Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, Florida, USA.
Teach Learn Med. 2024 Oct-Dec;36(5):601-612. doi: 10.1080/10401334.2023.2240774. Epub 2023 Aug 17.
Students become physicians not only by mastering medical knowledge, but also through a process of Professional Identity Formation (PIF). In this study, we used the conceptual framework of Jarvis-Selinger et al. to explore the impact of COVID, as a major public health crisis, on the PIF of preclinical medical students in our country.
At two U.S. medical schools, we interviewed 28 medical students twice as they moved from first to second year during the 2020-2021 COVID pandemic and explored the impact of COVID-19 on PIF. We coded the transcribed interviews and identified themes using constructivist thematic analysis.
We identified three themes: 1) mental health and wellness impacts; 2) inhabiting identity as a health professional during COVID; and 3) questioning the role of physicians in society. Routines and support systems were disrupted, undermining wellness and confidence in professional choices. Students noted the need to be public health role models, and COVID prompted feelings of pride, while also causing them to question expectations of self-sacrifice amid a new politicization of medicine. Students felt that physicians must be increasingly engaged in public health and political communication.
Our findings inform medical educators seeking to build a scaffolding to support PIF during a public health crisis, and highlight the importance of current events and politics on PIF. Our recommendations include the need for student support, longitudinal mentorship, curricular space to discuss the impact of sociopolitical factors on PIF, and revisiting foundational concepts such as professionalism to take into account the social and political context. Our findings add to understanding of PIF during the COVID pandemic, but are also relevant to teaching and learning during future public health crises.
学生不仅通过掌握医学知识成为医生,而且还通过专业身份形成(PIF)的过程。在这项研究中,我们使用了 Jarvis-Selinger 等人的概念框架来探讨 COVID 作为重大公共卫生危机对我国临床医学专业学生 PIF 的影响。
在两所美国医学院,我们对 28 名医学生进行了两次访谈,他们在 2020-2021 年 COVID 大流行期间从第一年到第二年过渡,并探讨了 COVID-19 对 PIF 的影响。我们对转录的访谈进行了编码,并使用建构主义主题分析确定了主题。
我们确定了三个主题:1)心理健康和健康影响;2)在 COVID 期间作为医疗保健专业人员的身份认同;3)质疑医生在社会中的角色。常规和支持系统被打乱,破坏了健康和对职业选择的信心。学生们指出需要成为公共卫生的榜样,COVID 引发了他们的自豪感,同时也让他们对在医学新的政治化背景下牺牲自我的期望产生了质疑。学生们认为医生必须更多地参与公共卫生和政治沟通。
我们的研究结果为寻求在公共卫生危机期间建立支持 PIF 的框架的医学教育工作者提供了信息,并强调了当前事件和政治对 PIF 的重要性。我们的建议包括需要学生支持、纵向指导、讨论社会政治因素对 PIF 影响的课程空间,以及重新审视专业精神等基础概念,以考虑到社会和政治背景。我们的研究结果增加了对 COVID 大流行期间 PIF 的理解,但也与未来公共卫生危机期间的教学和学习相关。