Affirming professional identities through an apprenticeship: insights from a four-year longitudinal case study.
OBJECTIVE
A four-year course, entitled Physician Apprenticeship, was introduced at McGill University's Faculty of Medicine in 2005. The primary objective of the course is to assist students in their transition from laymen to physicians. The goal of this study was to understand the apprenticeship learning process, particularly its contribution to professional identity formation.


METHODS
For data collection, the authors used a longitudinal case study design with mixed methods. They conducted the study over a four-year curricular cycle, from 2008-2009 to 2011-2012. The case consisted of three apprenticeship groups. Students (n = 24) and teachers (n = 3) represented two subgroups for data analysis.


RESULTS
Physician Apprenticeship activities promoted and sustained medical professionalization in the participants. Salient features of successful apprenticeship learning were access to authentic clinical experiences as well as the provision of a safe learning environment and guided critical reflection. The latter two ingredients appear to be mutually reinforcing and contributed to the creation of meaningful student-teacher relationships. Teachers exhibited several qualities that align with a parental role. Students became increasingly aware of having entered the kinship of physicians. Teachers experienced a renewal and validation of their commitment to the ideals of medicine.


CONCLUSIONS
Findings strongly suggest that a longitudinal apprenticeship in an undergraduate medical program can contribute to the formation and reaffirmation of professional identity. The case study design permitted the authors to create a provisional conceptual model explicating important features of the apprenticeship learning process.
Dr. Boudreau is associate professor, Department of Medicine, Arnold P. Gold Foundation Professor of Medicine, and core member, Centre for Medical Education, McGill University Faculty of Medicine, Montreal, Québec, Canada. Dr. Macdonald is assistant professor, Faculty of Dentistry, and core member, Centre for Medical Education, McGill University Faculty of Medicine, Montreal, Québec, Canada. Dr. Steinert is professor, Department of Family Medicine, Richard and Sylvia Cruess Chair in Medical Education, and director, Centre for Medical Education, McGill University Faculty of Medicine, Montreal, Québec, Canada.
J Donald
JD
Boudreau
Mary Ellen
ME
Macdonald
Yvonne
Y
Steinert
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005180:Faculty, Medical; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011361:Professional Competence; D015397:Program Evaluation; D012933:Social Identification; D013337:Students, Medical