A Critical Review of Professional Identity Formation Interventions in Medical Education

Abstract

Purpose Professional identity formation (PIF) can be defined as the integration of the knowledge, skills, values, and behaviors of a profession with one’s preexisting identity and values. Several different, and sometimes conflicting, conceptualizations and theories about PIF populate the literature; applying these different theories in PIF curricula and pedagogic strategies can profoundly impact the PIF of future physicians. The authors conducted a critical review of the recent literature on PIF interventions in medical education to explore the conceptualizations of and theoretical approaches to PIF that underlie them. Method The authors searched articles on PIF educational interventions published in 5 major medical education journals between 2010 and March 2021. The articles’ context and findings were extracted, analyzed, and summarized to identify conceptualizations and theoretical approaches to PIF. Results The authors identified 43 studies examining medical education interventions aimed at influencing PIF. The majority of the studies (n = 31) focused on undergraduate medical education. Reflective writing and the use of narrative reflections were the dominant modes of student activity in PIF interventions, supporting the dominant individualist approach to PIF. Less commonly PIF was understood as a socialization process or as an active process with both individually and socially focused influences. Conclusions Relying on reflective writing as the intervention of choice to impact PIF feeds the dominant individualist perspective on PIF. An unintended consequence of this individualist orientation is that cultural problems embedded in the profession can become burdens for individual physicians to personally bear. Future education and research into PIF should account for theoretical preferences and the impact of these preferences.

The development of professional identity in clinical psychologists: A scoping review

“…professional or minoritised groups), we necessarily only capture part of the story. Indeed, there is an increasing chorus of researchers critiquing the lack of diversity reflected in the ‘data’ on professional identities (historically comprising of White, male and medical cultures) and the need for a critical perspective from researchers 2,14,15,17 . One of these absent groups comprises mental health professionals, specifically clinical psychologists, which are the focus of this article.…”

“…All texts reported that professional identity was related closely to personal identity, with variations in emphasis, language and description of this relationship. Descriptions ranged from explicitly describing the evolution of professional identity from personal identity, characteristics or experience (2,6,7,8,10,16,17,19,20), the progressive integration or congruence between personal and professional identity (…”

“…The integration of personal and professional identity was particularly nuanced when master identities were considered. Master identities shaped professional identity in complex ways (4,7,9,15,17,18,20,21,24). Navigating how to integrate master identities into professional identity was most explicit when people perceived themselves as a minority, often experiencing marginalisation or being 'othered' on this basis.…”

“…Personal experiences associated with particular master identities were reported as being formative in shaping professional identity and contributed to greater awareness of context and power differentials (7,11,14,17,18,20). For example, while Black female clinical psychologists foregrounded discussions about their professional identity development within dilemmas about navigating gender, class and ethnic identities, their White counterparts did not (14).…”

When I say … Identity

“…Finally, clarifying your stance on identity facilitates aligning education practices to support professional identity formation. For example, an individual perspective of identity leads to student‐focused interventions, which might have unintended consequences of leaving the individual to grapple with cultural problems embedded within systems 13 . Alternatively, highlighting socialisation processes places the onus on educators to examine the learning environment as a shaping force on identities.…”