Measuring the development of a medical professional identity through medical school

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.

Keywords:

• Medical students
• professional identity formation
• assessment
• professional identity

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

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.