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Introduction Methods Results Discussion Health professions training programmes face increasing reports of professionalism lapses, which can delay, or end, trainee progression. How programmes respond to professionalism lapses to facilitate professional identity development has not been clarified. The objective of this study is to identify factors that facilitate and impair transformations around professionalism lapses in health professions training programmes.We conducted a qualitative study interviewing 5 faculty and 20 trainees with firsthand or secondhand experience with professionalism lapses from a range of health professions training programmes at McMaster University. Using reflexive thematic analysis, we coded verbatim transcripts informed by the lenses of social and transformative learning theories. We constructed themes through iterative and comparative analysis, seeking meaningful variation across professions and triangulating faculty and trainee perspectives.Four themes were constructed. First, lapses are in the eye of the beholder with personal definitions intersecting with institutional and situation norms. Difficulties exist in recognising and convincing trainees to respond to lapses that are perceived to be minor or subject to interpretation. Second, responses to professionalism lapses occurred within power hierarchies, which impacted how trainees reacted to the remediation process, risked superficial trainee responses to concerns and led to concerns around inequitable treatment in how standards were applied. Third, fostering transformation involves building trainee confidence, agency, trust and engagement. Focused support and advocacy for trainees can empower and promote agency in tackling disorienting lapses. Fourth, perspective shifts involve deep engagement over time, including but not limited to self‐reflection, structured discussion and seeking support.Identifying and addressing professionalism lapses is complex and requires nuanced and contextual exploration of personal, institutional and situational dynamics at play. By fostering environments that promote genuine reflection and dialogue and focus on building trainee confidence, agency, trust and engagement, health professions training programmes can better support trainees in navigating these complex situations and contribute to the broader goal of socialising to a professional culture and practice. [ABSTRACT FROM AUTHOR]

Introduction: Global workforce shortages in medical specialties strain healthcare systems, jeopardising patient outcomes. Enhancing recruitment strategies by supporting professional identity (PI) development may be one way to address this workforce gap—yet little research has explored this topic. The goal of the current study was to explore specialty‐specific recruitment through considering PI. As proposed causes of workforce shortages in anatomical pathology (AP) bear similarities to many other specialties, this study uses the field of AP as a model for specialist PI development and asks: (1)why, how and when do doctors choose to pursue AP trainingand (2) what can be learned from this for recruitment to AP and other specialties? Methods: A qualitative research approach was undertaken using narrative inquiry. Interviews with junior doctors interested in AP, AP registrars and AP consultants from Australia and New Zealand were interpreted as stories via 're‐storying'. Narrative synthesis of participants' collective stories identified chronological key events (i.e. 'turning points') in choosing AP. Results: Narrative synthesis resulted in identification of three portraits entering medical specialist training: (1) die‐hards, deciding upon initial exposure; (2) negotiators, choosing after comparing specialties; and (3) migrants, seeking to move away from non‐pathology specialties. The negotiators and migrants cemented their decision to pursue AP as a postgraduate doctor, whereas the die‐hards made this decision during medical school. Conclusions: Given the similarities in portrait traits between AP and other specialties across the literature, our results suggest ways to support specialty recruitment using PI development. We propose a medical specialist recruitment framework to support the PI development of doctors with die‐hard, negotiator and migrant traits. Use of this framework could enhance current specialty‐specific recruitment approaches, particularly in fields challenged by workforce shortages. Want to know more about doctors' decision‐making processes when choosing a specialty? Check out this article! [ABSTRACT FROM AUTHOR]

Introduction: Medical residents may be required to handle health care management (HCM) tasks alongside their clinical duties, despite not having received training to perform them. However, little research has been done on how medical residents acquire HCM skills at the workplace and how these experiences impact their learning. Methods: We completed a qualitative research study using the Constructivist Grounded Theory approach inform by the Figured World theory. To gather data, we held focus groups and conducted semi‐structured interviews with 22 medical residents from various disciplines and learning levels at Pontificia Universidad Javeriana. We utilised iterative data collection and analysis, constant comparison methods and theoretical sampling to construct our findings. Results: We constructed two different worlds to represent how residents acquire HCM skills: the non‐managing physician and the physician‐as‐manager. The former was characterised by a discourse that underplayed the role of the HCM tasks as part of residents' training, was full of negative interactions with the health care team and limited residents' agency. In the latter, residents collaborated and learned from health care team members, had supervisors who modelled how to incorporate HCM tasks into daily activities and expanded residents' agency. Residents developed their professional identity according to the world they were introduced into. Discussion: Educational leaders must understand that the non‐managing physician figured world gives residents a feeling of uprooting and discomfort when carrying out this type of tasks. To transform this world into the physician‐as‐manager, it is necessary to reconfigure some workplace hierarchies, consolidate interprofessional collaborations and change the discourse perpetuated by influential role models. Supervisors must also strengthen their knowledge of HCM and improve its integration into clinical practice. Any effort to train residents on HCM competencies could be lost if the workplace underscores their value in patient care. Exploring how residents navigate their learning, the authors highlight how educational leaders need to restructure workplace hierarchies, strengthen interprofessional collaboration, and change discourse around health care management tasks. [ABSTRACT FROM AUTHOR]

Background: While health advocacy is an established physician role, most of the educational attention to advocacy has been at the individual patient level. Public advocacy—efforts to effect change at the level of communities, populations or society—remains a poorly defined concept whose educational foundation is underdeveloped. To enrich our understanding of public advocacy, we explored how professionals in two disciplines—medicine and law—have approached its tasks and experienced its challenges. Methods: Using constructivist grounded theory, we interviewed 18 professionals (nine physicians, eight lawyers and one qualified in both disciplines) who engage in public advocacy. We used constant comparison throughout an iterative process of data collection and analysis to develop an understanding of what it means to be a professional in the public domain. Results: Public advocacy work occurs at the intersection of personal and professional identities. Lawyers perceived public advocacy as an embedded element of their professional identity, while physicians more often viewed it as outside their core professional scope. Nonetheless, professional identity influenced how both groups conducted their work. Physicians were more likely to draw on professional attitudes (e.g. their orientation towards evidence and their trusted social position), while lawyers were more likely to draw on professional skills (e.g. building an argument and litigating test cases). The work requires courage and often demands that individuals tolerate personal and professional risk. Conclusion: While medicine has enshrined advocacy in its competency frameworks, it is the legal profession whose practitioners more fully embrace advocacy as intrinsic to professional identity, suggesting that roles are difficult to engineer or impose. Collaboration across public‐facing professions like medicine and law creates opportunities to reimagine public advocacy, to identify the skills required to do it well and to refresh educational strategies. Public advocacy is high‐stakes work. This paper explores how doctors and lawyers navigate this often‐risky activity and speculates on what medicine might learn from law. [ABSTRACT FROM AUTHOR]

To enable success, Gheihman reflects on the importance of Winderbaum and Coventry's exploration of how to support new doctors in an evidence‐based manner. [ABSTRACT FROM AUTHOR]

