Abstract

The formation of a physician's professional identity and conception of him/herself as a doctor is often taken for granted and considered a by-product of learning. During professional socialization, medical students internalize knowledge, skills, attitudes, behavioral models as well as ethical and moral values of medicine. However, certain critical experiences may trigger an active construction of professional identity.

The aim of this research was to explore the process of constructing professional identity during medical education in the framework of cultural-historical activity theory. Multiple methods (questionnaires, videotapes of medical students' reflection group sessions, and interviews of the supervisors) were used in data collection and analysis.

Medical students were found to have differing orientations towards learning and practising medicine. Some of the students, more commonly females, expressed a need for more support for their professional development. Reflection groups offered medical students a possibility to share their experiences of critical situations. The topics of discussion dealt with career choice, medical education (teaching, patient encounters, communication), working experiences and career opportunities. Medical students' narratives of their experiences in university hospital learning situations revealed the way in which various interaction situations laid the basis for the development of professional identity. In constructing a physician's professional identity, medical students had to solve dilemmas encountered in three different activity systems: Personal life, Medical education and Work.

Encountering critical situations is part of the daily practice in medical schools. These situations may induce reflection on action and conscious development of professional identity. Medical students should be provided with more possibilities to elaborate on especially dilemmas concerning professionalism, communication skills, encountering death, and biomedical versus psychosocial aspects of medicine during their medical education.