Scales to evaluate developmental stage and professional identity formation in medical students, residents, and experienced doctors

BACKGROUND: To respond to the growing need to cultivate medical trainees with professional identity, it is necessary to evaluate professional identity formation (PIF) in medical trainees to understand their state of PIF and apply this to medical education. Previous qualitative studies indicated that Kegan’s human development model could explain medical trainees’ PIF. I proposed a development scale (DS) to quantitatively evaluate the degree of maturation and socialization as a physician; however, one scale is not enough to illustrate the helical and complex process of development. METHODS: Using Kegan’s model as the conceptual framework, scales that evaluate stage 2, 3, and 4, and higher stage-specific attributes were developed using data collected in a self-administered questionnaire (322 respondents), reliability analysis, group comparison, and analysis of individual DS scores. The respondents were 4th- and 6th-year medical students and 2nd-year residents at Kagoshima University, and experienced medical doctors (instructors). RESULTS: In addition to the DS, one self-administered questionnaire consisting of 27 items for stage 2, 3, 4, and higher stage-specific attribute scales was created. Students had the highest mean score in stage 2, and instructors had the highest mean score in stage 4 and higher stage scales. Individual analysis indicated that there were respondents with varied attributes in each group, that the average medical student might have inclusion preference typically seen at stage 3, and that the average instructor might have independent preference typically seen at stage 4 more than inclusion preference. CONCLUSIONS: Combining multiple stage attribute-specific scales and DS scores could quantify the complexity and divergent processes of PIF. These scales could provide meaningful information about individuals, groups, and education in terms of professional development that is different from assessment data of medical knowledge or professional skills.