From workplace learning to professional identity formation: Examining the mediating role of belonging in medical students.

Abstract

Introduction: Professional identity formation (PIF) is increasingly understood as a socially situated workplace learning process through which medical students develop identities and practices of physicians. Through participation in clinical work within the clinical learning environment (CLE), students learn what it means to become members of the profession. Within this context, a sense of belonging may be an important mechanism linking the CLE to PIF. However, quantitative evidence examining these relationships remains limited. This study examined whether sense of belonging mediates the relationship between the CLE and PIF.

Methods: This cross-sectional study used data from 459 undergraduate clinical students in Indonesia collected between November 1 and December 15, 2024. Students completed three validated instruments: the Professional Identity Formation (PIF) questionnaire, the Undergraduate Clinical Education Environment Measure (UCEEM), and the Belongingness Scale-Clinical Placement Experience (BES-CPE). Structural equation modelling (SEM) was employed to assess whether sense of belonging functioned as a mediator between the CLE and PIF.

Results: PIF showed a moderate positive correlation with both the CLE (r = 0.416; p < 0.001) and sense of belonging (r = 0.370; p < 0.001), while the CLE was strongly correlated to sense belonging (r = 0.578; p < 0.001). The SEM mediation model demonstrated good fit (SRMR = 0.038, CFI = 0.96, TLI = 0.94), indicating that belonging partially mediated the relationship between the CLE and PIF.

Discussion: The findings reveal that PIF are positively linked to both CLE and a sense of belonging. In addition, sense of belonging functions as a significant statistical mediator in the pathway linking the CLE to PIF. These findings suggest that workplace learning experiences contribute to PIF not only directly but also through fostering students' sense of belonging. Creating supportive clinical environments that promote participation, inclusion, and membership may therefore strengthen medical students' PIF.