Adaptation and Modification of The Professional Identity Formation Scale for Postgraduate Trainees In Basic Health Science: A Mixed Method Study

doi:10.21203/rs.3.rs-3772972/v1

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Adaptation and Modification of The Professional Identity Formation Scale for Postgraduate Trainees In Basic Health Science: A Mixed Method Study

https://doi.org/10.21203/rs.3.rs-3772972/v1

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Background:

The professional identity formation (PIF) of postgraduate trainees in basic health sciences is critical to their educational journey. Yet, there is a lack of appropriate measurement tools. This research aimed to adapt and modify an existing PIF scale to assess the professional identities of postgraduate basic health sciences trainees.

Methods:

A mixed-method study was conducted to validate a modified PIF scale. An instrument was developed following AMEE Guide 87. Seven medical educationalists and basic health science postgraduate supervisors established its content validity and reliability. Cognitive interviews were conducted with 15 participants, and the tool was validated through the Delphi technique. Piloting was undertaken on a simple random sample of 500 postgraduate trainees. Psychometric analyses, including structure factor analysis, internal consistency testing, and qualitative content analysis, were used to evaluate the modified scale.

Results:

Five factors were identified related to professional identity formation, “Commitment to Professional Identity, belonging and Values,” “Pursuit of Knowledge and Excellence,” “Professional Growth and Collaboration,” Personal Growth and Reflection,” and “Confidence and impact.” The modified PIF scale demonstrated robust psychometric properties, including a well-defined factor structure, significant reliability, and high internal consistency. With a Cronbach alpha 0.97, the PIF scale's five kept variables accounted for 99.99% of the variance.

Conclusions:

In this study, the modified PIF scale was found to be a reliable tool for assessing the professional identities of postgraduate trainees.

Professional identity formation

Postgraduate trainees

Basic health sciences

Professional identity refers to the understanding and reinterpretation of communications within a professional working environment and aligning one's behavior with the standards and culture of a particular professional. (1) It involves continuous learning and growth, enabling educators to enhance their teaching practices, expand their pedagogical knowledge, and stay abreast of current educational trends and research. (2)

The concept of professional development can be viewed from various perspectives. One significant paradigm perceives it as a process that helps professionals address gaps in their knowledge and skill sets. In this sense, professional development is seen as a means to overcome deficiencies in a postgraduate trainee's level of performance (3). Although doctoral students' academic success and happiness are becoming more investigated in higher education studies, much remains to learn about their professional identity. Professional identity development encompasses the amalgamation of one's personal and professional identity. (4). However, due to the complexity and multidimensionality of this process, suitable measurement criteria are not always available (5).

Moreover, different social and professional groups may have distinct views on what it means to be a professional, and these concepts and meanings can evolve (6). Despite its impact, students of basic health sciences often lack awareness of the construct and its influence on their professional lives because most of the work on PIF has been done in the clinical sciences (3)⁻(6). Moreover, qualitative study paradigms have explored PIF widely, emphasizing the need for more quantitative analysis with psychometric-based measures (6). Existing instruments for evaluating professional identity lack psychometric validation for postgraduates in the basic science (7)⁻(8).

Phase one: Instrument design/item development

Scale questions were produced from the literature gathered from PubMed, Google Scholar, and other sources to discover publications on developing tools for PIF in the medical and basic health sciences. The already validated tools PSIQ and Tagawa (11) were used, which were adapted and modified for the postgraduate trainees of basic health sciences. The main goal was to define the concept and determine whether the associated construct’s measurements are present. The response possibilities for each item were chosen as part of the survey's design process, and closed-ended survey questions were created. (Additional file: annexe II)

Phase 2: Judgmental evidence (validation)