Introduction: Feedback is crucial to promote learning and improve performance. However, we lack a nuanced understanding of how medical teachers reflect on and internalise (or not) student feedback (SF). This study aims to fill this gap by exploring how teachers make sense of SF to improve their performance and nurture their personal and professional development. Methods: In this cross‐sectional qualitative study based on a constructivist paradigm, 14 medical teachers individually drew a Rich Picture (RP) of a feedback experience in which they received informal or formal feedback from students, resulting in a personal or professional change. After the drawing, we interviewed the participants to deepen our understanding of teachers' experiences. We analysed the drawings and interview transcripts using an iterative process of thematic analysis. Results: SF that culminated in personal or professional change is a highly emotional experience for teachers, often with long‐lasting consequences. It may threaten or reassure their self‐concept and professional identity, generating feedback avoidance or feedback‐seeking behaviour. SF is particularly powerful in transforming teaching practices when teachers feel connected to students through an honest and constructive relationship. Remarkably, some teachers intentionally build relationships with certain (selected) students to get 'qualified' feedback. SF acceptance also increases when teachers are open to receiving feedback and there is an institutional culture that values feedback. Finally, medical teachers believe that formal (planned) feedback is relevant to improve the curriculum, while informal (spontaneous) feedback is important for promoting teachers' personal and professional development. Discussion: SF has the potential to become a transformative learning experience for teachers. The student–teacher relationship and teachers' emotional reactions affect the way teachers make sense of and internalise SF and enact behavioural change. Understanding the complexity surrounding SF is vital for supporting teachers in seizing opportunities for growth and in nurturing a meaningful relationship with the act of teaching. Receiving students' feedback is detailed to be an emotional process that happens in the context of a relationship and can nurture teachers' professional and personal development. [ABSTRACT FROM AUTHOR]

Introduction: The transition from medical student to first‐year doctor is notoriously difficult, yielding a high rate of transition failure, burn‐out and mental health deterioration. Doctors in this cohort experience unique challenges during this time, which manifest through performance gaps, issues of professional identity, new occupational pressures, and cultural expectations. Mentoring programs are commonly utilised in the medical profession to foster personal and professional development and improve psychosocial well‐being and career satisfaction. However, there exist no systematic reviews examining the use of mentorship specifically for the first‐year doctor cohort, given the unique transition challenges faced by this vulnerable group. Purpose: Due to their transition difficulties, evaluate the research on mentorship specifically for first‐year doctors, and identify the emerging themes that can inform the benefits to this group, the barriers that impede program implementation and the facilitators that contribute to successful mentorship programs for this cohort. Materials and Methods: The PEO (population, exposure outcome) framework was adopted to develop the research inquiry, after which, a systematic review was conducted, adhering to PRISMA guidelines. The search strategy was conducted with assistance from an experienced university librarian. Screening and selection were completed independently against inclusion/exclusion criteria, by two reviewers. The methodological quality of included studies was assessed using Joanna Briggs critical appraisal instruments. Data sources used included Web of Science Medline, Ebsco Cinahl Plus, Scopus, Web of Science Core Collection and Ovid Journals. Search parameters were restricted to English language and peer‐reviewed; date range was unobstructed up to 26 August 2022. Results: A total of 4137 articles were retrieved, with 13 considered to have met full inclusion criteria. An integrative review synthesis identified three major themes; benefits of mentoring for first‐year doctors, intrinsic and extrinsic barriers to mentoring programs and facilitating factors that improve successful program implementation. Conclusion: First‐year doctors report untenable and highly strenuous working conditions, that result in poor mental health and high attrition rates. Formalised, near‐peer, tier mosaic mentoring programs provide significant psychosocial and career benefits to this cohort specifically, bridge the training gap from medical student to first‐year doctor and ameliorate patterns of intergenerational bullying, hierarchy and emotional inhibition. However, mentorship is inextricably interrelated to societal–cultural considerations of identity. Mentorship alone cannot overcome endemic cultural challenges within medicine without broader systemic change; however, programs are a valuable option towards positive support for first‐year doctors. The authors' review demonstrates that while formalised, near‐peer, tiered mosaic mentorship, creates a critical support network for first‐year doctors, broader systemic and cultural change is required for long‐term, true well‐being. [ABSTRACT FROM AUTHOR]

Context: Western mental healthcare system reforms prioritise person‐centred care and require clinicians to adjust their professional positions. Realising these reforms will necessitate clinicians—including clinical psychologists—acquiring professional identities that align with them. Learners develop professional identities through socialisation activities: within interactional spaces such as supervision learners come to understand the self (clinician) and, by extension, the other (client). A clinician's understanding of who I am is intertwined with an understanding of who they are. Our study offers a moment‐by‐moment examination of supervision interactions of clinical psychology trainees to illuminate processes through which the identities of therapists and clients are constructed. Aim: We examined how clinical psychology trainees and supervisors construct identities for themselves and clients in supervision. Methods: We used positioning analysis to explore identity construction during interactions between supervisors (n = 4) and trainees (n = 12) in a clinical psychology training clinic. Positioning analysis focuses on the linguistic choices participants make as they position themselves (and others) in certain social spaces during everyday interactions. Twelve supervision sessions were audio recorded and transcribed. We found that clients were frequently positioned as fragile and subsequently analysed these sequences (n = 12). Results: Clients' identities were constructed as fragile, which co‐occurred with clinical psychologists' claiming positions as responsible for managing their distress. Supervisors played an active role in linguistically positioning clients and trainees in this way. Trainees rarely contested the identities made available to them by supervisors. Discussion and Conclusion: We suggest that linguistically positioning clients as fragile perpetuates paternalistic clinical discourses that do not align with mental healthcare reform priorities. We make visible how this is achieved interactionally through language and influenced by organisational power relations. Intentional efforts are required to support the professional identity construction of clinical psychologists in ways that do not perpetuate paternalism. We offer recommendations for education and clinical practice to support these efforts. Interactions between supervisors and trainees in which clients were positioned as fragile are examined to reveal how clinicians claiming identities for themselves can perpetuate paternalism over client‐centred care. [ABSTRACT FROM AUTHOR]

Introduction: Identity threats, such as stereotype threat and microaggressions, impair learning and erode well‐being. In contrast to identity threat, less is known about how learners experience feelings of safety regarding their identity. This exploratory study aims to develop a theory of identity safety in the clinical learning environment. Methods: This multi‐institutional, qualitative interview study was informed by constructivist grounded theory and critical pedagogy. Participants were clinical students at three public medical schools in the United States in 2022. Investigators purposively sampled participants for interviews based on their responses to an 11‐item survey with an open‐ended question soliciting students' personal identities and responses to both the racial/ethnic and gender Stereotype Vulnerability Scales. The investigators interviewed, coded, constantly compared and continued sampling until the codes could be developed into categories, then concepts and finally into a theory. The team engaged in critical reflexivity throughout the analytic process to enrich data interpretations. Results: Sixteen diverse students were interviewed. We organised their identity‐salient experiences into identity threat, threat mitigation and identity safety. Participants experienced identity threat through unwelcoming learning environments, feeling compelled to change their behaviour in inauthentic ways or sociopolitical threat. Threat mitigation occurred when a participant or supervisor intervened against an identity threat, dampening but not eliminating the threat impact. Participants characterised identity safety as the ability to exist as their authentic selves without feeling the need to monitor how others perceive their identities. Identity safety manifested when participants demonstrated agency to leverage their identities for patient care, when others upheld their personhood and saw them as unique individuals and when they felt they belonged in the learning environment. Discussion Attending to identity safety may lead to educational practices that sustain and leverage team members' diverse identities. Identity safety and threat mitigation may work together to combat identity threats in the learning environment. In this edition of @medEd_journal, @jbullockruns et al. describe identity safety, where learning environments allow learners to exist as their authentic selves. The figure is worth 1000 words. [ABSTRACT FROM AUTHOR]

