Doctor In Development

Abstract

The national and international healthcare systems are in a transition. The healthcare problems of the future ask for doctors who can deal with complex challenges, connect to their patients, support societal health, have skills for lifelong learning, and take care of themselves (Lemmens et al., 2019; Nooteboom et al., 2020; World Health Organization, 2022). Both international researchers and national institutions explain that supporting medical students in their process of Professional Identity Formation (PIF) prepares them for this future (Cruess et al., 2014; Jarvis-Selinger et al., 2012; van De Pol et al., 2020). PIF is a process of finding the right balance between the internalization of the values, norms and behaviours of the profession (professional side), and the development of a personal style and purpose (personal side). While the professional side is already part of many medical curricula, including the curriculum of University Medical Centre Utrecht (UMCU), attention to the personal side is lacking. Therefore, this project aims to support medical students in exploring their personal side of PIF.
An iterative approach with extensive involvement of students, teachers, medical professionals and educational experts, has led to the creation of the educational module AIO (Arts In Ontwikkeling/Doctor In Development). AIO is divided into four phases: hook the students for PIF education, create a safe atmosphere to open up, allow students to explore themselves, and support them in evaluating what their self-insights mean for their role as residents/medical professionals. These phases form the basis of the three-year course and are repeated within the exploration phase as well. The exploration phase consists of seven cycles of start workshop – challenge – end workshop. In the start workshop students are hooked and explore together by sharing stories, a variety of challenges to choose from enables them to further reflect on themselves, the end workshop allows sharing of the insights and supports them in using the self-insights to formulate a concrete takeaway. Most workshops are facilitated by older students instead of teachers, since they create a safe atmosphere to open up and can provide practical tips based on their experiences.
A pilot study showed that peer facilitators indeed play a key role in the education. Furthermore, the active and creative exercises were seen as extremely supportive in the exploration and sharing of experiences. Besides being desired by students, AIO addresses several requirements for medical education and is thereby viable for UMCU. The fact that AIO is a modular course, requires a limited amount of teachers, and has been designed for the organizational structure of UMCU makes it also feasible.
Besides supporting UMCU in integrating PIF into their new curriculum, the research and design of this graduation project can be used as inspiration for other (inter)national medical universities. Future research could investigate the long-term effects of the design as PIF is a longitudinal process. Still, the pilot showed that the designed education already addresses unmet needs, supports the resilience of residents and allows students to discuss the challenges the future of healthcare brings.