The accuracy of the items in reflecting the construct of the scale was assessed through instrument validation and content validity. We employed a two-stage Delphi technique to ensure the content's validation. (12). For the Delphi survey, experts were specifically identified as medical educationalists who hold a Master's degree in health professions education and have experience in the subject field. A panel of experts was chosen by purposive sampling methods. A set involving documents consisting of a cover letter, consent form, and a series of questions was electronically distributed to a group of twelve specialists at the initial round one. The cover letter provided details on the criteria used to pick the experts, the research's background, and instructions for rating the survey items. Participants were instructed to evaluate the significance of each item on a 5-point Likert scale in relation to the construct. (5. highly relevant or representative, 4. Relevant or representative, 3. Neutral, 2. Somewhat relevant or representative, 1. Not relevant or representative.) (13). Furthermore, the panelists were instructed to provide any remarks they may have in the designated comment area. A questionnaire was concluded with an open-ended question that encouraged panelists to propose any additional components. Data were analysed with descriptive statistics such as means, I-CVI, S-CVI, and CVR using Statistical Package for Social Sciences (SPSS) version 21. Delphi studies employ a certain threshold of concurrence among specialists to assess consensus within a group of experts. The consensus is quantitatively assessed by the utilization of specialists. The statistical measures of the field include the mean, median, mode, standard deviation, and percentage agreement. (14). In round two, the questionnaire was sent over to panellists who used Google Forms to respond in the first round. The experts were directed to classify each item according to its clarity and significance. In order to determine the relevance, participants were instructed to evaluate the items using a 5-point Likert scale, taking into consideration their relevance to the concept. To provide clarity, a 3-point Likert rating system was utilized. (1 = not straightforward, 2 = item needs revision, and 3 = highly clear; this indicates whether something is clear.). The study was ended after reaching consensus following the completion of the second phase. The items' content validity index (I-CVI) and the composite score for the content validity scale (S-CVI/Ave) were computed using the items' relevance to the construct in the previous round. Items with an I-CVI of 0.78 were excluded, items with an I-CVI ranging from 0.78 to 0.90 were modified, and items with an I-CVI of 0.90 were included.

The Delphi technique was used, and each item was revised for structure, relevance, and clearness, and dismissed questions were removed or unclear phrasing was modified (15). The content validity ratio (CVR) was determined using the Lawshe formula, which analyzes the significance of survey items. (16). The items with a CVR between 0.60 and 0.80 were modified, while those with values below 0.60 were eliminated from the instrument. Cognitive interviewing approaches were used to investigate how postgraduate trainees of basic health sciences comprehend the meaning of survey items (17). Participants were interviewed through Zoom meetings. Data were transcribed and analysed using the Braun and Clark framework (18) which comprises six stages (Fig. 2). The study followed GRAMMS (Good Reporting of a Mixed Methods Study) guidelines for mixed-method research (19).

Phase 3: Pilot testing

Two frequently used methods of pilot testing involve assessing the construct validity and internal consistency of the instrument. (9). Variables were classified into several dimensions using construct validity and assessed using factor analysis. The instrument was created through a process of iteration. The instrument's construct validity was verified by conducting exploratory factor analysis, followed by confirmatory factor analysis. (9). Reliability determined the internal consistency of the tool. Data was gathered from a sample of five hundred postgraduate trainees through the use of Google Forms and a traditional paper-based approach. The sample method employed was purposive sampling. The scale reliability of the questionnaire was assessed using scale analyses in SPSS to establish Cronbach's alpha value. Factor analysis was done for the construct validity. A combination of EFA and CFA was used to observe the scale's elements. The KMO test and Bartlett's test of sphericity were used to guarantee the sample size was appropriate for exploratory factor analysis (EFA). Following this, Confirmatory factor analysis (CFA) was implemented using AMOS (version 21.00) to authenticate the factor construction of the removed factors (20).

Data collection instrument:

The Modified Professional Identity Scale is given in (Additional file: annex II)

Ethical Concerns:

To ensure informed and voluntary consent, participants received a description of the investigation's design, methodology, and their right to leave at any time. The data were securely password-protected, backed up regularly, and stored in a safe place accessible only to the researcher. The researcher will hold data for a maximum of five years, after which it will be discarded.