'Are physicians who they ought to be?' This commentary advocates for a critical re‐examination of what is at the core of being a physician via a process of inclusive co‐construction [ABSTRACT FROM AUTHOR]

Hu and Chang use O'Sullivan and Irby's supposition that faculty development is embedded within two communities of practice ‐ faculty and workplace ‐ to enrich understanding of the challenges faced by rural community preceptors and support education sustainability. [ABSTRACT FROM AUTHOR]

Introduction: Silence is a part of all interactions, yet its potential significance within medical education remains underexplored. Existing literature primarily focuses on its use as a skill, leaving a gap in understanding its broader implications. Emerging evidence from higher education suggests that conceptualising silence as a way of being and becoming could enrich personal and professional growth. Unfolding dialogue on equality, diversity and inclusion suggests that silence on inequity can be oppressive. However, medical education has yet to consider the possible implications of conceptualising silence in this way. Methods: We explore silence through the philosophical lens of acknowledgement. Acknowledgement—communicative behaviour that grants attention to others—is a philosophy with roots in phenomenology. It is concerned with being and becoming, and silence can be part of the communicative behaviour that constitutes acknowledgement. Our aim in exploring the ontological nature of silence (silence associated with being) using acknowledgement is to offer a springboard for practitioners, educators, and researchers to consider how silence is connected with our existence as people. Results: Positive acknowledgement involves a commitment to turning towards the other and valuing this connection. Silence can be a way of demonstrating this—for example, giving patients the space they need to express their thoughts and emotions. Negative acknowledgement is the opposite and involves dismissing, ignoring or invalidating another's experiences. In the context of silence, negative acknowledgement may involve ignoring a person or group's ideas, or bystander silence when witness to discrimination. Conclusions: Within this work, we consider the ramifications of conceptualising silence as ontological, rather than purely a skill to be taught. This is a novel way of conceptualising silence, and there is a pressing need to explore this further to expand our understanding of the impact of silence for diverse groups of learners, educators, practitioners and patients. In this Cross‐cutting Edge article, the authors consider how philosophy can help us to think differently about what silence is, and how silence is used, within medical education. [ABSTRACT FROM AUTHOR]

The author highlights reasons why a more comprehensive research agenda is needed to extend theories and methodologies investigating interprofessional identity within the context of interprofessional education. [ABSTRACT FROM AUTHOR]

Introduction: To enter a profession is to take on a new identity. Professional identity formation can be difficult, with medical learners struggling to adopt professional norms. The role of ideology in medical socialisation may offer insight into these tensions experienced by medical learners. Ideology is the system of ideas and representations that dominates the minds of individuals or social groups and calls individuals into certain ways of being and acting in the world. In this study, we use the concept of ideology to explore residents' experiences with identity struggle during residency. Methods: We conducted a qualitative exploration of residents in three specialties at three academic institutions in the United States. Participants engaged in a 1.5‐hour session involving a rich picture drawing and one‐on‐one interview. Interview transcripts were coded and analysed iteratively, with developing themes compared concurrently to newly collected data. We met regularly to develop a theoretical framework to explain findings. Results: We identified three ways that ideology contributed to residents' identity struggle. First was the intensity of work and perceived expectations of perfectionism. Second were tensions between the developing professional identity and pre‐existing personal identities. Many residents perceived messages regarding the subjugation of personal identities, including the feeling that being more than physicians was impossible. Third were instances where the imagined professional identity clashed with the reality of medical practice. Many residents described how their ideals misaligned with normative professional ideals, constraining their ability to align their practice and ideals. Conclusion: This study uncovers an ideology that shapes residents' developing professional identity—an ideology that creates struggle as it calls them in impossible, competing or even contradictory ways. As we uncover the hidden ideology of medicine, learners, educators and institutions can play a meaningful role in supporting identity development in medical learners through dismantling and rebuilding its damaging elements. How does ideology impact residents' identity struggle during training? This study delves into the complexities. Ideological pressures like perfectionism, conflicting personal identities, and mismatched professional ideals create challenges. Recognizing and reshaping these ideologies can aid in healthier identity development. [ABSTRACT FROM AUTHOR]

Introduction: This study explores narratives of physicians negotiating liminality while becoming and being mentors for medical students. Liminality is the unstable phase of a learning trajectory in which one leaves behind one understanding but has yet to reach a new insight or position. Methods: In this study, we analysed semi‐structural interviews of 22 physician mentors from group‐based mentoring programmes at two Norwegian and one Canadian medical school. In a dialogical narrative analysis, we applied liminality as a sensitising lens, focusing on informants' stories of becoming a mentor. Results: Liminality is an unavoidable aspect of developing as a mentor. Which strategies mentors resort to when facing liminality are influenced by their narrative coherence. Some mentors thrive in liminality, enjoying the possibility of learning and developing as mentors. Others deem mentoring and the medical humanities peripheral to medicine and thus struggle with integrating mentor and physician identities. They may contradict themselves as they shift between their multiple identities, resulting in rejection of the learning potentials that liminality affords. Conclusion: Mentors with integrated physician and mentor identities can embrace liminality and develop as mentors. Those mentors with contradicting dialogues between their identities may avoid liminality if it challenges their understanding of who they are and make them experience discomfort, confusion and insufficiency while becoming a mentor. Support of the mentoring role from the clinical culture may help these physicians develop internal dialogues that reconcile their clinician and mentor identities. This work outlines the struggles inherent in physicians integrating "mentor" into their identity, which can lead them to tell contradicting stories as they shift between multiple identities. [ABSTRACT FROM AUTHOR]

Context: Assessment plays a key role in competence development and the shaping of future professionals. Despite its presumed positive impacts on learning, unintended consequences of assessment have drawn increasing attention in the literature. Considering professional identities and how these can be dynamically constructed through social interactions, as in assessment contexts, our study sought to understand how assessment influences the construction of professional identities in medical trainees. Methods: Within social constructionism, we adopted a discursive, narrative approach to investigate the different positions trainees narrate for themselves and their assessors in clinical assessment contexts and the impact of these positions on their constructed identities. We purposively recruited 28 medical trainees (23 students and five postgraduate trainees), who took part in entry, follow‐up and exit interviews of this study and submitted longitudinal audio/written diaries across nine‐months of their training programs. Thematic framework and positioning analyses (focusing on how characters are linguistically positioned in narratives) were applied using an interdisciplinary teamwork approach. Results: We identified two key narrative plotlines, striving to thrive and striving to survive, across trainees' assessment narratives from 60 interviews and 133 diaries. Elements of growth, development, and improvement were identified as trainees narrated striving to thrive in assessment. Neglect, oppression and perfunctory narratives were elaborated as trainees narrated striving to survive from assessment. Nine main character tropes adopted by trainees with six key assessor character tropes were identified. Bringing these together we present our analysis of two exemplary narratives with elaboration of their wider social implications. Conclusion: Adopting a discursive approach enabled us to better understand not only what identities are constructed by trainees in assessment contexts but also how they are constructed in relation to broader medical education discourses. The findings are informative for educators to reflect on, rectify and reconstruct assessment practices for better facilitating trainee identity construction. This study explores two plotlines describing how assessment impacts trainees' identity: "striving to thrive" and "striving to survive". Narratives reveal growth or oppression; character tropes play a role, shedding light on broader medical education discourses along with valuable insights for educators. [ABSTRACT FROM AUTHOR]

