The effectiveness of intervention programs on professional identity formation in nursing students: Systematic review and meta-analysis

A fundamental goal of medical education is the active, constructive, transformative process of professional identity formation (PIF). Medical educators are thus charged with designing standardized and personalized curricula for guiding, supporting, and challenging learners on the developmental professional identity pathway, including the process of socialization. The author of this Commentary provides an overview of foundational principles and key drivers of PIF supporting the being, relating, and doing the work of a compassionate and competent physician. Key elements of PIF including guided reflection, use of personal narratives, integral role of relationships and role modeling, and community of practice are viewed through various lenses of PIF theory and pedagogy. Questions informing the PIF discourse are raised, including interprofessional identity considerations. Central emergent themes of reflective practice, relationships, and resilience are described as supporting and reciprocally enhancing PIF. Overarching lessons include attending to learners' and faculty's PIF within a developmental trajectory of the professional life cycle; process and content within PIF curricula as well as learners' individual and collective voices; curricular/extracurricular factors contributing to socialization, self-awareness, development of core values, and moral leadership; integrating PIF domains within pedagogy; faculty development for skilled mentoring and reflective coaching; and implementing resilience-promoting skill sets as "protective" within PIF. Outcomes assessment including the impact of curricula on learners and on patient-centered care can be challenging, and potential next steps toward this goal are discussed.

BackgroundProfessional Identity formation is the process by which learners internalize a profession’s values, behaviors, and perceptions. With respect to physicians, this occurs at multiple levels of medical education, including the undergraduate, graduate, and continuing medical education stages. Professional identity formation likely starts even earlier, during the undergraduate pre-medical years but, to date, no known scoping or systematic review has been conducted on this topic. The objective of this scoping review is to systematically map the literature on professional identity formation among undergraduate pre-medical students.MethodsThis review protocol has been designed following the Arksey and O’Malley framework. We will search MEDLINE, CINAHL, Embase, and Scopus, as well as relevant grey literature, conference proceedings, and citations of selected articles. Inclusion criteria are articles (1) written in the English language, (2) involving undergraduate pre-medical students in the USA and Canada, and (3) containing original data about professional identity formation. Two independent reviewers will evaluate the titles, abstracts, and full articles for eligibility. A third reviewer will help resolve any disputes. Once the full text of articles are obtained, data will be abstracted using a standardized form. A narrative summary of findings will then be conducted, as well as a consultation exercise with university pre-medical students, pre-med advisors, and first-year medical students.DiscussionBy conducting this scoping review, we expect to gain a better understanding of how the experiences of undergraduate pre-medical students impact their professional identity formation. These findings will help to identify gaps in the literature, to better characterize professional identity formation in the specific context of the undergraduate pre-medical track, and to outline potential approaches to facilitate professional identity formation among undergraduate pre-medical students.Systematic review registrationThe protocol is registered with the Open Science Framework (htps://osf.io/nfzxc).

Background: There is a lack of synthesis in the existing literature concerning Professional Identity Formation (PIF) in public health professionals. The community of practitioners in public health may lack an understanding of opportunities for supporting PIF in public health education and practice. Hence, the purpose of the present Qualitative Meta-Analysis (QMA) was to gain insight into situations and factors that facilitate and challenge PIF among public health professionals. Material and Methods: A QMA was conducted to address the study objectives. We retrieved articles on PIF using a systematic search strategy across Medline, Scopus, and Google Scholar. Inclusion criteria included original qualitative and mixed methods research on PIF among public health students or professionals from various backgrounds, grey literature such as thesis, and studies in English, or with English translations, published in peerreviewed journals. Narratives, participant quotes, categories, and themes from the results and discussion sections were used for thematic and content analysis. Reporting followed the PRISMAScR checklist. Results and Conclusion: We derived five main meta-categories: 1) nature of public health practice and professional identity; 2) professional identity formation in the context of public health, which had three meta-categories on the role of the university in PIF, requirement of reconciliation with various other identities, and influence of job profile on professional identity; 3) facilitators of PIF included meta-categories of facilitators related to curricular aspects and while at work; 4) barriers related to PIF included metacategory related to curricular aspects and while at work; and finally, 5) perspectives of self and stakeholders included factors related to self, employers, and society. The results will provide a framework for future research and curriculum development in public health courses aimed at supporting PIF among students.

Keck School of Medicine of the University of Southern California.