The results of every step of the study are mentioned in Table 1

Table 1

Steps in the development of the professional identity formation scale.
Steps in the development of the professional identity formation scale for postgraduate basic health sciences
Steps for instrument development	Results
a. Literature search	Pubmed, Google Scholar, Eric, Science direct
b. Content Specification & Item Generation	Pre-validation tool ( tagawa & PSIQ)
c. Adaptation and Modification of the existing tool.	Modified tool with 63 items (PIF tool for basic health sciences postgraduates’ trainees
d. Expert validation ( Delphi procedure = two rounds ;N = 7, N = 7)	Conducted in two rounds with medical educationalists and subject experts .Out of 63 items consensus was made on 50 items, 13 items were removed. The value of S-CVI/Ave were 0.83.
e. Cognitive interviews ( N = 15)	50 items were assessed based on responses of the participants 10 items were rephrased: wording changed and adjusted to basic health sciences context.
f. Instrument piloting ( N = 500/500) Factor analysis	EFA & CFA showed a good fit, The significant value of Cronbach’s Alpha was 0.84 to 0.97, suggestive of good internal consistency of the tool.

Phase 1: Instrument design/item development

During phase one of the instrument design, items were established. After removing items and identifying duplicates in the PSI/PSIQ and Tagawa, 63 items were classified and identified as belonging to the category of PIF in basic health sciences.

Phase 2: judgmental evidence (validation)

Validation of instruments in the initial round of the Delphi survey, the response rate was 7/8. Items which met the predefined criteria and had an 80% consensus among experts were eliminated, while things that met the fair and good standards were selected for further evaluation in round two. (Additional file: annexe III). The response rate for the second round was 84%, with 7 out of 8 participants responding. The experts reached a consensus of 90% agreement on the items, hence the Delphi rounds were ended. The S-CVI/Ave values were 0.83. By applying predetermined criteria for I-CVI and CVR, two components were eliminated, thirteen items were modified, while the remaining ones were retained. As a result, the tool was reduced to 50 items at this stage (Additional file: annexe IV). After gathering responses from fifteen people (n 15) during cognitive pretesting of the 50-item measure, ten items were rephrased with minor modifications, and one item was eliminated. Table 2 displays the findings from phase two.