Background: Ensuring that students transition smoothly into the identity of a doctor is a perpetual challenge for medical curricula. Developing professional identity, according to cultural‐historical activity theory, requires negotiation of dialectic tensions between individual agency and the structuring influence of institutions. We posed the research question: How do medical interns, other clinicians and institutions dialogically construct their interacting identities? Methods: Our qualitative methodology was rooted in dialogism, Bakhtin's cultural‐historical theory that accounts for how language mediates learning and identity. Reasoning that the COVID pandemic would accentuate and expose pre‐existing tensions, we monitored feeds into the Twitter microblogging platform during medical students' accelerated entry to practice; identified relevant posts from graduating students, other clinicians and institutional representatives; and kept an audit trail of chains of dialogue. Sullivan's dialogic methodology and Gee's heuristics guided a reflexive, linguistic analysis. Results: There was a gradient of power and affect. Institutional representatives used metaphors of heroism to celebrate 'their graduates', implicitly according a heroic identity to themselves as well. Interns, meanwhile, identified themselves as incapable, vulnerable and fearful because the institutions from which they had graduated had not taught them to practise. Senior doctors' posts were ambivalent: Some identified with institutions, maintaining hierarchical distance between themselves and interns; others, along with residents, acknowledged interns' distress, expressing empathy, support and encouragement, which constructed an identity of collegial solidarity. Conclusions: The dialogue exposed hierarchical distance between institutions and the graduates they educated, which constructed mutually contradictory identities. Powerful institutions strengthened their identities by projecting positive affects onto interns who, by contrast, had fragile identities and sometimes strongly negative affects. We speculate that this polarisation may be contributing to the poor morale of doctors in training and propose that, to maintain the vitality of medical education, institutions should seek to reconcile their projected identities with the lived identities of graduates. How did new clinicians shape their identities during the pandemic? Twitter reveals a complex dialogue in which institutions tout heroism while interns express vulnerability. Bridging these identity gaps is key to nurturing the morale of doctors‐in‐training. [ABSTRACT FROM AUTHOR]

Introduction: It is unknown whether interprofessional identity is able to explain interprofessional behaviours. Extended professional identity theory provides clues by combining two psychological identity approaches. The aim of this study is to investigate whether interprofessional identity is a source for intrinsic motivation towards interprofessional collaboration related to wider group membership. Methods: Participants of this double‐blinded study were 47 dentistry and 41 dental hygiene students (86.3% response) without interprofessional education (IPE) experience. Group productivity was used as indicator of group effort and equal communication as indication for interprofessional direction. The extended professional identity scale (EPIS) was used to measure interprofessional identity eight weeks prior to a mandatory IPE course. Based on EPIS levels, students were assigned to a low or high interprofessional identity group condition. Subsequently, 12 interprofessional teams (four to five members) were randomly composed per condition. Each group received eight problems (regarding roles, responsibilities and collaborative practice) for which they were expected to provide up to 10 solutions. Six trained psychologists rated the validity of solutions after which the percentage of solutions per group was calculated. Additionally, the psychologists rated interprofessional direction by observing team communication (asking questions, topic control, prosocial formulations, and speech frequency) during the second group meeting. Results: No interprofessional identity differences were found with regard to gender and profession. The mean difference between groups with low versus high interprofessional identity was 0.5 (M = 3.4; SD = 0.5 and M = 3.9, SD = 0.4, respectively), t = −5.880, p < 0.001. Groups with high identity generated more solutions compared to low identity groups (91.5% vs. 86.4%), t = −2938, p = 0.004. The correlation between individual interprofessional identity and group effort was significant, r = 0.22, p = 0.036. Groups with high identity showed more interprofessional direction, t = −2.160, p = 0.034. Discussion: Interprofessional identity has a positive effect on congruent interprofessional behaviours after 10 weeks. More research is required to understand interprofessional identity in relation to performance in education and work. Reinders and Krijnen show that interprofessional identity is a source of intrinsic motivation towards interprofessional collaboration, influencing problem solving as well as teamwork. [ABSTRACT FROM AUTHOR]

Blissett and O'Sullivan contend that workplace learning environment contributes to learners devaluing administrative tasks and, as such, must be considered in strategies to promote a physician‐as‐manager identity. [ABSTRACT FROM AUTHOR]

Burm reflects on the unintended consequences of overemphasizing a marathon mindset and their implications for the professional identity and wellbeing of trainees. [ABSTRACT FROM AUTHOR]

Background: Medical academia is in crisis, with fewer people entering and growing concern at numbers leaving. While faculty development is often seen as part of the solution, there are significant issues with faculty not engaging with and resisting development opportunities. Lack of motivation may be linked to what might be called a 'weak' educator identity. We studied medical educators' experiences of career development to gain further insights into: how professional identity may develop; individuals' accompanying emotional responses to perceived identity change; and consideration of the accompanying temporal dimensions. Drawing on new materialist sociology, we explore medical educator identity formation in terms of an affective flow that places the individual within a constantly shifting assemblage of psychological, emotional and social relations. Method: We interviewed 20 medical educators at various career stages, with differing strengths of medical educator self‐identity. Using an adapted transition model as a basis for understanding the emotions experienced by those undergoing identity transitions, we explore the process that, for some medical educators, appears to lead to decreased motivation, ambiguous identity and disengagement, but for others results in renewed energy, a stronger and more stable professional identity and increased interest and engagement. Results: By more effectively illustrating the emotional impact of the transition process leading to a more stable educator identity, we show that some individuals, especially where the change was not sought or welcomed, express their uncertainty and distress through low mood, resistance and an attempt to minimise the significance of undertaking or increasing teaching duties. Discussion: Understanding the emotional and developmental phases of the transition to medical educator identity has several key implications for faculty development. Faculty development approaches should be alert to the individual educator's stage of transition since this will affect that individual's readiness to accept and respond to guidance, information and support. A renewed emphasis on early educational approaches that will support the transformational and reflective learning of the individual is needed, while traditional approaches emphasising skills and knowledge may be more useful in the later stages. Further testing of the transition model and its applicability to identity development in medical education is indicated. In a study of medical educators' career trajectories, Browne and Collett reveal how attitudes and emotions change, leading to a strong professional identity for some and disengagement for others. [ABSTRACT FROM AUTHOR]

