Impact of liminality and rituals on professional identity formation in physician training.

Purpose: The transition from medical student to practicing physician affects the complex processes of professional identity formation and professionalism, which have a lasting effect on the physician's career development. This study explored two different transitional processes of medical students i...

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Publicado en:Medical Education Vol. 59; no. 2; pp. 173 - 182
Autores principales: Hong, Jian‐Hua, Chu, Chun‐Lin, Tsai, Daniel Fu‐Chang, Liao, En‐Chi, Yeh, Huei‐Ming
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Feb2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2025
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/medu.15483
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        atl: Impact of liminality and rituals on professional identity formation in physician training.
      aug:
        au:
          Hong, Jian‐Hua
          Chu, Chun‐Lin
          Tsai, Daniel Fu‐Chang
          Liao, En‐Chi
          Yeh, Huei‐Ming
        affil: Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
      sug:
        subj:
          Professional Identity
          Education, Medical
          Physicians Education
          Interns and Residents
          Transitional Programs
          Rituals and Ceremonies
          Professional Development
          Program Evaluation
          Human
          Taiwan
          Students, Medical
          Snowball Sample
          Professionalism
          Social Identity
          Thematic Analysis
          Reflection
          Funding Source
          Comparative Studies
          Semi-Structured Interview
          Motivation
          Supervisors and Supervision
      ab: Purpose: The transition from medical student to practicing physician affects the complex processes of professional identity formation and professionalism, which have a lasting effect on the physician's career development. This study explored two different transitional processes of medical students in Taiwan, the associated rituals during this transitional period (the 'liminal phase') and their effect on the formation of professional identity. Method: Using snowball sampling, we recruited 13 medical students from two training systems: six from the traditional postgraduate year programme and seven from the accelerated postgraduate year (A‐PGY) programme. Semi‐structured interviews were thematically analysed to identify significant themes that encapsulated trainees' experiences. A consistent and mutually confirmed discussion ensured the identification of robust recurring themes. Results: A comparative analysis of the two training modalities provided critical insights into the relative impact of the training dynamics. The A‐PGY cohort, subjected to an altered 'incorporation' ritual, encountered an influx of unexpected symbolic social power, complicating their transformation within the liminal phase. Without a defined internship like in the PGY system, A‐PGY trainees exhibited confusion and inconsistencies in professional identity formation marked by conflicting internal and external perceptions. This ambiguity affected their clinical training, social integration and overall development of professionalism. The absence of a structured, sequential liminal phase increased conflict and diminished motivation, culminating in an incomplete self‐crafting journey for A‐PGY trainees. Conclusions: This study highlights the impact of the well‐sequenced implementation of rituals in liminality on professional identity formation. A good transition training programme for medical students should compass sequential rituals in the liminal phase, including clear starting and ending points, supervision by seniors, guided reflection and plenty of opportunities for observation and imitation in context. Optimal training and pivotal elements in a medical training system warrant delicate design and further research when developing and changing the structure of the training programme. Yeh et al. compare to medical education systems to explore how liminality and rituals influence physician training and professionalism. #MedicalEducation #PhysicianTraining.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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