Table 2

Result of Delphi round of basic health science postgraduate trainee PIF tool. Phase II (n1 = 7/8) (n2 = 7/8)
No	Items	I-CVI	CVR	Combined Results of experts and cognitive interview
Item-1	I feel like I am a member of basic science health profession.	1.00	1.00	Revised
Item-2	I feel I have strong ties with members of basic science health profession	0.71	0.71	Removed
Item-3	I find myself making excuses for belonging to basic science health profession.	0.43	-0.14	Removed
Item-4	I am pleased to belong to basic science health profession.	0.86	0.71	Included
Item-5	I can identify positively with members of basic science health profession.	0.86	0.71	Included
Item-6	Being a member of basic science health profession is important to me.	1.00	1.00	Included
Item-7	I feel I share characteristics with other members of basic science & medical profession.	0.86	0.71	Included
Item-8	I have never thought about the reasons or principles behind the required code of conduct.	0.43	-0.14	Removed
Item-9	I am sometimes unable to do something I was not interested in despite understanding its necessity.	0.57	0.43	Removed
Item-10	I behave correctly as an educator on a daily basis.	0.86	0.71	Included
Item-11	When I am acknowledged by senior trainees or colleagues, I feel that I am being recognized.	1.00	1.00	Included
Item-12	I first consider how to share responsibilities with trainees/colleagues in order to fulfill duties required of me.	0.86	0.71	Included
Item-13	I am working to improve my behavior as a trainee by constantly analyzing and reflecting on my own actions.	0.86	0.71	Included
Item-14	I take great care not to offend senior trainees or colleagues.	1.00	1.00	Included
Item-15	I act with respect for the opinions of my colleagues when I have a conflict of opinion with those around me.	1.00	1.00	Included
Item-16	Good test results and qualifications are important evaluation of self.	0.86	0.71	Included
Item-17	The way senior trainees act towards me is more important than how they feel about me.	0.43	-0.14	Removed
Item-18	The colleagues I can be close friends with are those who have the same concerns and interests as me.	0.43	-0.14	Removed
Item-19	If I were able to play a role in improving society and organizations, I would be satisfied even if I did not receive individual recognition.	0.86	0.71	Included
Item-20	I have used my own beliefs and ideals as a standard to evaluate my own actions as an educator & trainee.	0.71	0.71	Included
Item-21	I actively seek opportunities to collaborate with professionals from different disciplines within the field of basic science.	0.86	0.71	Included
Item-22	I feel a sense of responsibility to contribute to the advancement of scientific knowledge in my chosen area of expertise.	0.86	0.71	Included
Item-23	I strive to maintain a work-life balance that supports my personal well-being and professional growth.	1.00	1.00	Included
Item-24	I actively seek opportunities to collaborate with researchers from diverse backgrounds and disciplines within the basic sciences	0.86	0.71	Included
Item-25	I am motivated to contribute to the advancement of scientific knowledge and innovation in my specific field of study.	1.00	1.00	Included
Item-26	I feel a sense of pride and accomplishment when I successfully overcome challenges and obstacles in my research	1.00	1.00	Included
Item-27	I believe that my work as a postgraduate basic science trainee has a positive impact on society and the broader scientific community.	1.00	1.00	Included
Item-28	I actively seek mentorship and guidance from experienced researchers and professionals in my field	0.71	0.43	Revised
Item-29	I am committed to staying updated with the latest advancements and breakthroughs in my area of specialization within the basic sciences.	0.86	0.71	Included
Item-30	I am dedicated to promoting scientific integrity and ethical conduct in my research practices.	1.00	1.00	Included
Item-31	I value interdisciplinary collaboration and believe it enhances the quality and impact of my research.	1.00	1.00	Included
Item-32	I actively engage in professional development activities, such as workshops and conferences, to enhance my skills and knowledge.	0.86	0.71	Included
Item-33	I feel a sense of responsibility to effectively communicate my research findings to both scientific and non-scientific audiences.	1.00	1.00	Included
Item-34	I actively seek feedback from mentors and supervisors to enhance my professional growth and performance.	0.71	1.00	Removed
Item-35	I perceive myself as a contributor to the broader scientific community, beyond the boundaries of my own research projects.	0.57	0.14	Removed
Item-36	I prioritize the ethical conduct of research and adhere to the highest standards of integrity in my work.	1.00	1.00	Included
Item-37	I actively engage in professional networking activities to build connections and expand my knowledge base.	0.86	0.71	Included
Item-38	I seek opportunities to mentor and guide junior trainees in the field of basic science.	1.00	1.00	Included
Item-39	I am confident in my ability to contribute meaningfully to the field of basic science through my research and expertise.	1.00	1.00	Included
Item-40	I consider constructive criticism as an opportunity for personal and professional development.	1.00	1.00	Included
Item-41	I value collaboration and teamwork in the pursuit of scientific knowledge.	0.71	1.00	Included
Item-42	I recognize the importance of maintaining a positive work environment for the well-being of myself and my colleagues.	0.86	1.00	Included
Item-43	I am open to new ideas and perspectives that challenge my existing knowledge and beliefs.	1.00	1.00	Included
Item-44	I am committed to ongoing learning and continuous professional development in the field of basic science.	1.00	1.00	Included
Item-45	I strive to bridge the gap between research and clinical practice for the benefit of patients and society.	1.00	1.00	Included
Item-46	I am dedicated to upholding the ethical principles and values of the medical profession.	0.86	1.00	Included
Item-47	I feel a sense of pride in the contributions I make as a postgraduate in basic sciences trainee.	0.71	0.71	Included
Item-48	I have a clear understanding of the professional values and ethical standards that are expected in my field.	0.86	1.00	Included
Item-49	I feel confident in my ability to integrate my personal and professional values in my work as a postgraduate in basic sciences trainee.	0.57	1.00	Removed
Item-50	I actively seek out role models and mentors who exemplify the professional identity I aspire to have.	0.71	0.71	Removed
Item-51	I feel supported and encouraged by my academic advisors or supervisors in my professional identity formation journey.	0.71	0.71	Removed
Item-52	I am aware of the opportunities and resources available to me for networking and building professional connections.	1.00	1.00	Included
Item-53	I actively engage in activities or initiatives that promote interdisciplinary collaboration and teamwork within my field.	0.71	1.00	Removed
Item-54	I feel a sense of belonging and inclusion within the community of postgraduates in basic sciences trainees.	0.71	1.00	Included
Item-55	I am committed to lifelong learning and continuous professional development as a postgraduate in basic sciences trainee.	0.86	0.71	Included
Item-56	I actively seek opportunities to engage in professional networking events and conferences relevant to my field of study.	0.71	0.71	Included
Item-57	I feel confident in articulating my professional goals and aspirations as a postgraduate in basic sciences trainee.	0.86	1.00	Included
Item-58	I actively seek out feedback and constructive criticism to help shape and refine my professional identity.	0.71	0.43	Revised
Item-59	I engage in reflective practices to deepen my understanding of the values and ethics inherent in my field of study.	0.86	0.71	Included
Item-60	I actively seek out opportunities to collaborate with professionals from diverse backgrounds to broaden my perspective	0.71	0.71	Removed
Item-61	I actively seek opportunities to participate in research projects and scientific discussions relevant to my field of study.	0.86	0.71	Included
Item-62	I have a clear understanding of the core competencies and skills required to excel in my chosen discipline within the basic sciences.	0.86	1.00	Included
Item-63	I feel confident in my ability to apply theoretical knowledge to real-world scientific challenges.	1.00	1.00	Included
	Proportion relevance	0.83 S-CVI/ Ave	0.78
PIF; professional identity formation, n1: number of participants in round 1; n2: number of participants in round 2; I-CVI: Content Validity Index of Item; CVR: Content Validity Ratio.
( Additional file: annexe VI Table 2 results)