Introduction: Our professional identity refers to our sense of who we are and how we should behave as professionals. Professional identities are developed through socialisation processes: Established ways of knowing and doing are acquired and reproduced. The professional identities of health care professionals have implications for the realisation of health care reforms that require new ways of being and doing from clinicians. Tension and frustration can arise when professional identities are incongruent with reform directions. More knowledge is required about the professional identities of mental health care professionals—including clinical psychologists—so that they can be supported to develop professional identities that align with health care system reforms. Method: We undertook a scoping review of existing literature aiming to (i) identify the relevant literature; (ii) review the literature quality; (iii) thematically summarise the literature findings; (iv) consult with clinical psychologists; and (v) identify recommendations for research, training and practice. Results: A systematic database search (PsycINFO, CINAHL, Scopus and Web of Science) identified 24 relevant published articles and dissertations. Quantitative studies were excluded due to their markedly different research focus. Included studies were independently reviewed and findings summarised. Findings were organised around three themes: 'integration of personal and professional identities', 'intersectionality' and 'changes in professional identity over time'. Research quality issues were identified. The trustworthiness of the findings was corroborated in consultation with clinical psychologists. Discussion: Clinical psychologists recognise their professional identities as being interrelated with their personal identities and changing over time. They recognised professional identity as important yet inadequately considered in the profession. The research area is emerging yet remains undertheorised and requires improved research methodologies. Future theoretically informed research is required to build up a credible research base to better understand the development of clinical psychologists' professional identities so that this process can be facilitated to enable the realisation of health care reforms. Schubert at al. review the literature to determine what is required to nurture and support professional identity from training to practice in ways that support the realisation of mental healthcare reform. [ABSTRACT FROM AUTHOR]

Background: Transitions are critical periods that can lead to growth and, or, distress. Transitions are a sociocultural process, yet most approaches to transitions in practice and research do not explore the social or developmental aspects of entering a new training phase. Wenger reminds us that identity development is crucial when newcomers navigate change. In this paper, we use Wenger's modes of identification: engagement, imagination and alignment to explore students' identity development (as a student and professional) during the transition from pre‐clinical to clinical training. Methods: We enrolled nine 2nd‐year medical students who generated 61 entries comprising audio diary (or typed) reflections over 9 months (starting 3 months before clinical clerkships began) and interviewed them twice. We used research poems (transcripts reframed as poetry) to help construct a meaningful, emotive elicitation of our longitudinal data and analysed data using sensitising concepts from Wenger's modes of identification. Results: Students described their transition as a journey filled with positive and negative emotions and uncertainty about their current and future careers. Students navigated the transition using three mechanisms: (1) becoming more engaged through taking charge, (2) shaping their image of self through engagement and finding role models and (3) learning to flexibly adapt to clerkship norms by managing expectations and adopting a journey mindset. Conclusions: We successfully narrated students' identity formation during their transition to clinical training. We learned that students became more engaged over time by learning to take charge. They shaped their image of self by engaging in team activities and reflecting on role models. They learnt to adapt flexibly to clerkship norms by managing expectations and adopting a journey mindset. We suggest that institutions provide a safe opportunity for medical students to reflect, allowing students' transition periods to be lived, reflected on and supported. The authors showcase Wenger's three modes of identification (engagement, imagination, and alignment) as medical students transition to clinical training using longitudinal qualitative methods and research poetry. [ABSTRACT FROM AUTHOR]

Introduction: People with disabilities are underrepresented in health professions education and practice. Barriers for inclusion include stigma, disabling discourses, discriminatory programme design and oppressive interactions. Current understandings of this topic remain descriptive and fragmented. Existing research often includes only one profession, excludes particular types of disability and focuses on one aspect of the career journey. To expand understanding, we examined the recurrent forms of social relations that underlie the participation of disabled individuals in learning and practice contexts across five health professions. Method: We analysed 124 interviews with 56 disabled health practitioners and students. Participants were interviewed up to three times over 1.5 years. Using constructivist grounded theory, authors used a staged analytic approach that resulted in higher level conceptual categories that advance interpretations of social processes. Finally, the authors compared and integrated findings among students and practitioners. Results: Participants experience challenges to their sense of legitimacy and belonging as health providers. They describe tensions within the health education and practice between the commitment to inclusion and the day‐to‐day realities experienced by disabled participants. We identified six distinct, but related, conditions underlying these tensions: (i) validity and transparency of competencies' evaluation; (ii) the social and physical contexts; (iii) integration of inclusive practices; (iv) boundaries between personal and professional identities; (v) vulnerability to authority figures; and (vi) dynamic person‐level factors. Discussion: If we are to commit to health practitioners and students with disabilities experiencing an overall sense of legitimacy and belonging, priority needs to be given to system‐level practices and policies to support inclusion. Attention to the day‐to‐day marginalisation of students and practitioners with disabilities in the health professions is also needed. Additionally, inclusive and transparent delineation of competency requirements is needed. Finally, educational actions are needed to increase understanding of disability in the health professions, with particular attention to promoting social relations that foster collective responsibility for supporting inclusion. The authors demonstrate how priority needs given to system‐level practices and policies that support inclusion if practitioners and students with disabilities are to experience a sense of legitimacy and belonging. [ABSTRACT FROM AUTHOR]

Background: Longitudinal coaching in residency programmes is becoming commonplace and requires iterative and collaborative discussions between coach and resident, with the shared development of goals. However, little is known about how goal development unfolds within coaching conversations over time and the effects these conversations have. We therefore built on current coaching theory by analysing goal development dialogues within resident and faculty coaching relationships. Methods: This was a qualitative study using interpretive description methodology. Eight internal medicine coach–resident dyads consented to audiotaping coaching meetings over a 1‐year period. Transcripts from meetings and individual exit interviews were analysed thematically using goal co‐construction as a sensitising concept. Results: Two themes were developed: (i) The content of goals discussed in coaching meetings focused on how to be a resident, with little discussion around challenges in direct patient care, and (ii) co‐construction mainly occurred in how to meet goals, rather than in prioritising goals or co‐constructing new goals. Conclusions: In analysing goal development in the coach–resident relationships, conversations focused mainly around how to manage as a resident rather than how to improve direct patient care. This may be because academic coaching provides space separate from clinical work to focus on the stage‐specific professional identity development of a resident. Going forward, focus should be on how to optimise longitudinal coaching conversations to ensure co‐regulation and reflection on both clinical competencies and professional identity formation. Farrell et al. demonstrate that longitudinal academic coaching provides residents a space to focus on professional identity development separate from clinical work. [ABSTRACT FROM AUTHOR]

This commentary discusses the importance of professional identity formation in medical education and clinical psychology. The authors argue that both professions face similar challenges in adopting theoretical perspectives that enhance research on professional identities. They suggest that a social constructionist lens can provide valuable insights into how professional identities are shaped and constructed through interactions with others. While the authors acknowledge the value of a model proposed by Sarraf-Yazdi et al., they also highlight the need for further theoretical development and exploration of the underlying processes involved in professional identity formation. They recommend considering multiple levels of identity construction and the balance between individual agency and social influences. [Extracted from the article]