Evolving individual, contextual, organizational, interactional and sociocultural factors have complicated efforts to shape the professional identity formation (PIF) of medical students or how they feel, act and think as professionals. However, an almost exclusive reliance on online learning during the COVID-19 pandemic offers a unique opportunity to study the elemental structures that shape PIF and the environmental factors nurturing it. We propose two independent Systematic Evidence-Based Approach guided systematic scoping reviews (SSR in SEBA)s to map accounts of online learning environment and netiquette that structure online programs. The data accrued was analysed using the clinically evidenced Krishna-Pisupati Model of Professional Identity Formation (KPM) to study the evolving concepts of professional identity. The results of each SSR in SEBA were evaluated separately with the themes and categories identified in the Split Approach combined to create richer and deeper 'themes/categories' using the Jigsaw Perspective. The 'themes/categories' from each review were combined using the Funnelling Process to create domains that guide the discussion. The 'themes/categories' identified from the 141 included full-text articles in the SSR in SEBA of online programs were the content and effects of online programs. The themes/categories identified from the 26 included articles in the SSR in SEBA of netiquette were guidelines, contributing factors, and implications. The Funnelling Process identified online programs (encapsulating the content, approach, structures and the support mechanisms); their effects; and PIF development that framed the domains guiding the discussion. This SSR in SEBA identifies the fundamental elements behind developing PIF including a structured program within a nurturing environment confined with netiquette-guided boundaries akin to a Community of Practice and the elemental aspect of a socialisation process within online programs. These findings ought to be applicable beyond online training and guide the design, support and assessment of efforts to nurture PIF.

The purpose of the work was to study the processes of formation and development of professional identity. The object of this article is professional identity. The subject of the research is the formation and formation of the professional identity of a specialist. The socio-psychological vision of the I-concept of a specialist has been determined. The main components of the development model of the professional identity of an expert in an organization are presented, their content is described. Special attention is paid to the psychological mechanisms of the formation of professional identity: social categorization, identification, alienation. The authors note that the development of professional identity for professionals is better understood as one of the aspects of their socialization in the field of professional activity. In the article, on the basis of a comprehensive theoretical analysis of approaches to the problem of the development of the professional identity of a specialist in an organization that exists in domestic and foreign psychology, a theoretical model of this phenomenon has been built. It can be argued that the formation and development of a positive professional identity is considered the result of the activities of certain psychological mechanisms that are triggered by the basic needs of the individual. The starting point here is the appropriate level of growth of the professional self-consciousness and the “I-concept” of the individual. Professional identity is represented in the “I-image”. Based on a theoretical analysis of the problem of identity formation, the authors identified several factors that influence the development of identity. The main factors are: society and its structure, information environment, elements of collective activity, psycho-physiological characteristics of a person.

Background and Purpose: As the nursing profession adapts to changing disease patterns and critical care environments, nurses' professional identity continues to evolve. However, empirical evidence suggests a lack of recently developed nursing professional identity formation scales that could serve as future diagnostic tools for assessing professional identity formation among nurses. The purpose of this study was to develop and test the Nursing Professional Identity Formation Scale specifically tailored to assess nurses' professional identity formation in clinical settings. Methods: This observational study involved 447 participants and used exploratory and confirmatory factor analyses with parallel classification. Results: We deleted 10 of the 32 original items from the exploratory factor analysis following the Delphi expert panel approach. Thus, the final Nursing Professional Identity Formation Scale had 22 items across four factors (fulfilling professional standards, continuous professional development, professional values and ethics, and maintaining professional roles), which together explained 72.04% of the total variance. A second-order confirmatory factor termed "nursing professional identity formation" with 17 items (root mean square residual = .054) was identified using a second-order confirmatory factor analysis. The Nursing Professional Identity Formation Scale scores differed across nursing position levels, indicating good convergent validity. The final Nursing Professional Identity Formation Scale had a Cronbach's alpha of .94 (range = .86-.90 for the four subscales). Conclusions: The Nursing Professional Identity Formation Scale was validated to fit the data adequately. It can evaluate clinical nurses' professional identity formation and can be used to develop educational strategies to promote their professional identity.

In medical education, the influence of shame is largely absent from current conceptualizations of professional identity formation (PIF), even though this process is susceptible to the effects of shame experiences. This study endeavors to examine how shame influences PIF among medical learners. Adopting a constructivist approach and hermeneutic phenomenology, the authors interviewed 9 final-year graduate medical trainees at 2 U.S. military medical centers between September 2022 and February 2023. The authors used a semistructured interview guide and photo-elicitation to deeply explore participants' shame experiences and how these influenced participants' PIF. Data analysis focused on understanding the lived experiences of these events and their impact on PIF, yielding themes central to the phenomenon of shame-induced PIF that helped characterize its deeper meaning. Participants described shame events triggered by incidents like board exam failure, patient care mistakes, and needing educational remediation. Analyzing the influence of these events on PIF revealed 2 processes that helped propel identity arcs toward-and sometimes away from-an ideal version of the self: identity disruption and identity work. Identity disruption led to a distancing from the community and could lead to isolation, anxiety, and impaired belonging. These feelings of disruption often led to significant identity work, which involved modifying self-talk, leveraging agency, and engaging in identity negotiation (often in service of growth toward a modified professional identity). This study uncovers the potential for shame to serve as a catalyst for meaningful identity work in medical trainees. The findings expand on existing conceptualizations of PIF by highlighting that it is a dynamic, ongoing, nonlinear, and multidimensional process. The analysis points to actions educators and learners can take to support learners' constructive navigation of shame experiences and their impact on PIF.