Table 2 here: (Result of Delphi round of basic health science postgraduate trainee PIF tool. Phase II (n1 = 7/8) (n2 = 7/8))

Thematic analysis:

The results and findings from the thematic analysis are given in Table 3.

Table 3

Themes, Sub-themes and Representative Quotes.
Theme	Sub-Theme	Representative Quotes
Theme 1: Understanding	Item Wording and Structure	"Item 12 may be redesigned separately and divided into two parts for better clarity, one qualification, and other test results." (Participant-1)
	Terminology and Clarity	"Consider using 'new guidelines' or 'research-practice gap for patient and societal benefit' in item 37." (Participant-4)
	Diverse Perspectives	"The researchers recognized that various factors could influence participants' views and opinions, making it important to consider the diverse perspectives in the study." (Participant-5)
Theme 2: Judgment	Question Relevancy	"Item 12 required rewording to differentiate between 'good test result' and 'qualification' as they have different meanings and could be confusing to the reader." (Participant-1)
	Redundancy and Similarity	"Items 1 and 2 are quite similar. Suggested modification: Consider rephrasing item 2 to avoid redundancy with item 2." (Participant 2)
Theme 3: Response	Comprehensive and Well-Defined	"The questionnaire is comprehensive and well-defined, making it an enjoyable reading experience." (Participant 6)
	Clarity and Participant Benefits	"Item 37 would benefit from rephrasing to address 'new guidelines' or explore the gap between recent research and its implementation in clinical practice for the benefit of patients and society."( Participant 11)
Theme 4: Adequacy of Content	Coverage of Aspects	"The questionnaire covers all aspects of professional identity formation effectively." (Participant 12)
	Language and Target Population	"The language used was academic and appropriate for the target population, allowing readers to grasp the researchers' intentions clearly." (Participant 12)

Table 3 here: (Themes, Sub-themes and Representative Quotes.)

Phase 3: Piloting

Demographic Characteristics of Participants

Participants were selected based on inclusion criteria and provided written informed consent. Demographic data was collected on a paper proforma and through Google form. The piloting survey had two sections: demographics and 50 questions on PIF measured on a 5-point Likert Scale. (13). Demographic characteristics are mentioned below in Table 4.

