Lusk P, Ark T, Crowe R, Monson V, Altshuler L, Harnik V, Buckvar-Keltz L, Poag M, Belluomini P, Kalet A
Graduate School of Education, University of Pennsylvania, Philadelphia, PA, USA.
The Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee,WI, USA.
Med Teach. 2024 May;46(5):665-671. doi: 10.1080/0142159X.2023.2273218. Epub 2023 Nov 2.
The Professional Identity Essay (PIE) is a theory and evidence-based Medical Professional Identity Formation (MPIF) measure. We describe trajectories of PIE-measured MPIF over a 4-year US medical school curriculum.
Students write PIEs at medical school orientation, clinical clerkships orientation, and post-advanced (near graduation) clerkship. A trained evaluator assigns an overall stage score to narrative responses to nine PIE prompts (inter-rater ICC 0.83, 95% CI [0.57 - 0.96], intra-rater ICC 0.85). Distribution of PIE stage scores across time points were analyzed in the aggregate and individual students were classified as Increase, Stable (no score change) or Decrease based on the trajectories of PIE stage scores over time.
202 students completed 592 PIEs from 2018-2023. There was a significant change in the proportion of PIEs in stages over time ( 84.40, < 0.001), 47% ( = 95) students were categorized in the Increase trajectory, 45.5% ( = 92) as Stable and 7.4% ( = 15) as Decrease. Older age and time-predicted stage scores change within trajectories ( < 0.05).
Medical students' PIE stage scores increase over time with three distinctive trajectories. Further study is needed to explore the utility of this method for formative assessment, program evaluation, and MPIF research.
专业身份论文（PIE）是一种基于理论和证据的医学专业身份形成（MPIF）测量方法。我们描述了在美国四年制医学院课程中，通过PIE测量的MPIF的轨迹。
学生在医学院入学指导、临床实习指导和高级（接近毕业）实习后撰写PIE。一名经过培训的评估人员会为对九个PIE提示的叙述性回答分配一个总体阶段分数（评分者间ICC为0.83，95%CI[0.57 - 0.96]，评分者内ICC为0.85）。分析了PIE阶段分数在各个时间点的总体分布情况，并根据PIE阶段分数随时间的轨迹，将个体学生分类为上升、稳定（分数无变化）或下降。
202名学生在2018年至2023年期间完成了592篇PIE。各阶段PIE的比例随时间有显著变化（χ² = 84.40，P < 0.001），47%（n = 95）的学生被归类为上升轨迹，45.5%（n = 92）为稳定轨迹，7.4%（n = 15）为下降轨迹。年龄较大以及时间可预测轨迹内的阶段分数变化（P < 0.05）。
医学生的PIE阶段分数随时间上升，有三种不同的轨迹。需要进一步研究以探索这种方法在形成性评估、项目评估和MPIF研究中的效用。
