Hello COMSEP!
It’s May, month of blooming flowers, graduations, and other beginnings. Fitting that two of our three reviews this month are about professional identity formation.
Maybe this is a good time to begin a new project and write a review yourself? More information can be found here.
Karen, Jon and Amit
Patient, Partner, Teacher, Mentor
Busey L, May N, Martindale JR et al. Stimulating Medical Student Professional Identity Formation Through Mentored Longitudinal Partnerships With Patient Teachers. Academic Medicine 2025 ; 100(4) : 428-432. https://dx.doi.org/10.1097/ACM.0000000000005960
Reviewed by Kasey Wiseman & Preetha Krishnamoorthy
What was the study question?
Does a longitudinal 4-year Patient Student Partnership (PSP) mentorship program affect the development of medical students’ professional identity?
How was it done?
Grounded in 3 conceptual frameworks: professional identity formation, experiential learning, and communities of practice, a 4-year longitudinal PSP program was implemented for all students at one institution. Students were paired with volunteer patients with chronic illnesses and met regularly. Students engaged in reflective small-group discussions with peers and clinical coaches and completed assignments on concepts including electronic health record utilisation, medical interviewing, patient handoffs, and illness and experience of their patient partner. Anonymous electronic surveys were distributed at 5 different time points across the four years, with both survey and open-ended questions.
What were the results?
Survey response rates ranged from 26.9% to 62.8%. Key themes from preclinical experiences included gaining perspective on patients’ lives and illness beyond medical charts and connecting classroom learning to clinical practice. During and after clerkship, students reported improved communication skills with patients, families, and healthcare teams; insights into chronic illness trajectory; playing valuable roles in patient care; and understanding their future roles as physicians. 70% of patient partners accepted student pairings in future cohorts.
How can this be applied to my work in education?
This study highlights the value of chronic illness exposure in early medical training, and the impact of longitudinal patient interaction on medical student identity and communication skills. While longitudinal clerkship programs may not be feasible at all schools, patient-student mentorships offer an interesting alternative. Whether it be 1-1 pairs, or 1 patient per small group, this has the potential to foster meaningful discussions, appreciation of continuity of care, and direction for students’ future as physicians.
Editor’s Note: A unique aspect of this longitudinal approach represents a truly long-term relationship between students and their patient teachers, extending into clerkship. As noted by the authors, the themes described in student comments shift from student-centered themes during their preclerkship experiences, to patient-centered themes during clerkship, supporting the conceptual framework of professional identity formation in this program. (KFo)
Have you heard what they say about pediatricians?
Schrepel C, Amick AE, Bann M, Watsjold B, Ilgen JS, Jauregui J. Self, Physician, and Specialty: A Qualitative Exploration of Medical Students’ Specialty Identity Formation During Undergraduate Medical Training. Academic Medicine 2024; 99(11):1184-1190. https://dx.DOI.org/10.1097/ACM.0000000000005818
Reviewed by Hosanna Au and Abbey Rokeby
What was the study question?
How does the process of specialty selection shape professional identity formation during undergraduate medical training?
How was the study done?
Fourteen senior medical students from the University of Washington underwent semi-structured interviews aiming to explore specialty identity formation. Thematic analysis of the transcripts was performed.
What were the results?
Results were split into three areas:
Nascent Understanding
Early specialty identity impressions during pre-clinical training were formed based on personal values and how different specialties reflected them, as well as biases shared by peers and mentors through negative comments about certain specialties. The pre-clinical environment also contributed, with some students noting a perceived superiority of specialists over generalists signaled by a predominance of specialist educators.
Experiential Grounding
Participants emphasized the impact of clinical experiences with supervisors on their ability to imagine their future in a given specialty. Students felt more interested in specialties with psychologically safe environments, and when they encountered expressions of bias, this impacted perceived specialty identity and psychological safety. Clinical experiences also demonstrated how specialties align with personal values. When students felt their values were reflected in a specialty’s clinical environment, they were more likely to want to pursue it.
Projecting Forward
Participants highlighted that even once committed to a specialty, their identities may still be developing and uncertainty may persist. They considered specialty priorities like work-life balance and happiness and continued to struggle with external biases regarding importance, prestige, perceived intelligence, and competitiveness.
How can this be applied to my work in education?
This study highlighted the impact of expressions of biases from supervisors and of psychological safety in clinical experiences for specialty identity formation. We should recognize the impact one can have as a supervisor/mentor even in a short interaction and be mindful when discussing other specialties and our own. By working to minimize the biases we communicate, implicitly and explicitly, we can hopefully create spaces where students feel safe to explore identities and reduce the passing on of biases that may deter students from certain paths.
Editor’s Note: The flipside of this discussion is that short interactions can also have a positive effect on students’ perception. Students in the study commented on the impact of seeing supervisors be skillful with patients, kind to students, and joyful in their work on the student’s own career choice. (JG)
Please phrase your response in the form of a question
Birks S, Gray J, Darling-Pomranz C. Using artificial intelligence to provide a 'flipped assessment' approach to medical education learning opportunities. Med Teach. 2024 Dec 1:1-8. DOI: 10.1080/0142159X.2024.2434101
Reviewed by Tosin Adeyanju
What was the study question?
How confident are medical students using generative AI to create practice questions, and how do they feel about its use?
How was the study done?
From the invited 620 medical and physician associate students at the University of Sheffield, 68 were recruited through purposive sampling. A pre-intervention questionnaire contained questions on thoughts and experiences of using GenAI. Students attended a 30-minute didactic demonstrating the question-synthesis capabilities of GenAI, with emphasis on the importance of verifying AI-generated content. Students then wrote practice exam questions using Google Bard under guidance of the research team after which questions were peer reviewed. Upon completion all participants completed a post-intervention questionnaire and the authors used a convenience sample to conduct a focus group (n=7).
Paired t-tests were done with questionnaire data and a thematic analysis was performed on the transcripts from the focus groups.
What were the results?
Most students (82%) had never used AI to generate questions. After the workshop confidence significantly increased in using GenAI both overall (2.75 to 4.1) and for creating exam questions (1.94 to 4.17). Students in the focus group found learning how to use GenAI valuable but felt both the appropriate instruction (particularly prompt generation) and group review were necessary to ensure high quality questions. Many students were surprised to see GenAI portrayed positively by their instructors.
How can I apply this to my work in education?
While recent literature has discussed the use of GenAI in writing multiple choice questions for assessments, this study flips that on its head. For those seeking opportunities to teach our students how to use AI wisely, the generation (and verification) of single best answer questions for the purpose of studying is another application to add to your toolbox.
Editor’s Note: While GenAI has some utility in generating questions for studying, the students note there is a lot of quality control needed. It would also be nice to know outcomes other than student rated confidence. (AP)