From Reflection to Professionalism: Evaluating the Impact of Guided Group Reflection on Professional Identity Formation in Undergraduate Medical Students

Introduction: Professional Identity Formation (PIF) is fundamental to medical education, shaping students into competent, ethical practitioners. Objective: This randomized controlled trial (RCT) evaluates the impact of Guided Group Reflection (GGR) on PIF among undergraduate medical students. Methods: A randomized controlled trial with a mixed-methods approach was conducted at Quaid-e-Azam Medical College, Bahawalpur, Pakistan. Seventy-two students were randomized into either the intervention group (GGR, n = 36), participating in bi-weekly sessions for 12 weeks, or the control group (SDR, n = 36), using reflective journals. Quantitative data were collected using the Professional Identity Questionnaire (PIQ) and the Professional Self-Identity Questionnaire (PSIQ), administered pre- and post-intervention. Qualitative data were gathered through semi-structured interviews and focus group discussions (FGDs). Statistical analysis included paired and independent t-tests, with effect sizes (Cohen’s d) and 95% confidence intervals (CIs) reported. Thematic analysis was conducted for qualitative insights, with inter-rater reliability (κ = 0.82). Results: The GGR group demonstrated more significant improvements in professional identity (p < 0.001, d = 1.20), communication skills (p < 0.001, d = 1.50), teamwork (p < 0.001, d = 1.55), ethical decision-making (p = 0.003, d = 0.90), and clinical confidence (p = 0.009, d = 0.85). The thematic analysis identified four key themes: enhanced self-awareness, strengthened peer collaboration, reinforced professional values, and improved stress management. Conclusion: Guided Group Reflection fosters professional identity formation in medical students by enhancing self-awareness, ethical reasoning, and teamwork. Its integration into medical curricula can support professional development, particularly in resource-limited settings.