Professional identity formation of medical students: A mixed-methods study in a hierarchical and collectivist culture.

ABSTRACT

BACKGROUND: Professional identity formation (PIF) has been recognized as an integral part of professional development in medical education. PIF is dynamic it occurs longitudinally and requires immersion in the socialization process. Consequently, in the medical education context, it is vital to foster a nurturing learning environment that facilitates PIF. AIM: This study assesses PIF among medical students in various stages of study and explores their perceptions of PIF, with its contributing and inhibiting factors. METHOD: This mixed-methods study uses a sequential explanatory approach with undergraduate (years 2, 4, and 6) and postgraduate medical students in Indonesia. We examine the subjects by administering an adapted questionnaire on PIF. We completed a series of FGDs following questionnaire administration. Quantitative and thematic analyses were conducted sequentially. RESULTS & DISCUSSION: A total of 433 respondents completed the questionnaire. There were statistically significant differences among subjects on the subscales "Recognition and internalization of professional roles" and "Self-control in professional behavior"; the more senior students had higher scores. We conducted 6 FGDs in total. The results characterize PIF as a complex, dynamic, and longitudinal journey to becoming a medical doctor that is closely related to a student's motivation. The FGDs also highlight the importance of both internal factors (students' values, attributes, and personal circumstances) and external factors (curriculum, the learning environment, workplace-based learning, and external expectations) for PIF in medical education. CONCLUSION: Higher-level students show higher scores in some aspects of PIF, which further validates the potential use of the questionnaire to monitor PIF, a dynamic process influenced by internal and external factors. Generating awareness among medical students and encouraging reflection on their PIF stage may be crucial for PIF processes.