Table 4

Demographic Characteristics of Participants
	Category	Number	Percentage
Gender distribution	Male	205	40.0%
Gender distribution	Female	308	60.0%
Respondent Age	25 years and below	41	8.0%
	25 years and below	272	53.0%
	26 to 35 years	164	32.0%
	36 to 45 years	27	5.3%
	46 to 55 years	9	1.8%
	56 years and above	41	8.0%
Qualification distribution	M.Sc.	19	3.7%
	MHPE scholars	137	26.7%
	MPhil scholars	241	47%
	PhD	62	12.1%
	MHR	54	10.5%
Profession distribution	Demonstrator/lecturer	126	24.6%
	Registrar.	21	4.1%
	Assistant professor	115	22.4%
	Associate professor	74	14.4%
	Not working	113	22.0%
	Professor	64	12.5%

The response rate for this phase in the pilot testing was 95% (n 470/500). The Kaiser- Meyer Olkin Measure of sampling adequacy (KMO) yielded a value of 0.9954, indicating a high level of adequacy. Additionally, the results were found to be statistically significant result (approximately chi-square = 17799.554; degrees of freedom = 1225; p = 0.000 < 0.05) comes from Bartlett's test of sphericity, the sample size was acceptable for factor analysis. According to the scree-plot graphic, four is the ideal number of PIF scale variables, as shown in Fig. 3.

The five elements reserved in the PIF scale were intended for 99.99% of the variance (Additional file: annexe V). All the factor loadings were higher than 0.400, between 0.51 and 0.84. The EFA was done by extracting factors with eigenvalues more than 1.0, using the basic component of the analysis , and then rotating the factors using the varimax rotation (21). The Varimax technique identified five factors with acceptable loading values. The rotational component matrix helps analyze how distinct items group together depending on underlying variables and provides insight into the latent constructs in the data.

Confirmatory Factor Analysis (CFA)

Goodness of Fit of the CFA Model for the PIF-Scale

The CFA model generated 14 items associated with the five elements of PIF “Commitment to Professional Identity, belonging and Values” (15 items; factor loadings: 0.436–0.757), “Pursuit of Knowledge and Excellence,” (8 items; factor loadings: 0.499– 0.646), “Professional Growth and Collaboration,” ( 7 items; factor loadings: 0.486– 0.707), “Personal Growth and Reflection,” ( for that six items; the factor loadings: 0.461– 0.767), “Confidence and Impact” (6 - items; factor loadings: 0.425– 0.552). The CFA model is shown in Figure 4, showing 42 items in the scale formed. The results of the fit indices of the tool specify that the values of absolute and incremental fit indices resemble to a good fit model (Table 5)

Table 5. Results of confirmatory factor analysis of the 50-items instrument (Phase-3) (n 500/500).

Fit Indices	Cut-off values	Measured values
Absolute fit measures Observed normed χ 2/df	< 5 The smaller, the better	4.707
Root mean square error of approximation (RMSEA)	0.08 to 0.1 (0.05 is cut off for good fit model)	0.082
Incremental Fit measures Tucker-Lewis Index (TLI)	Adjacent to 1 (Higher the better) (0.9 is cut off value)	0.75
Comparative fit index (CFI)	Near to 1 (Higher the better) (0.9 is cut off value	0.78

Reliability for a CFA model:

The correlation between the studied constructs was found to be statistically significant (p < .01). The Cronbach's Alpha coefficient ranged from 0.84 to 0.97, indicating a high level of internal consistency for the tool. The initial exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) models for the Professional Identity Formation (PIF) scale are deemed to be reliable in assessing participants' professional identity, since they demonstrate satisfactory levels of reliability.

This study aimed to examine how PIF develops during different stages of basic health sciences education and explore the factors contributing to or inhibiting its development. This study involved PIF scale development through a multidimensional, multi-phased, rigorous methodology comprising a theoretical framework, a Delphi technique, exploratory factor analysis followed by confirmatory factor analysis, and pilot testing.

To evaluate the scale's content validity, we have used I- CVI and S-CVI to make up for the skewness by eccentricity in the S-CVI (14). The I-CVIs and CVR scores showed that the items were meaningful and pertinent to determining the PIF for postgraduate students in basic health sciences. Low CVRs were found for some items. However, it's possible that experts didn't understand what they were measuring. Two more studies aimed to measure professional identity among medical students using valid and reliable instruments. (24). The first study used Brown et al.'s Professional Identity Questionnaire (PIQ) and identified two factors, PIF-attachment and detachment, while the second study used Tagawa's scale and identified five factors. While the modified scale also identified factors related to the basic health science postgraduates. The first study evaluated content validity using item-level CVI and CVR. It explored correlations with the Academic Self-Regulation Scale, (23).

At the same time, the second study assessed content validity with the item Content Validity Index (I-CVI) and noted a low response rate. Both studies offer valuable insights and avenues for refinement in measurement tools within the medical education context. The CFA and Cronbach's alphas value indicated the high internal consistency of the tool. From the values, it can be proven that each component of the CFA model is a sufficient to excellent indicator of the variable in question (25)(26). The baseline EFA model's indices demonstrate that the PIF scale has an acceptable and trustworthy factor structure and a good model fit. The CFA model's validity for the PIF scale was assessed through the examination of Cronbach's alpha and composite reliability statistics. (27) All Cronbach's alpha values were more significant than 0.70, some even exceeding 0.90, showing high internal reliability (28).

Additionally, rigorous qualitative research found the overall PIF scale to have high content validity. This was established by conducting interviews with multiple experts until saturation was reached. Understanding the factors affecting PIF across multiple domains can enhance prospective respondents' skills, behavior, and personal values. It can be valuable for educational institutions, policymakers, and healthcare workers to identify personal and professional growth areas.

The study developed a tool to evaluate professional identity for postgraduate students in basic health sciences with five valid factors and 50 items.

Future Directions

Future studies may anticipate using a larger sample to confirm the viability of the created tools.

The PIF scale was validated with high consistency and reliability. It contributes to assessing professional identity in medical education and has practical implications for institutions, policymakers, and healthcare workers. The study has a few limitations: the questionnaire may not be relevant for other clinical populations, outcomes may be exaggerated due to recall bias or self-reported measures, and the form takes 20–30 minutes to complete.

This study was conducted six months after authorization of the synopsis from the Advanced Study and Research Board (ASRB), Khyber Medical University (KMU) Peshawar (ASRB002059/AM/ IHPE) obtained in 135th meeting of the KMU AS&RB held online on 31st/05/2023, along with ethical clearance certificate. All methods were carried out according to relevant guidelines and regulations, and informed consent was obtained from all participants.

Funding

Not Applicable

Conﬂict of interest/Competing interests

The authors report there are no competing interests to declare.

Consent for publication

The author took permission from the participant about the publication.

Availability of data and materials

This published article and its supplementary information files include all data generated or analyzed during this study.

Authors’ contributions

US designed the study, collected data, and analyzed the data.

UM conceptually designed the study, revised the manuscript, and gave final approval of the manuscript.

NM Analysed the data and revised the manuscript.

BM Substantially reviewed and revised the manuscript.

ASA Substantially reviewed and revised the manuscript.

MB revised the manuscript and reviewed the draft.

All the authors have read and approved the final manuscript.

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Adaptation and Modification of The Professional Identity Formation Scale for Postgraduate Trainees In Basic Health Science: A Mixed Method Study

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Abstract

Background:

Methods:

Results:

Conclusions:

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Background

Methods

Phase one: Instrument design/item development

Phase 2: Judgmental evidence (validation)

Phase 3: Pilot testing

Data collection instrument:

Ethical Concerns:

Results

Phase 1: Instrument design/item development

Phase 2: judgmental evidence (validation)

Thematic analysis:

Phase 3: Piloting

Demographic Characteristics of Participants

Confirmatory Factor Analysis (CFA)

Goodness of Fit of the CFA Model for the PIF-Scale

Reliability for a CFA model:

Discussion

Conclusions

Future Directions

Strengths and Limitations

Declarations

References

Additional Declarations

Supplementary Files

Status:

Version 1