.@kmcowen outlines how medical education could better support students connect their behavior during medical school to their future identities as physicians. [ABSTRACT FROM AUTHOR]

In the latest "When I Say..." Percival et al. analyze the term 'epistemic injustice' to outline how it impacts medical learners, teachers, patients and clinicians. [ABSTRACT FROM AUTHOR]

Farrell details the importance of coaches developing a shared conceptualization of identity and willingingness to cede control of discussion to allow for the emergence of creative and open conversations with coachees. [ABSTRACT FROM AUTHOR]

Introduction: The threshold concept framework (TCF) was first described nearly 20 years ago, but its application in the field of medical education has recently seen a significant growth of interest with a diverse range of literature published on the subject. The transformative nature of threshold concepts (TCs) offers potential for the design of learning experiences and curricula across the medical education continuum. A scoping review was conducted to map the extent of the current literature regarding TCs in medical education—to describe the types of available evidence and its focus—and identify research gaps. Methods: The review followed the JBI Manual for Evidence Synthesis approach for scoping reviews. Four databases and two additional websites were searched for articles exploring TCs in medical education. Data were analysed using quantitative and qualitative thematic approaches. A framework of conceptual change was used to synthesise the TCs identified. Results: Thirty‐six papers, spanning undergraduate, postgraduate and continuing medical education, were included in the final analysis. The most frequent application of the TCF was in the identification of TCs, which related to basic scientific knowledge, ways of thinking and ways of practising in medicine. Uncertainty, patient care, clinical reasoning and professional identify formation were themes that emerged at multiple stages of training. Several papers evaluated the use of the TCF in teaching. Conclusion: The understanding and embodiment of TCs increases in complexity across the medical education continuum, with TCs recurring with changes in clinical environment and responsibilities. This lends support to a holistic approach to curriculum design spanning all stages of training. Further research is needed to develop a consistent approach for describing and applying the TCF in medical education and to address how the TCF can be used in teaching and how threshold crossing can be measured. Understanding and embodiment of threshold concepts across the medical education continuum is argued through this review to support a holistic approach to curriculum design. [ABSTRACT FROM AUTHOR]

Kitchuk comments on ways in which identity threats and identity safety impact 'belongingness' for diverse students, highlighting that there remains need to further explore what is meant by belonging and the effects this has on students. [ABSTRACT FROM AUTHOR]

Introduction: The experience of remediation in practising physicians has not been widely studied. Remediatees frequently present negative emotions, but observers can only infer the underlying reasons behind these. Understanding remediatees' perspectives may help those mandating and organising remediation to structure the process in ways that improve the experience for all concerned parties and maximise chances of a successful outcome for remediatees. Methods: Seventeen physicians who had undergone remediation for clinical competence concerns were interviewed via telephone. Participant data were first iteratively analysed thematically and then reanalysed using a narrative mode of analysis for each participant in order to understand the stories as wholes. Figured worlds (FW) theory was used as a lens for analysing the data for this constructivist research study. Results: Participants entering the FW of remediation perceived that their position as a 'good doctor' was threatened. Lacking experience with this world and with little available support to help them navigate it, participants used their agency to draw on various discursive threads within the FW to construct a narrative account of their remediation. In their narratives, participants tended to position themselves either as victims of regulatory bodies or as resilient individuals who could make the best of a difficult situation. In both cases, the chosen discursive threads enabled them to maintain their self‐identity as 'good doctor'. Conclusion: Remediation poses a threat to a physician's professional and personal identity. Focusing mainly on the educational aspect of remediation—that is, the improvement in knowledge and skills—risks missing its impact on physician identity. We need to ensure not only that we support physicians in dealing with this identity threat but that our assessment and remediation processes do not inadvertently encourage remediatees to draw on discursive threads that lead them to see themselves as victims. Practising physicians undergoing remediation are shown in this paper to adapt to threatening situations by constructing narrative that enables them to maintain the self‐identity of 'good doctor'. [ABSTRACT FROM AUTHOR]

Introduction: There are growing concerns about the quality and consistency of postgraduate clinical education. In response, faculty development for clinical teachers has improved formal aspects such as the assessment of performance, but informal work‐based teaching and learning have proved intractable. This problem has exposed a lack of research into how clinical teaching and learning are shaped by their cultural contexts. This paper explores the relationship between teacher–learner identity, educational practice and the workplace educational cultures of two major specialties: internal medicine and surgery. Methods: This was a secondary analysis of a large dataset, comprising field notes, participant interviews, images and video‐recordings gathered in an ethnographic study. The lead author embedded himself in four clinical teams (two surgical and two medical) in two different hospitals. The authors undertook a critical reanalysis of the observational dataset, using Dialogism and Figured Worlds theory to identify how teachers and postgraduate learners figured and authored their professional identities in the specialty‐specific cultural worlds of surgery and internal medicine. Results: Surgery and internal medicine privileged different ways of being, knowing and talking in formal and informal settings, where trainees authored themselves as capable practitioners. The discourse of surgical education constructed proximal coaching relationships in which trainees placed themselves at reputational risk in a closely observed, embodied practice. Internal medicine constructed more distal educational relationships, in which trainees negotiated abstract representations of patients' presentations, which aligned to a greater or lesser degree with supervisors' representations. Conclusions: Our research suggests that clinical education and the identity positions available to teachers and learners were strongly influenced by the cultural worlds of individual specialties. Attempts to change work‐based learning should be founded on situated knowledge of specialty‐specific clinical workplace cultures and should be done in collaboration with the people who work there, the clinicians. Cantillon et al. explore how clinical teaching and learning are uniquely shaped by the specialty‐specific cultures of postgraduate training. [ABSTRACT FROM AUTHOR]

The article provides information on an innovative course entitled "Medical Improv," implemented by health humanities faculty to address the challenge of effective clinical communications with patients, families and co-workers. Topics include an overview of the course, examples of course activities, and significance of the course to students.

The article provides information on solving the complex problem of faculty evaluation, a form of teaching evaluation by the students regarding the teaching effectiveness of the teacher. Topics include study finding on the lack of correlation between student learning and faculty evaluation, effects of negative feedback in faculty evaluation, and lessons learned from the activity.

The article provides information on a process developed for students to participate further in diversity, equity and inclusion (DEI) events while building community with a cohort of peers and achieving recognition. Topics discussed include how the arts and humanities can help in advancing DEI according to medical educators, students that participated in the initiative, and lessons learned from the initiative.

