Characteristics of the status of professional identity of medical university residents

Malyutina Tat'yana Vladimirovna ORCID: 0000-0001-8741-4684 PhD in Psychology Associate Professor of the Department of Pedagogy and Psychology of DPO, Omsk State Medical University 644074, Russia, g. Omsk, ul. Lenina, 12 malyutina1971@mail.ru Other publications by this author     Tsygankova Ol'ga Yurievna ORCID: 0000-0002-3553-055X PhD in Medicine Associate Professor, Department of Obstetrics and Gynecology, Omsk State Medical University 644097, Russia, Omskaya oblast', g. Omsk, ul. Lenina, 12 tsygoyu@mail.ru

Lonskaya Larisa Vladimirovna ORCID: 0000-0001-6467-8169 PhD in Pedagogy Associate Professor, Department of Pedagogy and Psychology of DPO, Omsk State Medical University 644097, Russia, Omsk oblast', g. Omsk, ul. Lenina, 12 lonskayal@mail.ru

In modern conditions of transformation of professional and public social attitudes, the problem of the formation of the professional identity of a modern doctor and its role in the development of key components of the personality of a medical specialist is considered a very modern position of study for both heuristic and transdisciplinary research ^{[3, 4]}.

In the situation of the transition period that has developed in society, including Russian society, there is a destabilization of the classical systems of personality, its priorities, meanings, values and moral attitudes. The ambiguity of the social and evolutionary living of a contemporary is manifested in the desire to search for unity and stability of self-identity ^{[1, p.99]}.

The formation of professional identity is considered throughout the entire university education from the 1st to the 6th courses, as well as at the stage of training in clinical residency. The period of study in the residency consists in preparation for medical activity in a clinical specialty. Training in residency is aimed at deeper training in clinical specialty, the development of independent medical practice abilities on the basis of knowledge already acquired at the university. It can be emphasized that residency training is considered to be the leading period of the development of the identity of the "yesterday's" student to himself as a medical specialist, to his professional activity.

Clinical residency is a part of the higher education of medical professionals. At this stage, there is a more stable formation of the professional qualities of a doctor as an independent specialist. This is a form of training in which a graduate of a medical university has the opportunity to improve his professional skills in a narrower specialization of medical activity, replenish his knowledge in the field of medical technologies, and also have clinical practice in the healthcare system.

The stage of training in clinical residency, for a young specialist, is not mandatory, so we can say that this is a conscious choice of a medic. The internship curriculum, as in the previous stages of training, provides for a mandatory and variable part of the disciplines and a fund of evaluation tools corresponding to a certain discipline for monitoring the knowledge of residents. The main forms of residency training do not differ from university studies: lectures on disciplines of a narrow clinical profile, practical classes, clinical examination of patients with analysis of medical history, research work on the profile of residency, speaking at conferences.

Formulation of the purpose of the article and tasks

The purpose of the article: to study and characterize the status of professional identity of residents of the first year of medical university.

Objectives of the article:

1. To define and characterize the status of professional identity.

2.   To analyze the formation of the status of professional identity among first-year residents.

3. Develop recommendations that promote the development of professional identity among residents

Presentation of the main material of the article.

Relying, in our work, on the L.B. Schneider system, we understand professional identity as a system of dynamic, multilevel psychological phenomena directly related to professional self-determination, professional self-awareness, professional space and professional development of a specialist as a whole ^[4,6].

As part of our study, a group of first-year residents was formed, in the number of (n=60) respondents. In our study, we applied the L.B. Schneider methodology to study the status of the professional identity of the MIPI ^[4,6].

Five professional identity statuses are considered and described: premature identity, diffuse, moratorium, achieved identity and pseudo-identity. In her work, L.B. Schneider gave a more complete description of the classification of identity statuses proposed by J. Marcia ^{[2,4,5,6,7,8,9,10]}.

1. Premature identity. It is demonstrated in a person who is not experiencing an identity crisis. They are characterized by well-established personal goals, views, and worldview. This is a consequence of their mutual identification with their parents, the immediate environment, and not the result of their own initiative to make a decision when choosing a profession.

2. Diffuse identity. It is typical for a person who does not have established views, ideology, principles, attitudes in the learning process, I do not make much effort to form them. The choice of a profession in need is made in agreement with the close environment: parents, acquaintances, friends. It is possible that at different stages of formation, professional identity will be replaced by a "moratorium" or "achieved" identity, it is likely that it will remain as a "diffuse" or "pseudo-identity".

3. The moratorium. Describes people in a state of crisis who are dynamically trying to get out of this crisis, trying various options, is in a state of searching for useful information to resolve the crisis.Nevertheless, the goals and expectations of their interests, intentions, and drives are not fully defined, they can radically revise their beliefs both in relation to themselves and to the learning process as a whole and the choice of profession, including. At the same time, a person with the status of "moratorium" is characterized by adequate self-esteem, diversification of interests and social relations.

