Department of Humanities, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Departments of Humanities and Public Health Sciences, Medical Education Research, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Med Educ. 2019 Feb;53(2):119-132. doi: 10.1111/medu.13781.
Despite a recent surge in literature identifying professional identity formation (PIF) as a key process in physician development, the empiric study of PIF in medicine remains in its infancy. To gain insight about PIF, the authors examined the medical literature and that of two other helping professions.
The authors conducted a scoping review and qualitative metasynthesis of PIF in medicine, nursing and counselling/psychology. For the scoping review, four databases were searched using a combination of keywords to identify empiric studies on PIF in trainees. After a two-step screening process, thematic analysis was used to conduct the metasynthesis on screened articles.
A total of 7451 titles and abstracts were screened; 92 studies were included in the scoping review. Saturation was reached in the qualitative metasynthesis after reviewing 29 articles.
The metasynthesis revealed three inter-related PIF themes across the helping professions: the importance of clinical experience, the role of trainees' expectations of what a helping professional is or should be, and the impact of broader professional culture and systems on PIF. Upon reflection, most striking was that only 10 of the 92 articles examined trainee's sociocultural data, such as race, ethnicity, gender, sexual orientation, age and socio-economic status, in a robust way and included them in their analysis and interpretation. This raises the question of whether conceptions of PIF suffer from sociocultural bias, thereby disadvantaging trainees from diverse populations and preserving the status quo of an historically white, male medical culture.
尽管最近有大量文献指出专业身份形成（PIF）是医师发展的关键过程，但医学领域对 PIF 的实证研究仍处于起步阶段。为了深入了解 PIF，作者检查了医学文献以及另外两个辅助专业的文献。
作者对医学、护理和咨询/心理学中的 PIF 进行了范围界定审查和定性元分析。在范围界定审查中，使用关键词组合对四个数据库进行了搜索，以确定关于受训者 PIF 的实证研究。经过两步筛选过程，对筛选出的文章进行了主题分析，以进行元综合。
共筛选出 7451 篇标题和摘要；92 项研究纳入范围界定审查。在审查了 29 篇文章后，定性元综合达到了饱和。
元综合揭示了三个相互关联的 PIF 主题，涵盖了辅助专业：临床经验的重要性、受训者对帮助专业人员的期望的作用，以及更广泛的专业文化和系统对 PIF 的影响。反思后，最引人注目的是，在 92 篇文章中，只有 10 篇以稳健的方式检查了受训者的社会文化数据，如种族、民族、性别、性取向、年龄和社会经济地位，并将其纳入分析和解释。这引发了一个问题，即 PIF 的概念是否受到社会文化偏见的影响，从而使来自不同群体的受训者处于不利地位，并维持历史上以白人、男性为主导的医学文化的现状。
