Abstract
Purpose
The Professional Identity Essay (PIE) is a theory and evidence-based Medical Professional Identity Formation (MPIF) measure. We describe trajectories of PIE-measured MPIF over a 4-year US medical school curriculum.
Methods
Students write PIEs at medical school orientation, clinical clerkships orientation, and post-advanced (near graduation) clerkship. A trained evaluator assigns an overall stage score to narrative responses to nine PIE prompts (inter-rater ICC 0.83, 95% CI [0.57 − 0.96], intra-rater ICC 0.85). Distribution of PIE stage scores across time points were analyzed in the aggregate and individual students were classified as Increase, Stable (no score change) or Decrease based on the trajectories of PIE stage scores over time.
Results
202 students completed 592 PIEs from 2018-2023. There was a significant change in the proportion of PIEs in stages over time (X2 84.40, p < 0.001), 47% (n = 95) students were categorized in the Increase trajectory, 45.5% (n = 92) as Stable and 7.4% (n = 15) as Decrease. Older age and time-predicted stage scores change within trajectories (p < 0.05).
Conclusions
Medical students’ PIE stage scores increase over time with three distinctive trajectories. Further study is needed to explore the utility of this method for formative assessment, program evaluation, and MPIF research.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
P. Lusk
Penelope Lusk, MS, is Doctoral Researcher, Graduate School of Education, at the University of Pennsylvania, 3700 Walnut St, Philadelphia, PA.
T. Ark
Tavinder Ark, PhD, is Assistant Professor, Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee, WI.
R. Crowe
Ruth Crowe, MD, PhD, is Associate Professor, Department of Medicine, New York University Long Island School of Medicine, New York, NY.
V. Monson
Verna Monson, PhD, is Adjunct Professor, Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee, WI.
L. Altshuler
Lisa Altshuler, PhD, is Assistant Professor, Department of Medicine, New York University Grossman School of Medicine, New York, NY.
V. Harnik
Victoria Harnik, PhD, is Associate Professor, Department of Cell Biology, New York University Grossman School of Medicine, New York, NY.
L. Buckvar-Keltz
Lynn-Buckvar-Keltz, MD, is Associate Professor, Department of Medicine, New York University Grossman School of Medicine, New York, NY.
M. Poag
Molly Poag, MD, is Clinical Associate Professor, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY.
P. Belluomini
Pamela Belluomini, EdD, MS, MA, is Director, Student Affairs and Disability Services, New York University Grossman School of Medicine, New York, NY.
A. Kalet
Adina Kalet, MD, MPH is Director, Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin.