Medical students' professional identity: self-reflection during the preclinical years.

Critical thinking, readiness for self-reflection and professional development have recently been emphasized as important goals of medical education. However, little is known about the developmental processes through which a medical student elaborates his or her personal experiences during the training, and about the way he or she gradually develops a professional identity. How does the student identify the opportunities and alternatives offered by the profession and finally commit to the professional values and goals he or she finds personally important? In order to grasp the essential characteristics of the personal development process in depth, qualitative, process-oriented and individually tailored methods are warranted. In this paper, the quality of professional self-reflection and identity formation during the preclinical training are described on the basis of two qualitative materials--learning logs and identity status interviews. Four types of learning log reports on the early patient contact course could be identified: 'committed reflection', 'emotional exploration', 'objective reporting' and 'diffuse reporting'. At the end of the preclinical training, the identity status of several students could still be characterized as diffuse or giving rise to only very tentative professional considerations.