Cornerstones of professional identity formation: Developing a language to express requirements, provide feedback, and establish standards in medical education.

What was the educational challenge?: Due to the complexity of professionalism, medical education worldwide has implemented support and assessment tools based on unprofessional behavior to help students with professional identity formation (PIF). Despite attempts to conceptualize professionalism, providing a framework for faculty members and students is still challenging.

What was the solution?: To provide a simple yet clear framework to support and assess clinical and preclinical settings, we used four domains for PIF: Involvement, Integrity, Interaction, and Introspection. These domains, originally used to describe unprofessional behavior, were redefined with positive attributes to form a new framework.

How was the solution implemented?: By focusing on professional qualities to promote desirable traits for PIF, rather than deficiencies. The framework was introduced in clinical rotations for formative and summative assessment, used in reflection groups and written reflections, and later applied in preclinical tutorial groups.

What lessons were learned that are relevant to a wider global audience?: The framework of cornerstones supports constructive feedback and coaching, is resource-light, requires no technology, and is adaptable to various educational environments.

What are the next steps?: The framework can be adapted to other health professions and cultures. A longitudinal study is planned to assess its long-term impact.