Do professionalism, leadership, and resilience combine for professional identity formation? Evidence from confirmatory factor analysis.

Introduction: Professional identity formation (PIF) is an ongoing, self-reflective process involving habits of thinking, feeling and acting like a physician and is an integral component of medical education. While qualitative work has suggested that PIF is informed by professionalism, resilience, and leadership, there is a dearth of quantitative work in this area. Multiple methods build rigor and the present study aimed to quantitatively assess the relative psychometric contributions of professionalism, resilience, and leadership constructs to informing PIF, using a latent factor analysis approach. Methods: We analyzed data from the PILLAR study, which is an online cross-sectional assessment of a pre-clinical cohort of medical students in the RCSI University of Medicine and Health Sciences, Dublin, using established and validated quantitative measures in each area of interest: PIF, professionalism, leadership and resilience. A total of 76 items, combining four validated scales, along with a selection of demographic questions, were used. The hypothesis that PIF is informed by, and correlates with, professionalism, resilience and leadership was examined by conducting a confirmatory factor analysis of a proposed three-factor higher-order model. Model estimation used Maximum Likelihood Method (MLM) with geomin rotation. The hypothesized (measurement) model was examined against an alternative (saturated) model, as well as a three-factor model. Results: Latent variable analysis from 1,311 students demonstrated that a three-factor higher-order model best fit the data; suggesting PIF is informed by professionalism, resilience, and leadership, and that these constructs are statistically distinct and account for differential aspects of PIF. This higher-order model of PIF outperformed both the saturated model and the three-factor model. The analysis of which component may be the most or least influential was inconclusive, and the overall model was not influenced by year of training. Discussion: Building upon existing conceptual contentions, our study is the first to quantitatively support the contribution of professionalism, resilience, and leadership to the development of professional identity, and to delineate the inter-relationships between PIF and these constructs. This information can be used by medical educators when designing curricula and educational strategies intended to enhance PIF. Future work should seek to assess the influence of these constructs longitudinally.

Medical students, mental health and the role of resilience - A cross-sectional study.

BACKGROUND: Medical students have reported high prevalence of mental health difficulties and burnout. However, there are limited investigations examining the association between resilience and these difficulties. We investigated: (1) depression, anxiety, personal and professional burnout, and comorbidity; (2) demographic and education characteristics associated with these outcomes; (3) the association between resilience and these outcomes; and (4) whether these results were attributable to sampling bias. METHODS: Participants were n = 521 medical students from RCSI University of Medicine and Health Sciences. Outcomes were measured using validated scales. We report descriptive statistics, and risk factors for the difficulties were investigated using generalized linear modelling. RESULTS: One-in-three students reported incidence of depression or anxiety (24.5% co-morbidity). 8.9% of students reported all four difficulties. Difficulties were more common in female students and those in middle years of the programme. Resilience was negatively correlated with all outcomes and stable across demographic and educational variables. Weighting the data for sampling bias did not affect these results. CONCLUSIONS: Our results emphasise the high incidence of depression, anxiety, burnout, and comorbidity in students. We advocate for further investigation into the role of resilience as a modifiable factor that may ameliorate the incidence of depression, anxiety, and burnout in medical students.

Young and restless, old and focused: Age-differences in mind-wandering frequency and phenomenology.

The consistently observed age-accompanied diminution in mind-wandering stands seemingly opposed to accounts that present mind-wandering as a failure of executive control. This study examined the impact of aging on the frequency and phenomenology of mind-wandering and investigated distinct variables mediating age-related differences in unintentional and intentional mind-wandering. Thirty-four younger and 34 healthy older adults completed a neuropsychological test battery and contrast change detection task embedded with experience sampling probes asking participants to discriminate the nature of their thoughts. Results revealed age-related decreases in unintentional and intentional mind-wandering, but equivalent task accuracy. Parallel mediations demonstrated that older adults reduced their unintentional mind-wandering through having less anxiety and greater task engagement than younger adults. Despite the evidence of age-related decline on cognitive function tests, neither executive function nor task demand variables further contributed to the model. Our results adjudicate between competing theories, highlighting the roles of affective and motivational factors in unintentional mind-wandering. Intentional mind-wandering showed no significant associations with the neuropsychological measures; however, intentional mind-wandering was associated with more false alarms, which was mediated by greater reaction time variability (RTV). In the context of the exploitation/exploration framework, we suggest that younger adults were more inclined to intentionally mind-wander, indexed by increased RTV, while preserving comparable performance accuracy to older adults. Conversely, older adults exploited greater task focus, marked by reduced RTV, with less bias toward, or resources for, exploration of the mind-wandering space. Therefore, dispositional and strategic factors should be considered in future investigations of mind-wandering across the lifespan. (PsycInfo Database Record (c) 2021 APA, all rights reserved).