Context The transition from medical student to junior doctor is challenging. Junior doctors need to become part of the physician community of practice (CoP), while dealing with new responsibilities, tasks and expectations. At the same time, they need to learn how to navigate the frontiers and intersections with the other communities of practice that form the Landscape of Practice (LoP). This study aims to understand how junior doctors experience interprofessional collaboration (IPC) and what elements shape these experiences considering their transition to clinical practice. Methods: In this multicentre qualitative study, 13 junior doctors individually drew two rich pictures of IPC experiences, one positive and one negative. A rich picture is a visual representation, a drawing of a particular situation intended to capture the complex and non‐verbal elements of an experience. We used semi‐structured interviews to deepen the understanding of junior doctors' depicted IPC experiences. We analysed both visual materials and interview transcripts iteratively, for which we adopted an inductive constructivist thematic analysis. Results: While transitioning into a doctor, junior doctors become foremost members of the physician CoP and shape their professional identity based on perceived values in their physician community. Interprofessional learning occurs implicitly, without input from the interprofessional team. As a result, junior doctors struggle to bridge the gap between themselves and the interprofessional team, preventing IPC learning from developing into an integrative process. This professional isolation leaves junior doctors wandering the landscape of practice without understanding roles, attitudes and expectations of others. Conclusions: Learning IPC needs to become a collective endeavour and an explicit learning goal, based on multisource feedback to take advantage of the expertise already present in the LoP. Furthermore, junior doctors need a safe environment to embrace and reflect on the emotions aroused by interprofessional interactions, under the guidance of experienced facilitators. Van Duin et al. demonstrate that junior doctors learn interprofessional collaboration implicitly, leading to practical implications to help junior doctors become effective team members. [ABSTRACT FROM AUTHOR]

Objective: The participation of students from both undergraduate medical education (UGME) and postgraduate medical education (PGME) in independent patient care contributes to the development of knowledge, skills and the professional identity of students. A continuing collaboration between students and their preceptor might contribute to opportunities for students to independently provide patient care. In this systematic review, we aim to evaluate whether longitudinal training models facilitate the independent practice of students and what characteristics of longitudinal training models contribute to this process. Method: This systematic review was performed according to the PRISMA guidelines. In May 2020, we performed a search in three databases. Articles evaluating the impact of longitudinal training models on the independent practice of students from both UGME and PGME programmes were eligible for the study. A total of 68 articles were included in the study. Quality of the included studies was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Results: Both UGME and PGME students in longitudinal training models are more frequently allowed to provide patient care independently when compared with their block model peers, and they also feel better prepared for independent practice at the end of their training programme. Several factors related to longitudinal training models stimulate opportunities for students to work independently. The most important factors in this process are the longitudinal relationships with preceptors and with the health care team. Conclusion: Due to the ongoing collaboration between students and their preceptor, they develop an intensive and supportive mutual relationship, allowing for the development of a safe learning environment. As a result, the professional development of students is fostered, and students gradually become part of the health care team, allowing them the opportunity to engage in independent patient care. This work demonstrates how longitudinal rotation models can make an important contribution to the entrustment of patient care to students. [ABSTRACT FROM AUTHOR]

In the latest "Connections" article, Church and Brown use the concept of 'critical mass' to explain how stigma, lack of career pathways and prioritization of clinical seniority may discourage non‐practicing clinicians from becoming educationalists. [ABSTRACT FROM AUTHOR]

As part of this State of the Science series on Self, Society and Situation, we focus on how we might see the situation of the workplace as a learning environment in the future. Research to date into how health professionals learn while working in clinical workplace environments has mostly focused on the supervisor‐trainee relationship or on the interaction between the affordances of a workplace and the receptiveness of trainees. However, the wider environment has not received as much focus—though frequently mentioned, it is seldom investigated. We suggest there is a need to embrace the wider institution factors, recognise and acknowledge an organisation's values and culture as they impact on clinical learning in order to work with these, not around them or ignore them, to make what may be tacit visible through reflection and observation and to embrace a range of perspectives on culture. Sheehan and Wilkinson focus on how learning is shaped by the physical environment, the interactions and behaviours of other health professionals, the systems in place to guide care, and culture to challenge beliefs about who 'holds' knowledge. [ABSTRACT FROM AUTHOR]

Context Medical educators are increasingly paying attention to how bias creates inequities that affect learners across the medical education continuum. Such bias arises from learners' social identities. However, studies examining bias and social identities in medical education tend to focus on one identity at a time, even though multiple identities often interact to shape individuals' experiences. Methods: This article examines prior studies on bias and social identity in medical education, focusing on three social identities that commonly elicit bias: race, gender and profession. By applying the lens of intersectionality, we aimed to generate new insights into intergroup relations and identify strategies that may be employed to mitigate bias and inequities across all social identities. Results: Although different social identities can be more or less salient at different stages of medical training, they intersect and impact learners' experiences. Bias towards racial and gender identities affect learners' ability to reach different stages of medical education and influence the specialties they train in. Bias also makes it difficult for learners to develop their professional identities as they are not perceived as legitimate members of their professional groups, which influences interprofessional relations. To mitigate bias across all identities, three main sets of strategies can be adopted. These strategies include equipping individuals with skills to reflect upon their own and others' social identities; fostering in‐group cohesion in ways that recognise intersecting social identities and challenges stereotypes through mentorship; and addressing intergroup boundaries through promotion of allyship, team reflexivity and conflict management. Conclusions: Examining how different social identities intersect and lead to bias and inequities in medical education provides insights into ways to address these problems. This article proposes a vision for how existing strategies to mitigate bias towards different social identities may be combined to embrace intersectionality and develop equitable learning environments for all. The authors share a vision for addressing bias and inequities in medical education by embracing the intersection of multiple social identities. [ABSTRACT FROM AUTHOR]

The authors provide a taxonomy of EPA frameworks, identifying 3 dominant lines of logic, and highlighting a fourth category of EPAs that do not lend themselves easily to entrustment ratings. [ABSTRACT FROM AUTHOR]

The author argues that the COVID‐19 pandemic caused members of the medical education community to reflect on their role and their norms, resulting in tensions between personal identity and organizational expectations. [ABSTRACT FROM AUTHOR]

Introduction: Despite its widespread application in medical education, belonging to a single community of practice does not reflect the overall experience of physician‐educators. Knowing how physician‐educators find their way among different communities of practice (ie their landscape of practice) has implications for professional development but the limited description in the literature. In this longitudinal qualitative research, we explored how physicians who pursue graduate degrees in medical education navigate their landscape of practice. Methods: 11/29 physicians in one cohort of a masters in medical education programme were interviewed annually from 2016 (programme start) to 2020 (2 years post‐graduation). We iteratively collected and analysed data, creating inductive codes and categorising coded data by mode of identification (engagement, imagination, alignment) and time. We organised narratives into time‐ordered data matrices so that final analysis wove together mode, time and participant. Results: All participants consistently spoke of navigating their landscape of practice, which included the community created in the graduate programme; but that single community 'doesn't define the journey itself'. They shifted engagement from teaching individual learners to translating what they learned in the graduate programme to develop educational projects and produce scholarship. They shifted the imagination from relying on internal and external assessments to experience‐inspired versions of their future self. And they shifted alignment from belonging to the graduate programme's community of practice, then belonging to different communities in their landscape of practice and ultimately focussing on communities that mattered most to them. Discussion: Physicians in a graduate programme in medical education navigated their dynamic landscape of practice by shifting how they engaged in medical education, as well as what they imagined and who they aligned with as physician‐educators. Our work offers novel insights into how knowledgeability emerges through time as overlapping modes of identification. In this study, the authors explore how physician‐educator identity developed in one community of practice (a graduate program in medical education) expands to interactions with other communities to form a landscape of practice. [ABSTRACT FROM AUTHOR]

