Fostering connections, psychological safety and meaningful relationships: The role of preclerkship learning communities in professional identity formation

INTRODUCTION: Professional identity formation (PIF) in medicine is a developmental process of integrating personal and professional values, attributes, and practices into one's character. This process may be advanced through experiential learning, socialization, and role models, all of which are found in longitudinal integrated experiences such as learning communities (LCs). LCs, present in more than half of U.S medical schools, often function as communities of practice (CoP) that may promote PIF. To better understand the influences of LCs on PIF in the preclerkship phase, we conducted a qualitative, multi-institution study to determine the LC activities, relationships, and key experiences medical students perceived as impacting their PIF. METHODS: Preclerkship students from five U.S. medical schools with LCs completed an open-ended survey eliciting perspectives on LC factors influencing their PIF. We used constant comparison to develop a codebook, code and analyze survey responses, and develop individual school and cross-school summaries. RESULTS: A total of 208 students across the schools (29% of those recruited) completed the survey. LCs offered students opportunities for connections within psychologically safe environments; this combination promoted meaningful professional relationships that contributed to students' PIF. However, LCs may not impact the PIF of all students. DISCUSSION: This study is the first to describe the interrelationship of three key structural elements in preclerkship LCs - facilitating multiple connections, building psychologically safe environments, and fostering meaningful relationships - that appear to lay a foundation for and scaffold student growth and PIF. Our study provides empirical support for the impact of LCs, functioning as CoP, on preclerkship students' PIF.