Introduction
Professional identity formation, commonly referred to as PIF, can be defined as a reflection of the self established through socialization. PIF is completed in the manner in which students transform to become a part of their careers. Modern social contexts, practical exposures, and pedagogical emphases greatly influence how young doctors and nurses perceive professionalism as they transition to active career participation. Patient-clinician interactions, collaborative workplace culture, time constraints, large work volumes, and being prepared for any eventuality are all regarded as important factors in career development by Cruess, Cruess, and Steinert (2019). Medical curricula must assess their impact on student development, particularly in light of the current shift to competency-based medical training.
My community of practice has informed my learning since I began working in a culturally diverse environment, where educators challenged us to think beyond traditional approaches. This approach is, in a way, based on Vygotsky’s (1980) concept of the zone of proximal development. Under this theory, a skilled professional guides students’ learning by providing tasks that challenge them but are within the scope of their knowledge and understanding, an approach prevalent in my community of practice. This approach has informed my learning because it helped me understand that students do not develop professionally when provided with easy tasks. Based on personal experiences as a neurosurgery educator, this paper outlines effective educational strategies that can be adopted to enhance PIF among medical trainees.
Professional Identity Formation
As a neurosurgery educator with a background in nursing, I understand that the transition from student to a medical professional can be complex and demanding. A student must establish a solid professional identity to deliver healthcare services with confidence and professionalism. There are various ways to make professional identity development easier, including exploring the aspect of group mentorship programs (Sawatsky, Huffman, and Hafferty, 2020). The skills gained during medical training should be reinforced with several other competencies and attributes that are equally important in the journey of a professional neurosurgeon.
One of the assumptions that I used to have was that versatility is the easiest and most basic skill to develop. However, it is often neglected until the doctor has to put it to the test. PIF extends beyond agility, as problem-solving skills have recently proven crucial in its formation. Many neurosurgeons are familiar with the long hours spent trying to determine the best approach to solve a problem. With such intricate issues to address, every conceivable consequence must be thoroughly considered.
In most cases, surgeons have only seconds to make a decision, which is why problem-solving abilities must be combined with accelerated thinking (Matsui et al., 2019). Due to the lengthy nature of the procedures that accompany them, surgery, in particular, necessitates a significant degree of physical tenacity. During my training as a clinician, I did not view decision-making as a skill that could be developed.
However, an educator changed my perspective by presenting a complicated patient case for resectional surgery, as this patient had several comorbid conditions. Hence, we as students had to offer a strategy that would allow us to reduce the patient’s epilepsy symptoms while using methods that would be suited to the patient’s comorbidities. This case has altered my perspective on versatility and decision-making in clinical practice.
Educational Strategies to Support PIF
As an educator, I can support PIF in my learners by providing them with challenging patient cases and encouraging them to find different solutions, then discussing these in class and brainstorming the most effective ways to perform a neural surgery. Hence, the first strategy combines Vygotsky’s (1980) theory on the zone of proximal development and personal experience as a learner. The second strategy is encouraging self-learning, as continuous education is essential for future healthcare professionals. This approach can be implemented by suggesting reading materials or asking questions that require learners to locate the answers independently, outside of the mandatory literature.
Effective Communication and Collaboration
Prior communication of standards should include realistic conceptions about the demanding and collaborative nature of working in today’s healthcare professions for students and educators. Concurrently, when individuals from multiple health professions collaborate, they can deliver higher-quality care that translates to better health outcomes. This form of collaboration should be emphasized from the start of a medical student’s education (Tagawa, 2019).
An integrative orientation will expose learners to possibilities for healthcare from various professional programs, allowing them to engage and be educated alongside one another through curricular and practical learning experiences. Adopting the Competencies for Inter-professional Collaborative Practice template can help define the ethos, duties, trans-disciplinary interactions, and teamwork of healthcare professionals who collaborate across different disciplines. Additionally, PIF can be emphasized through simple observation when senior doctors work with their juniors, especially when attending to patients in critical conditions.
