Research Division, Institute of Mental Health, Singapore, Singapore.
Institute of Health Sciences Education, Faculty of Family Medicine & Health Science, McGill University, Montreal, Quebec, Canada.
Perspect Med Educ. 2021 Oct;10(5):279-285. doi: 10.1007/s40037-021-00673-w. Epub 2021 Jul 7.
Conceptual frameworks for professional identity (PI) formation highlight the importance of developmental stages and socialization as the learner progresses from legitimate peripheral to full participation. Based on extant literature and clinical impressions, the authors aimed to explore factors associated with PI formation in psychiatry residents over time, and hypothesized that time in training, seniority status, and duration of exposure to psychiatry prior to residency would be associated with PI formation.
Eighty out of 96 psychiatry residents (response rate, 83.3%) from the National Psychiatry Residency Program in Singapore participated and rated their PI development using the Professional Self Identity Questionnaire (PSIQ) across four timepoints from January 2016-December 2019. The residents were classified as junior (first 3 years) or senior residents (years 4-5). Linear mixed model analyses were conducted, with time in training, seniority status (junior versus senior residents), duration of psychiatry postings prior to residency, and their interaction as associated factors with PI over time.
Time in training, seniority, and duration of psychiatry postings before residency (all p < 0.01) were significantly associated with higher PSIQ scores at baseline. Over time, although all residents had increases in PSIQ scores, this rate of change did not differ significantly between junior and senior residents.
Exposure to psychiatry postings before residency, time in learning, and seniority are factors which influence PI development in residents. This has implications for psychiatry residency selection and training, adequate clinical exposure during training rotations, and continual support for new and senior residents to foster PI formation over time.
职业认同（PI）形成的概念框架强调了发展阶段和社会化的重要性，因为学习者从合法的边缘参与者逐渐过渡到完全参与。基于现有文献和临床印象，作者旨在探讨与精神病住院医师 PI 形成随时间变化相关的因素，并假设培训时间、资历地位以及在住院医师培训之前接触精神病学的时间长短与 PI 形成相关。
新加坡国家精神病学住院医师计划的 96 名精神病住院医师中有 80 名（应答率为 83.3%）参与了研究，并在 2016 年 1 月至 2019 年 12 月期间使用专业自我认同问卷（PSIQ）在四个时间点评估他们的 PI 发展情况。住院医师被分为初级（前 3 年）或高级住院医师（第 4-5 年）。采用线性混合模型分析，将培训时间、资历地位（初级与高级住院医师）、住院医师培训前精神病学实习时间长短及其交互作用作为与 PI 随时间变化相关的因素。
培训时间、资历地位和住院医师培训前精神病学实习时间长短（均 p<0.01）与基线时较高的 PSIQ 评分显著相关。尽管所有住院医师的 PSIQ 评分随时间增加，但初级和高级住院医师之间的变化率没有显著差异。
住院医师培训前接触精神病学实习、学习时间和资历地位是影响住院医师 PI 发展的因素。这对精神病学住院医师的选拔和培训、培训轮转期间的充分临床接触以及为新住院医师和高级住院医师提供持续支持以促进 PI 形成具有重要意义。
