Crossroads experiences for promoting self-authorship of clinical medical students: A qualitative survey

The capacity of self‑authoring one’s own beliefs, identity, and relationships is core to many expected outcomes of future health‑care professionals. Students’ personal and professional development for self‑authorship can be promoted by the variety of developmentally effective “crossroads” experiences that they encounter. Identifying the characteristics of the crossroads experiences in clinical rotations can provide a foundation for medical educators to provide an environment that can foster self‑authorship.

A cross‑sectional qualitative survey was conducted using a researcher developed semi‑structured questionnaire which had three open questions and asked medical interns to describe their internship experiences that stimulated their thinking along the self‑authorship dimensions of identity, relationships, and ways of knowledge acquisition. Data were analyzed using Braun and Clarkes’ thematic analysis method.

The survey was completed by 167 medical interns (response rate: 83%). The key features of significant crossroads experiences and their effects were created into six themes: Experiences by being respected and validated; experiences by involvement in patient management; experiences by participation in interactive learning environments; experiences by participation in authentic clinical work environments; experiences by the observation of professional behaviors; experiences through the uniqueness of different specialties.

Authentic experiences of patient management in the real world of clinical settings with a high interactive environment have the potential to promote interns’ self‑authorship development. Educators can support learners by respecting and validating their capacities and by role modeling of professional behaviors.