Exposure to Extreme Cases
Trainees should observe their seniors handling challenging situations, such as dealing with patients in extreme conditions, as it enhances their knowledge and understanding of professionalism. The goal of achieving a comprehensive professional status well-suited for all situations may be regarded as a precursor to the focus on unique contexts (Browne et al., 2018). These severe cases may not fit into a teaching framework on the basic substratum, and their rarity may not be seen as an essential component of one’s profession. However, learners should acknowledge that patient care is a primary focus, and any inability to inculcate and immediately relate to these circumstances can result in negative patient outcomes. The appreciation for the significance of situations that may not always occur or be relevant daily demonstrates the value of a well-rounded and well-prepared neurosurgeon.
Enhancement of Self
Despite the heightened commitment to their line of duty with patients, one’s professional identity formation ultimately revolves around oneself. Trainees should be informed that to establish an integrated and cohesive PIF, they must incorporate their everyday lives into their career paths. Due to time constraints and a multitude of service responsibilities, learners must be willing to sacrifice their downtime to study and reflect on their educational program’s achievements.
Furthermore, in a collaborative learning setting, the ability to connect with other professionals on a personal level can lead to increased involvement and, ultimately, enhanced learning opportunities. Bearing this in mind, one’s educational success can be measured by one’s ability to straddle the boundary between one’s individual and career identities. While external socialization variables propel it, PIF must be considered as part of the broader identity formation process. How a surgeon embodies these attributes and perceives their link to their personal evaluation through reflection cannot be disregarded.
Teaching Philosophy
As an educator specializing in neurosurgery, I must focus my teaching role on emphasizing the importance of creating an inclusive and welcoming learning environment, particularly for newcomers to the field. Many junior doctors claim that their obstacles surpass their abilities, with approximately 31% reporting work-related stress in their first year of practice (Joynes, 2018). To address this issue, I would utilize group coaching to help learners develop a professional perspective on common workplace issues.
At the end of the training programs, trainees should be able to reflect on and evaluate their own performance. The technique fundamentally maximizes work efficiency by optimizing the learner’s potential (Wald et al., 2019). The usefulness of coaching has been proven in numerous research studies to be an essential component supporting PIF in the medical sphere.
Common Challenges During Clinical PIF and Possible Solutions
Although junior surgeons recognize the hierarchy in medical training, the intrinsic function of assessment in the training program makes it difficult to build personal ties with supervisors. This affects how at ease and open they are when dealing with their colleagues and their ability to connect with them on a personal level (Cruess, Cruess, and Steinert, 2019). While there may be some variation depending on individual personality qualities, trainees should generally feel more at ease when engaging with senior residents.
This is because they have gone through similar experiences in their training more recently than the rest of the team and can often relate better to the experiences of more junior residents. For example, if an interaction with a patient goes wrong, a trainee can ask a senior resident for the reasons behind the unplanned outcome. When the trainee is around a group of people, however, they are less likely to question their course of action or seek further clarification to demystify their doubts.
Further Reading
Even though they all relate to the overarching notion of patient care, some trainees may lack effective clinical information analysis and technical competency. Learners’ skills should be considered as interwoven factors that contribute significantly to the objective of assisting patients, rather than discrete elements that must be acquired to achieve favorable outcomes on a personal level. When articulating patient care expectations, specialized and particular goals, and examples, these skills should be substituted with a broader pattern of service. According to Chandran et al. (2019), this marks the beginning of the development of a fully integrated moral self with internalized and regularly applied professional ideals. The awareness of self clarifies an individual’s position in the broader realm of neurosurgery, as well as critically enables one to evaluate and apply ethical principles in a wide range of surgical contexts.
Challenges Learners May Face
Over the course of their training, neurosurgery students must gain extensive knowledge and observe experienced professionals perform surgeries before beginning to do so on their own, as neurosurgery is a complex subject. As stated by Joynes (2018), 30% of medical students struggle to keep up with the learning material they need due to high stress levels, and since the tasks exceed their abilities, they are unable to overcome them. One way to address this is by focusing on Vygotsky’s (1980) statement about peer learning support and providing adequate challenges tailored to the students’ abilities. This approach will help create a more welcoming learning environment.
