formation and consolidation of professional identity was discussed. Fourth- and sixth-year medical students (n=551) participated and answered a questionnaire about the activity and the learning outcome. Results: The students felt comfortable during the activity, due to "openness to dialogue", "proximity with colleagues and teachers" and the "judgment-free environment". More than 90% reported that what they had learned would be useful in their professional and personal lives, providing a greater "understanding of emotions", "empathy", "ability to listen" and "ability to deal with conflicts". More than half of them were motivated to study, especially "doctor-patient relationship", "treatment", "common diseases" and "medicine in general". Students considered the activity important for retrieving the initial reasons that had led them to embarking on the medical profession in the first place. Conclusions: Reflecting on disease and its impact on patients’ daily life may motivate learning in medicine, allowing for the recovery of the personal and social meaning of its practice. In-depth debriefing was important to nurture professional identity committed to empathy and patients’ interests. Activities planned to discuss the influence and importance of emotions in medical practice can help students to reconcile personal and professional identities.

scholarly journals Professional Identity Formation Among College Premedical Students: A Glimpse into the Looking Glass Using a Career Eulogy Reflective Exercise

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
William J. Crump ◽  
R. Steve Fricker ◽  
Allison M. Crump
Keyword(s):  
Medical Students ◽  
Professional Identity ◽  
Identity Formation ◽  
Conflicts Of Interest ◽  
Human Subjects ◽  
Small Towns ◽  
Professional Identity Formation ◽  
Group Settings ◽  
Institutional Review ◽  
Upper Level

Introduction  Pre-medical students are at the very beginning of their formation of a professional identity as a physician. Working with these students early in their education can help them appreciate the importance of professional identity formation as well as inform educators on best methods to understand this process.  Methods  A reflective exercise was used at the beginning of sessions with pre-medical students at their home campus who attended  a medical school presentation on the admissions process. Students were asked to reflect on what they wished to be said about them at the end of their career in the form of a “Career Eulogy.” A simple form was developed and administered to the students to capture their reflective writing and their basic demographics anonymously. Qualitative data were blinded and then coded into clusters by the authors using an iterative process.  Results  Reflections from 79 pre-medical students indicated a preference to be remembered for quality and excellence in care, especially among upper level students and students from small towns. Compassion, patient relationships, and the doctor as teacher terms were more likely to be written by Juniors and Seniors while Freshmen and Sophomores tended to focus on terms related to enjoyment of life and service.  Discussion  This reflective exercise provided useful insight into professional identity formation among these college pre-meds and could be used with larger, more diverse groups to determine its value and clarify true differences among the demographic characteristics. Involving similar pre-medical students in focus group settings could also further assist with interpretation of the meaning of these reflections.  Funding/Support: None.  Human Subjects: This study was determined exempt by the Baptist Health Madisonville Institutional Review Board.  Conflicts of Interest: None

scholarly journals “Can virtue be taught?”: a content analysis of medical students’ opinions of the professional and ethical challenges to their professional identity formation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Michael Hawking ◽  
Jenny Kim ◽  
Melody Jih ◽  
Chelsea Hu ◽  
John D. Yoon
Keyword(s):  
Content Analysis ◽  
Medical Students ◽  
Professional Identity ◽  
Identity Formation ◽  
National Sample ◽  
Professional Issues ◽  
Professional Identity Formation ◽  
Clinical Experiences ◽  
Survey Item ◽  
Ethical And Professional Issues

Abstract Background Efforts have begun to characterize the ethical and professional issues encountered by medical students in their clinical years. By applying previously identified taxonomies to a national sample of medical students, this study seeks to develop generalizable insights that can inform professional identity formation across various clerkships and medical institutions. Methods In a national survey of medical students, participants answered an open-ended survey item that asked them to describe a clinical experience involving an ethical or professional issue. We conducted a content analysis with these responses using the Kaldjian taxonomy of ethical and professionalism themes in medical education through an iterative, consensus-building process. Noting the emerging virtues-based approach to ethics and professionalism, we also reexamined the data using a taxonomy of virtues. Results The response rate to this survey item was 144 out of 499 eligible respondents (28.9%). All 144 responses were successfully coded under one or more themes in the original taxonomy of ethical and professional issues, resulting in a total of 173 coded responses. Professional duties was the most frequently coded theme (29.2%), followed by Communication (26.4%), Quality of care (18.8%), Student-specific issues of moral distress (16.7%), Decisions regarding treatment (16.0%), and Justice (13.2%). In the virtues taxonomy, 180 total responses were coded from the 144 original responses, and the most frequent virtue coded was Wisdom (23.6%), followed by Respectfulness (20.1%) and Compassion or Empathy (13.9%). Conclusions Originally developed from students’ clinical experiences in one institution, the Kaldjian taxonomy appears to serve as a useful analytical framework for categorizing a variety of clinical experiences faced by a national sample of medical students. This study also supports the development of virtue-based programs that focus on cultivating the virtue of wisdom in the practice of medicine.

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