Professional Identity Formation (PIF) in Health Professions Education
Doing is Different from Being
by Lauren C. McConnell, PharmD
(This article originally appeared on the Educational Theory and Practice blog)
Professional identity formation, or PIF, is the process through which a person becomes a professional — typically from student to practicing professional. The progression of PIF is uniquely individual and superimposed on each student’s personal identity, values, morals, and beliefs.1 The goal of forming a professional identity is to develop a resilient sense of belonging within a health profession.2 PIF goes beyond students acquiring knowledge (‘thinking’) and demonstrating professionalism (‘acting’) to support one’s perception of self (‘feeling’).
Professionalism, as defined by The White Paper on Pharmacy Student Professionalism, is “the active demonstration of the traits of a professional”.3 Health professions students are intrinsically and extrinsically motivated to join a professional community and are willing to uphold certain professional expectations, such as wearing a white coat, communicating respectfully, and being accountable.4,5 However, acting like a professional and being a professional are two different phenomena.
Interrelationship Between Professional Identity and Professionalism
Professionalism and professional identity are distinct yet related concepts, which makes the fluid relationship between the two challenging to describe. Professionalism is an outward display of the conduct of a professional, while a professional identity is the internal perception of one’s role as a professional.6 Professional traits and behaviors are crucial for PIF, as ‘acting’ like a professional encourages assimilation to that role.7 Similarly, self-awareness of a professional identity is essential for developing a professional demeanor. Several stepwise models exist that have attempted to describe this relationship. Acts of professionalism are observable signs which indicate the concurrent development of professional identity.6
According to Moseley et al., “as the internalization process of PIF occurs, outward professional behaviors are displayed, and as one chooses to behave as a professional, their sense of identity blossoms.”7 This model aligns with the proposal that the end goal of health professions education should not just focus on ‘doing’ but also on ‘being’.8 As with all educational goals, methods for teaching and evaluating progress are essential. The conundrum is how this fluid process can be measured and supported.
PIF-Friendly Teaching Strategies
Obtaining a professional identity is the desired outcome in health professions education, as it is the backbone of all decisions students will make as professionals.8 However, many students (and admittedly, myself included) fail to recognize themselves as professionals early in their health education journey. For this reason, PIF has long been an elusive target amongst health professions educators. Furthermore, PIF is a non-linear process, and each student progresses toward their professional identity at a different pace, which makes it challenging to foster and evaluate progress.9 For this reason, health professions educators should incorporate PIF-friendly teaching strategies into curricula.
PIF pedagogy is the practice of teaching, facilitating, and coaching students through their PIF journey — teaching methods that support the development of an identity that aligns with the values of their profession. Educators are a fundamental component of the student’s journey. The formation of a professional identity is influenced by external factors, such as curricula, learning environments, expectations, mentorship, and feedback.5 I distinctly remember key preceptors who created positive learning environments and served as role models that positively impacted how I perceived myself as a future pharmacist. Therefore, it is important for educators to foster relationships and create experiences that are meaningful to students, as PIF is facilitated, not taught.
Self-assessment and self-reflection are two PIF-friendly strategies that educators can use in curricula to help students become more aware of their professional strengths and weaknesses.10 The ability of the student to be self-aware of their presence and growth within a professional community increases PIF and creates a sense of belongingness.9 Other meaningful relationships outside the formal education environment (e.g., with preceptors, other health professionals, and patients) play a similar and equally important role. To me, there is no replacing the feeling you get the first time a patient mistakenly refers to you as a pharmacist or when a physician shows appreciation by stating ‘good catch.’ Through these interactions, students gain recognition for their place on the healthcare team. Situated learning theory suggests that “learning should take place in a setting the same as where the knowledge will be used”.11 Therefore, it is no surprise that students report early introduction to their profession, direct interaction with patients, and frequent collaboration with other health professionals as key drivers of identity construction.12
Because educators are facilitators of PIF, structured evaluations (e.g., exams or performance-based assessments) are not helpful measures of student progression, particularly given that PIF does not occur at a single point in time. Experts recommend that assessments of PIF should occur longitudinally to ensure that the student’s professional identity is progressively developing over time.13 Unfortunately, there are no standardized methods for measuring PIF, and assessments rely on students’ understanding of who they are within a profession. I remember creating short- and long-term career goals as a first-year student pharmacist, thinking I knew exactly who I was and what pharmacy career path I wanted to pursue. But with each semester, I revisited these goals and was honestly embarrassed by what I thought I knew about who I wanted to be.
There are several other activities and instructional strategies that can be used to promote PIF, such as feedback, experiential education, co-curricular activities (e.g., health fairs), mentoring/role modeling, student well-being groups, and white coat ceremonies.7,15 Of course, most professional curricula already incorporate many of these pedagogical methods, but require active effort by educators to foster PIF intentionally. Reflecting on my time as a student, I now know why I have always appreciated professors who were passionate about what they taught, preceptors who encouraged autonomous work, and mentors who led by example – they intentionally helped create my professional identity.
There are several other activities and instructional strategies that can be used to promote PIF, such as feedback, experiential education, co-curricular activities (e.g., health fairs), mentoring/role modeling, student well-being groups, and white coat ceremonies.7,15 Of course, most professional curricula already incorporate many of these pedagogical methods, but require active effort by educators to foster PIF intentionally. Reflecting on my time as a student, I now know why I have always appreciated professors who were passionate about what they taught, preceptors who encouraged autonomous work, and mentors who led by example – they intentionally helped create my professional identity.
References cited in this article can be found at:
Educational Theory and Practice – Professional Identity Formation