Reflection
Reflection is among the few known personal initiatives that can help trainees transition from institutionalized to individual self-realization. Trainers should emphasize this component in every graduate’s education (Wyatt et al., 2021). Explicit reflecting activities can help a student comprehend how the new skills and insights they’ve gained as part of their training program align with their own individual ideas and values. As a result, it is suggested that reflection be emphasized in their training programs. Service commitments, on the other hand, frequently take precedence over formal learning and training sessions, and the tight schedules often leave little time for active reflection on one’s own learning and achievement.
Reflection as a Solution
There is always an implicit belief in one’s training course that one will receive all of the necessary disclosure in various protocols in order to be prepared for autonomous practice at the end of training. On the contrary, this does not usually occur in real training sessions (Best and Williams, 2019). Given that one of the primary goals of medical education is to prepare students for self-directed practice, the capacity to perceive one’s own values as an expert greatly impacts efficiency. To overcome the emotions of loneliness and a lack of purpose in the organizational self, a serious reflection on the limitations of autonomy is required. As a result, it is only through introspection that an individual can focus on themselves, commit to the goals of various groups, and maintain their own identity.
Conclusion
The experience as a neurosurgery educator enables one to garner relevant information from involvement with patients and students. As a result, a trainer can clearly identify and critique the efficacy of different teaching approaches to determine when they align with the required principles or support basic teaching philosophies. The techniques blended into this paperwork align with trainers’ beliefs and therefore have a huge impact on the learners’ PIF.
Reference List
Best, S. and Williams, S. (2019) ‘Professional identity in interprofessional teams: findings from a scoping review’, Journal of Interprofessional Care, 33(2), pp. 170-181.
Browne, C., Wall, P., Batt, S. and Bennett, R. (2018) ‘Understanding perceptions of nursing professional identity in students entering an Australian undergraduate nursing degree’, Nurse Education in Practice, 32, pp. 90-96.
Chandran, L., Iuli, R.J., Strano-Paul, L. and Post, S.G. (2019) ‘Developing a way of being: deliberate approaches to professional identity formation in medical education, Academic Psychiatry, 43(5), pp. 521-527.
Cruess, S.R., Cruess, R.L. and Steinert, Y. (2019) ‘Supporting the development of a professional identity: general principles’, Medical Teacher, 41(6), pp. 641-649.
Joynes, V.C. (2018) ‘Defining and understanding the relationship between professional identity and interprofessional responsibility: implications for educating health and social care students’, Advances in Health Sciences Education, 23(1), pp. 133-149.
Matsui, T., Sato, M., Kato, Y. and Nishigori, H. (2019) ‘Professional identity formation of female doctors in Japan–gap between the married and unmarried’, BMC Medical Education,19(1), pp. 1-9.
Sawatsky, A.P., Huffman, B.M. and Hafferty, F.W. (2020) ‘Coaching versus competency to facilitate professional identity formation’, Academic Medicine, 95(10), pp. 1511-1514.
Tagawa, M. (2019) ‘Development of a scale to evaluate medical professional identity formation’, BMC Medical Education,19(1), pp. 1-9.
Vygotsky, L. S. (1980) Mind in society: The development of higher psychological processes. Harvard University Press.
Wald, H.S., White, J., Reis, S.P., Esquibel, A.Y. and Anthony, D. (2019) ‘Grappling with complexity: medical students’ reflective writings about challenging patient encounters as a window into professional identity formation’, Medical Teacher, 41(2), pp. 152-160.
Wyatt, T.R., Rockich-Winston, N., White, D. and Taylor, T.R. (2021) ‘Changing the narrative: a study on professional identity formation among Black/African American physicians in the US’, Advances in Health Sciences Education, 26(1), pp. 183-198.