Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
Med Educ. 2014 May;48(5):489-501. doi: 10.1111/medu.12382.
Professional identity formation plays a crucial role in the transition from medical student to doctor. At McMaster University, medical students maintain a portfolio of narrative reflections of their experiences, which provides for a rich source of data into their professional development. The purpose of this study was to understand the major influences on medical students' professional identity formation.
Sixty-five medical students (46 women; 19 men) from a class of 194 consented to the study of their portfolios. In total, 604 reflections were analysed and coded using thematic narrative analysis. The codes were merged under subthemes and themes. Common or recurrent themes were identified in order to develop a descriptive framework of professional identity formation. Reflections were then analysed longitudinally within and across individual portfolios to examine the professional identity formation over time with respect to these themes.
Five major themes were associated with professional identity formation in medical students: prior experiences, role models, patient encounters, curriculum (formal and hidden) and societal expectations. Our longitudinal analysis shows how these themes interact and shape pivotal moments, as well as the iterative nature of professional identity from the multiple ways in which individuals construct meaning from interactions with their environments.
Our study provides a window on the dynamic, discursive and constructed nature of professional identity formation. The five key themes associated with professional identity formation provide strategic opportunities to enable positive development. This study also illustrates the power of reflective writing for students and tutors in the professional identity formation process.
专业身份的形成在医学生向医生的过渡中起着至关重要的作用。在麦克马斯特大学，医学生通过维护一份叙事性的经验档案，为他们的专业发展提供了丰富的数据来源。本研究旨在了解影响医学生专业身份形成的主要因素。
从 194 名学生中，有 65 名（46 名女性；19 名男性）医学生同意对他们的档案进行研究。共分析了 604 份反思，并采用主题叙事分析进行编码。这些代码被合并为子主题和主题。确定常见或反复出现的主题，以便为专业身份形成开发一个描述性框架。然后，对个人档案中的反思进行纵向分析，以检查随着时间的推移，这些主题对专业身份形成的影响。
与医学生专业身份形成相关的有五个主要主题：既往经历、榜样、患者遭遇、课程（正式和隐性）和社会期望。我们的纵向分析表明，这些主题如何相互作用并塑造关键时刻，以及个人如何通过与环境的互动构建意义，从而使专业身份具有迭代性。
我们的研究提供了一个观察医学生专业身份形成的动态、话语和构建性质的窗口。与专业身份形成相关的五个关键主题为积极发展提供了战略机会。这项研究还说明了反思性写作对学生和导师在专业身份形成过程中的作用。
