Burford Bryan, Rosenthal-Stott Harriet E S
School of Medical Education, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.
Department of Psychology, Durham University, Durham, UK.
BMC Med Educ. 2017 Nov 13;17(1):209. doi: 10.1186/s12909-017-1049-2.
The emergence of medical students' professional identity is important. This paper considers this in a snapshot of the early years of undergraduate medical education. From the perspective of social identity theory, it also considers self-stereotyping, the extent to which individuals associate with attributes identified as typical of groups.
Paper questionnaires were completed by first and second year medical students following teaching sessions at the beginning (October) and end (April) of the academic year. Questionnaires consisted of scales measuring the strength and importance of identity and self-stereotyping, referent to 'doctors' and 'students'. Linear mixed effects regression considered longitudinal and cross-sectional effects of progress through the course, and differences in responses to 'doctor' and 'student' measures.
In October, responses were received from 99% (n = 102) and 75% (n = 58) of first and second year cohorts respectively, and in April from 81% (n = 83) and 73% (n = 56). Response rates were over 95% of those present. Linear mixed effects regression found that all 'doctor'-referent measures were higher than 'student' measures. Strength of identity and self-stereotyping decreased between beginning and end of the year (across both groups). Men indicated lower importance of identity than women, also across both groups. There were no differences between year groups. Self-stereotyping was predicted more by importance of identification with a group than by strength of identification.
Findings reinforce observations that medical students identify strongly as doctors from early in their studies, and that this identification is greater than as students. Decreases over time are surprising, but may be explained by changing group salience towards the end of the academic year. The lack of a gender effect on strength of identification contrasts with the literature, but may reflect students' lack of 'performance' of professional identity, while the effect on importance is speculated to be linked to social identity complexity. Identification with professional group may have implications for how medical schools treat students. The findings on self-stereotyping have relevance to recruitment if applicant populations are limited to those already internalising a stereotype. There may be consequences for the wellbeing of those who feel they cannot fulfil stereotypes when in training.
医学生职业身份的形成很重要。本文从本科医学教育早期阶段的一个快照来考虑这一问题。从社会身份理论的角度来看,它还考虑了自我刻板印象,即个体与被视为群体典型特征的属性的关联程度。
在学年开始(10月)和结束(4月)的教学课程后,一年级和二年级医学生完成了纸质问卷。问卷包括测量身份认同和自我刻板印象的强度及重要性的量表,涉及“医生”和“学生”。线性混合效应回归考虑了课程进展的纵向和横向影响,以及对“医生”和“学生”测量结果的反应差异。
10月,一年级和二年级队列分别有99%(n = 102)和75%(n = 58)的学生回复,4月分别有81%(n = 83)和73%(n = 56)的学生回复。回复率超过在场学生的95%。线性混合效应回归发现,所有与“医生”相关的测量结果都高于与“学生”相关的测量结果。在这一年中(两个组都是如此),身份认同和自我刻板印象的强度从年初到年末有所下降。在两个组中,男性表示身份认同的重要性低于女性。不同年级组之间没有差异。自我刻板印象更多地由对群体认同的重要性而非认同强度来预测。
研究结果强化了这样的观察结果,即医学生在学习早期就强烈认同自己是医生,且这种认同大于作为学生的认同。随着时间推移的下降令人惊讶,但可能可以用学年末群体显著性的变化来解释。认同强度上缺乏性别效应与文献情况不同,但可能反映了学生在职业身份方面缺乏“表现”,而对重要性的影响据推测与社会身份复杂性有关。对专业群体的认同可能会影响医学院校对待学生的方式。如果申请人群仅限于那些已经内化了某种刻板印象的人,那么关于自我刻板印象的研究结果与招生有关。对于那些在培训中觉得自己无法符合刻板印象的人来说,可能会对他们的幸福感产生影响。