House Staff NewYork-Presbyterian Morgan Stanley Children's Hospital New York, New York, United States
Background: Within academic medicine, professional identity formation (PIF) is the process by which learners think, act, and feel like a physician. It is the process by which individuals internalize how their personal identity interplays with and is changed by their role in medicine. Thus far, literature has been focused on medical student PIF with limited focus on residents and even less on pediatric residents. Challenging encounters are commonplace in residency — with patients, among interdisciplinary members, or within the system. Given the dynamic nature of PIF, we anticipate that difficult encounters may bring forth tensions within the self that impact how one views their role in the professional space. Despite this, there is limited to no research on the impact of challenging encounters on resident PIF. Objective: To better understand challenging encounters and how they may impact PIF. Design/Methods: This is a prospective qualitative study of pediatric residents at a large academic quaternary care hospital. Semi-structured interviews will be conducted by a peer interviewer with those who have completed at least 12 months of residency. Interns will be excluded given limited residency exposure. Interviews will be conducted until thematic sufficiency is reached. A semi-structured interview guide was created using a published socialization framework, which has been previously utilized in literature to evaluate how one’s existing identities may be impacted by environmental factors. This framework served as the basis for interviews to explore participants’ experiences with challenging encounters, including their environment and relationships, and the impact they have on PIF. The guide was piloted with graduates to ensure clarity and ability to meet objectives. Two investigators will independently apply inductive codes to deidentified interview transcripts using the constant comparison method using NVivo software and disagreements will be resolved via triangulation. Analysis will be completed by March 1.
