Resumen:
Background: Recent literature on professional identity formation (PIF) conceptualizes
the developmental process into stage theories that remove critical context. This study employed
a longitudinal approach to PIF that explored the processes through which professional identity is
formed in second (MS2) and third (MS3) year medical students and how their perceptions of
professionalism transformed and influenced their PIF.
Methods: Nine medical students (n=9) from Indiana University School of Medicine
completed this study spanning MS2 and MS3. Participants completed three semi-structured
interviews and submitted 10 audio diaries at two-month intervals between interviews.
Participants also completed the Professionalism Assessment Tool (PAT) at the beginning of MS2
(PAT1) and end of MS3 (PAT2). Interviews and audio diaries were analyzed using the constant
comparative approach and a Wilcoxon signed-rank test was used to determine significant
differences between mean domain scores of PAT1 and PAT2.
Results: This study found several processes of PIF within five themes: Exploring Self in
Medicine, Connecting to Image of Medicine, Embodying Role, Internalizing Values, and Exploring
Specialty Choice. Processes of participating in patient care and selecting a specialty have the
most profound impact on PIF and resulted in medical students feeling like members of the
medical community. Analyses revealed participants’ perceptions of professionalism became
more complex with clinical experiences and their perceptions of their ability to enact those
behaviors transformed across the study period. Furthermore, the participants’ perceptions of professionalism set the foundation for the values they desired to demonstrate as part of their
professional identities.
Conclusions: This study presents a cohesive picture of how PIF occurs across MS2 and
MS3 and how professionalism influences this important developmental process. These results
indicate PIF is best cultivated within a medical curriculum where students are able to utilize
processes to foster its development. Since professionalism serves as an important foundation to
professional identity and a comprehensive understanding is needed for medical students to
appreciate a physician’s role in society, the curriculum must be structured in a way to promote a
complex, reflective understanding of professionalism that is based on values, actions, and who
one wants to be as a physician.
