Maya G Sardesai, Jessica M Lewis, Brian E Mavis, David Hatem, Meg G Keeley, Thuy L Ngo, Silvia Lizett Olivares Olivares, Jennifer L Quaintance, Marjorie D Wenrich, Robert B Shochet
{"title":"Drawing the ARC: How medical students shape their professional selves.","authors":"Maya G Sardesai, Jessica M Lewis, Brian E Mavis, David Hatem, Meg G Keeley, Thuy L Ngo, Silvia Lizett Olivares Olivares, Jennifer L Quaintance, Marjorie D Wenrich, Robert B Shochet","doi":"10.1080/0142159X.2026.2630977","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Challenges with developing a strong professional identity can have adverse consequences like burnout and misconduct. While conceptual models describe how medical students internalize the attitudes, behaviors and norms ascribed to physicianhood, a comprehensive catalog of the processes students employ to drive PIF is lacking. This study aimed to use qualitative evidence to deconstruct and codify so-called 'mechanisms' for professional identity formation (PIF) and generate a practical construct for educators.</p><p><strong>Methods: </strong>We undertook a cross-sectional qualitative multi-institutional study of 52 graduating medical students from four U.S. medical schools to explore their experiences during medical school. Pairs of investigators coded semi-structured interview transcripts identifying passages relevant to PIF with audit by a third coder for additional validation. Excerpts were reviewed to identify mechanisms and characterize patterns.</p><p><strong>Results: </strong>Analysis of 52 transcripts identified 20 discrete mechanisms that despite overlap, could primarily be categorized into one of three domains: action (experiencing/role enactment, observing, learning from role models, experimenting, acting with agency, isolating oneself, and stepping back), reflection (metacognition/reflection, self-evaluation, evaluation/feedback from others, turning negatives into learning, compartmentalization, and imagining/visualizing) and connection (having support, talking, attachments to others, being trusted, trusting others, teaching, and asking). Students used multiple mechanisms to develop their professional identities with interplay across domains.</p><p><strong>Conclusion: </strong>Discrete mechanisms actively employed by medical students to develop their professional identities can be categorized within domains of action, reflection, and connection (ARC). The ARC construct helps validate existing theories and could be used by educators and advisors to systematize and optimize interventions for PIF.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1533-1544"},"PeriodicalIF":4.0000,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Teacher","FirstCategoryId":"95","ListUrlMain":"https://doi.org/10.1080/0142159X.2026.2630977","RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/26 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Challenges with developing a strong professional identity can have adverse consequences like burnout and misconduct. While conceptual models describe how medical students internalize the attitudes, behaviors and norms ascribed to physicianhood, a comprehensive catalog of the processes students employ to drive PIF is lacking. This study aimed to use qualitative evidence to deconstruct and codify so-called 'mechanisms' for professional identity formation (PIF) and generate a practical construct for educators.
Methods: We undertook a cross-sectional qualitative multi-institutional study of 52 graduating medical students from four U.S. medical schools to explore their experiences during medical school. Pairs of investigators coded semi-structured interview transcripts identifying passages relevant to PIF with audit by a third coder for additional validation. Excerpts were reviewed to identify mechanisms and characterize patterns.
Results: Analysis of 52 transcripts identified 20 discrete mechanisms that despite overlap, could primarily be categorized into one of three domains: action (experiencing/role enactment, observing, learning from role models, experimenting, acting with agency, isolating oneself, and stepping back), reflection (metacognition/reflection, self-evaluation, evaluation/feedback from others, turning negatives into learning, compartmentalization, and imagining/visualizing) and connection (having support, talking, attachments to others, being trusted, trusting others, teaching, and asking). Students used multiple mechanisms to develop their professional identities with interplay across domains.
Conclusion: Discrete mechanisms actively employed by medical students to develop their professional identities can be categorized within domains of action, reflection, and connection (ARC). The ARC construct helps validate existing theories and could be used by educators and advisors to systematize and optimize interventions for PIF.
期刊介绍：
Medical Teacher provides accounts of new teaching methods, guidance on structuring courses and assessing achievement, and serves as a forum for communication between medical teachers and those involved in general education. In particular, the journal recognizes the problems teachers have in keeping up-to-date with the developments in educational methods that lead to more effective teaching and learning at a time when the content of the curriculum—from medical procedures to policy changes in health care provision—is also changing. The journal features reports of innovation and research in medical education, case studies, survey articles, practical guidelines, reviews of current literature and book reviews. All articles are peer reviewed.
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