Context: Although the uptake of Longitudinal Integrated Clerkships (LICs) is increasing worldwide, and there are documented benefits to participation, there is a lack of conceptual evidence regarding how LICs exert many of their benefits, including their influence on the recruitment and retention of practitioners to underserved areas or specialties. Whilst career choice and professional identity development have been previously connected within medicine, what is known about the ways in which LICs influence identity remains unclear. A scoping review was conducted to explore current knowledge and map directions for future research. Method: In 2020, the authors searched nine bibliographic databases for articles discussing identity within the context of LICs using a systematic search strategy. Two reviewers independently screened all articles against eligibility criteria and charted the data. Eligible articles were analysed by quantitative and qualitative thematic analysis. Results: 849 articles were identified following an extensive search. 131 articles were selected for full‐text review, with 27 eligible for inclusion. Over half of all articles originated from the United States or Canada, and research most frequently explored identity development from sociocultural orientations. Qualitatively, four themes were identified: (a) The importance of contextual continuities; (b) Symbiotic relationship of responsibility and identity development; (c) Becoming a competent carer; and (d) Influence of LICs on career identity. Conclusions: This scoping review adds weight to the supposition that participation in LICs facilitates identity development, namely through contextual continuities and the responsibility students assume as they become co‐providers of patient care. There are suggestions that LICs encourage the development of an 'ethic of caring'. As little research compares comprehensive LICs with other clerkship models, it remains difficult to say to what degree identity formation is facilitated above and beyond other models. Future comparative research, and research exploring identity formation from diverse theoretical perspectives would add depth. The authors explore what is known about identity development within Longitudinal Integrated Clerkships, suggesting they manifest their benefits and influence identity through continuity, relationships and responsibility. [ABSTRACT FROM AUTHOR]

The article offers a response to a commentary made by F. A. Ganotice on the transition from professional to interprofessional identity through interprofessional education (IPE) and collaboration. Topics discussed include the importance of the journey of self-discovery of medical students, the challenge in the development of an interprofessional identity, as an extension of their professional identity, and way medical students can foster meaningful and sustainable interprofessional relationships.

In this commentary, @ChrisWatling3 highlights new papers by Schrepel and by Cantillon to consider the often problematic influences of medicine's professional subcultures on clinical practice and education. [ABSTRACT FROM AUTHOR]

Introduction: Capitalising on direct workplace observations of residents by interprofessional team members might be an effective strategy to promote formative feedback in postgraduate medical education. To better understand how interprofessional feedback is conceived, delivered, received and used, we explored both feedback provider and receiver perceptions of workplace feedback. Methods: We conducted 17 individual interviews with residents and eight focus groups with health professionals (HPs) (two nurses, two rehabilitation therapists, two pharmacists and two social workers), for a total of 61 participants. Using a constructivist grounded theory approach, data collection and analysis proceeded as an iterative process using constant comparison to identify and explore themes. Results: Conceptualisations and content of feedback were dependent on whether the resident was perceived as a learner or a peer within the interprofessional relationship. Residents relied on interprofessional role understanding to determine how physician competencies align with HP roles. The perceived alignment was unique to each profession and influenced feedback credibility judgements. Residents prioritised feedback from physicians or within the Medical Expertise domain—a role that HPs felt was over‐valued. Despite ideal opportunities for direct observation, operational enactment of feedback was influenced by power differentials between the professions. Discussion: Our results illuminate HPs' conceptualisation of feedback for residents and the social constructs influencing how their feedback is disseminated. Professional identity and social categorisation added complexity to feedback acceptance and incorporation. To ensure that interprofessional feedback can achieve desired outcomes, education programmes should implement strategies to help mitigate intergroup bias and power imbalance. Miles et al reveal how interprofessional feedback to residents creates a complex social process that requires education programs to implement strategies that address intergroup bias and power imbalance. [ABSTRACT FROM AUTHOR]

Objectives: Professional identity formation (PIF) is a growing area of research in medical education. However, it is unclear whether the present research base is suitable for understanding PIF in physicians considered to be under‐represented in medicine (URM). This meta‐ethnography examined the qualitative PIF literature from 2012 to 2019 to assess its capacity to shine light on the experiences of minoritised physicians. Methods: Data were gathered using a search of six well‐known medical education journals for the term 'professional identit*' in titles, keywords, abstracts and subheadings, delineated with the date range of 2012‐2019. All non‐relevant abstracts were removed and papers were then further reduced to those that focused only on learners' experiences. This left 67 articles in the final dataset, which were analysed using a collaborative approach among a team of researchers. The team members used their professional expertise as qualitative researchers and personal experiences as minoritised individuals to synthesise and interpret the PIF literature. Results: Four conceptual categories were identified as impacting PIF: Individual versus Sociocultural Influences; the Formal versus the Hidden Curriculum; Institutional versus Societal Values; and Negotiation of Identity versus Dissonance in Identity. However, a major gap was identified; only one study explored experiences of PIF in URM physicians and there was an almost complete absence of critical stances used to study PIF. Combined, these findings suggest that PIF research is building on existing theories without questioning their validity with reference to minoritised physicians. Conclusions: From a post‐colonial perspective, the fact that race and ethnicity have been largely absent, invisible or considered irrelevant within PIF research is problematic. A new line of inquiry is needed, one that uses alternative frameworks, such as critical theory, to account for the ways in which power and domination influence PIF for URM physicians in order to foreground how larger sociohistorical issues influence and shape the identities of minoritised physicians. Using post‐colonial theory and meta‐ethnography, the authors analyze the Professional Identity Formation literature to develop a new interpretation of it that can be used to study under‐represented minority physicians [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic created an urgent need for staff development. However, COVID‐19 has created many challenges, including the inability to meet in‐person, travel restrictions to conferences, overwhelming clinical demands on already overextended faculty members and the increased need to focus on personal health and safety. Although current challenges were immediately met with solutions borne out of an emergency, questions remain on how to identify and sustain best practices and further evolve staff development beyond the immediate crisis. Reviewing the Medical Adaptations series revealed several lessons. Several authors used cognitive apprenticeship to provide scaffolding upon which learners can build skills, knowledge and attitudes. Additionally, moderators were recommended during live educational sessions in order to manage the chat box and engage the audience. Comprehensive IT support was key. A post‐session debrief helped deepen understanding and provided a space for peer support and community building. Building a repository for educational materials was recommended. Although we made significant gains in the ability to offer staff development, we must consider potential and unintended consequences and explore how we can use transformative learning theory to capitalize on what we have gained. Utilizing technology can potentially increase access to online learning; however, when not implemented carefully, it can magnify inequities. While providing IT support can serve to mitigate some inequities borne by socioeconomic and generational differences, additional strategies should be implemented to account for English as a second‐language learners; those with disabilities who do not have access to adaptive technology; and other marginalized groups who may already feel vulnerable to presenting arguments in oppositions of authority or the majority. Crafting online education experiences to allow for small group, peer‐to‐peer and social interactions is vital to continued professional and identity development. Now that the urgency has lessened, taking time to ensure what is being offered follows best practices in developing and disseminating quality online education is paramount for broad acceptance. [ABSTRACT FROM AUTHOR]