4. Achieved identity. It is typical for those who have survived the stage of crisis, defined goals, tasks, as a result of which they have formed a specific set of personally significant goals, values and beliefs. They adapt well to new conditions, are quite independent, show a good level of academic performance and interest in learning, creative approach, are prone to reflexivity. The representation of a "well-developed" identity is considered an indicator of a positive self-assessment of one's qualities, a successful regulation of the identification and individualization system.They accept their achievements as the main ones, providing them with an attitude and awareness of actions.

5. Pseudo-identity. It has the right to perceive it as "hyperidenticity". It is expressed as a deepening in the role as a result of a steady understatement and rejection of one's personal uniqueness or, on the contrary, its excessive emphasis. Violation of the system of identification and differentiation towards exaggeration is also characterized by deformation of the real life situation, rigidity, low reflexivity, denial of criticism towards oneself.

As a result of the study, groups of residents related to specific identity statuses were identified. Residents (1st year, n=5), have the status of premature identity, they do not have permanent professional goals, plan, principles, but at the same time they strive to develop them and form some options for their subsequent professional development in clinical specialization.

Most often, this status belongs to young people who, during their studies at the university, did not show due attention and interest in learning, or young people do not sufficiently realize the importance and significance of choosing a profession. Most likely, at the time of training, it was not possible to make a choice of a clinical specialty and the decision to study in residency was unconscious.

Residents (1st year, n=13) who have the status of diffuse identity are characterized by the fact that they do not have permanent goals, orientation and strive to actively form them. The main characteristics of residents with the status of diffuse identity are:

1. the relative level of satisfaction with one's own decision to study in residency, the choice of a clinical specialty, one's own achievements and abilities,

2. indecision in the success of their goals, low independence,

3. an increased level of anxiety and anxiety, isolation and lack of attention to one's own successes and results, a small desire to achieve the tasks and results are also manifested,

4. showing concern about the opinions of others about themselves, self-condemnation of mistakes, preferences, etc.

     For the above group, residency training and the choice of a clinical specialty is undesirable: a budget place, a passing score, low motivation, etc.

Residents who have the status of a moratorium (1st year, n-15) are characterized by the study of alternative options for professional development and are actively trying to get out of this state by making an informed decision about their professional future. This is an identity status in which young people are in a state of crisis, but they are actively trying to resolve it, while trying various ways out of the current situation. They are usually characterized by increased anxiety, dissatisfaction with the current situation, increased cognitive activity, but at the same time low self-esteem and assessment of their own capabilities to achieve their goals, seeking social support and avoiding problems.

For residents who have the status of achieved identity (1st year, n= 20), there are characteristic signs that manifest themselves in the formation of certain personally significant goals, beliefs, and orientation for him. It can also be noted that the following signs are characteristic of students with an achieved identity:

1. High cognitive need.

2. The importance of the professional sphere and satisfaction with the chosen profession.

3. A sufficiently high level of manifestation of volitional effort to achieve the intended goals.

4. An adequate assessment of their potential to achieve performance results.

5. The manifestation of initiative in independent practical activity.

Based on this, the ability to solve emerging problems and the regularity of achieving the goals of their professional development is formed.

A group of residents with the status of pseudo-identity (1st year, n=7) is characterized by a stable violation of identification with a future professional role. This condition is typical for students who have chosen a clinical specialization not by their own decision, but on the advice of parents or friends, the availability of budget places, the prestige of the chosen specialization, the material component, etc.

For a certain time, this state provides comfort, but in the future leads to disappointment and worries about their professional future. Residents with this identity status are characterized by a manifestation of cognitive activity, but at the same time low satisfaction with the achieved results of activity. There is also a low assessment of one's potential, a low manifestation of initiative and mobilization of efforts to achieve results, increased emotional anxiety and general tension.

Conclusions:

Thus, we can summarize the results of our study of the formation of the status of professional identity of residents of the 1st year of medical university:

1.      Residents (1st year, n=5) with the status of premature identity, residents (1st year, n=13) with the status of diffuse identity, residents with the status of moratorium (1st year, n=15), residents with the status of achieved identity (1st year, n=20), a group of residents with the status pseudo-identity b (1st year, n=7).

2. The analysis of the transformation of the identity status suggests that at the stage of training in residency there is a more meaningful accumulation of professional knowledge and skills, but it can also be noted that not all residents fully present themselves as a future representative of the professional community.

Summarizing the above, we note that the formation of professional identity at the stage of training in residency is manifested through the formation of a personal assessment of the value of a clinical specialty, satisfaction with it, the formation of professional behavior. From our point of view, it is necessary to create a technology to support the development of professional skills in the course of clinical disciplines, practical classes in the simulation center, the development of communication skills and interaction abilities in the classroom in the discipline "pedagogy and psychology".