Professional identity formation, with its focus on the development of professional values, actions, and aspirations, is the ideal goal of medical education. Medicine is a community of practice, and medical education is a socialization process by which novice trainees become full community members. The authors believe coaching provides an ideal means for promoting this socialization process to develop a learner's identity as they engage in the community. Coaching involves an orientation toward growth and development, valuing reflection and nurturing continuous reflection, and embracing failure as an opportunity for learning. However, there are challenges to implementing coaching in medical education. Competency-based medical education has provided clear outcomes (competencies) for medical education and programs of assessment around these competencies. Yet, there is a tension in medical training between professional identity formation (the process of socialization into the profession) and the formal assessment process. The ideal of multiple low-stakes assessments and written evaluations, intended as formative assessments, are perceived by residents as high-stakes evaluations with significant consequences for their future. The authors present a resident story that highlights this tension. They outline Goffman's theory of impression management, postulating that medicine's assessment system encourages residents to stage a performance for evaluators that displays their competence and conceals their perceived weaknesses. This performance hinders coaching and the formation of an appropriate professional identity. Coaching, the authors believe, provides a model that aligns assessment and professional identity formation. Given the challenges to implementing coaching in medical education, the authors propose several questions to contemplate when integrating coaching into medical education to facilitate the goal of professional identity formation.

ObjectivesGlobalisation has given medical university students the opportunity to pursue international electives in other countries, enhancing the long-term socialisation of medical professionals. This study identified the long-term effects of international...

<p style="text-align:justify">This study aims at exploring the professional identities of six ELT students through the lens of critical incidents. For the sake of this aim, six ELT students took part in this research at an Anatolian High School in 2018-2019 spring semester. The teaching practicum process was conducted from April to mid of May 2019, once a week over six-week practicum. The main data collection of this study was the Critical Incident Questionnaire (CIQ). Additionally, two questions were asked to the participants to evaluate their actual and designated professional identities. The first question was answered before the practicum and the second one was answered at the end of the practicum process. The results showed that some internal and external factors influenced their professional identity. Additionally, it was found that critical incidents could be used to spot the changes in the participants’ professional identity formation processes. Results of the study indicated that not only negative but also some positive critical incidents contributed to the participants’ professional identity formation. As a result of the encountered incidents that influenced their formation of identities, it was observed that the actual identities of four students changed from positive to negative at the end of the process. Correspondingly, the findings of this study put forward that how the participants explored their identity formation process through the critical incidents.</p>

This study aims at exploring the professional identities of six ELT students through the lens of critical incidents. For the sake of this aim, six ELT students took part in this research at an Anatolian High School in 2018-2019 spring semester. The teaching practicum process was conducted from April to mid of May 2019, once a week over six-week practicum. The main data collection of this study was the Critical Incident Questionnaire (CIQ). Additionally, two questions were asked to the participants to evaluate their actual and designated professional identities. The first question was answered before the practicum and the second one was answered at the end of the practicum process. The results showed that some internal and external factors influenced their professional identity. Additionally, it was found that critical incidents could be used to spot the changes in the participants’ professional identity formation processes. Results of the study indicated that not only negative but also some positive critical incidents contributed to the participants’ professional identity formation. As a result of the encountered incidents that influenced their formation of identities, it was observed that the actual identities of four students changed from positive to negative at the end of the process. Correspondingly, the findings of this study put forward that how the participants explored their identity formation process through the critical incidents.

Emotional intelligence and professional identity formation in pharmacy education

Clinical ethics consultation is the practice of using ethical principles and theories to engage in complex interventions with stakeholders (patients, families, healthcare providers) to address moral issues. Ethicists must master ethical principles and apply them to complex healthcare dilemmas, employing critical thinking and practical knowledge to address nuances in healthcare. Essential to a clinical ethics consultant's development is the need for professional identity formation. Central this discussion of professional identity formation is what defines a professional and what qualifies a person to serve in that professional capacity. Are these qualifications skills-based, or are there characteristics that a clinical ethicist must have to be in the profession? Must someone have a professional or educational background that begins the professional identity formation process before entering the field of clinical ethics? Furthermore, can someone be taught these qualifications through structured learning activities with the goal of socializing them to a professional community? This essay will explore the reasons why professional identity formation has eluded the clinical ethics consultation field and how educational and training programs in clinical ethics have a duty to help learners develop a professional identity as a clinical ethicist. These programs must not only impart theoretical knowledge and practical skills but also foster the interpersonal abilities essential for ethics consultation. By embedding reflective practices, values clarification, and mentorship opportunities, such programs can guide learners through the complexities of professional identity formation, ensuring they are equipped to navigate the moral and relational challenges of the field.

Becoming a pharmacist: Students’ perceptions of their curricular experience and professional identity formation