{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:01:57Z","timestamp":1784520117290,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["asmepublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Education"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Medical students entering through undergraduate\u2010entry (UEMS) and post\u2010baccalaureate (PBMS) pathways differ significantly in age, life experience and prior exposure to healthcare. These differences may shape how each group navigated the emotionally and cognitively demanding transition into early clinical training. The authors compared how UEMS and PBMS experienced role transition during early clinical training using Mezirow's transformative learning theory (TLT) to examine disorienting experiences, reflective processes and evolving sense of role.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multi\u2010institutional longitudinal qualitative cohort study was conducted from 2023 to 2025 and tracked a cohort of 81 medical students (53 UEMS, 28 PBMS) from six universities in Taiwan, representing both undergraduate\u2010entry and post\u2010baccalaureate medical programmes. Students from both pathways were trained within comparable teaching hospital environments and participated in similar clinical rotations. For this analysis, data from 61 participants who contributed at least one semi\u2010structured interview and\/or audio diary during the first 2 years of the study were analysed thematically and interpreted through key phases of TLT, including disorienting dilemmas, critical reflection and role reintegration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both groups encountered emotionally disruptive experiences at the start of clinical immersion, but the nature and intensity of these challenges differed. Most UEMS participants reported anxiety, uncertainty and imposter\u2010like feelings and relied heavily on peer support to interpret early clinical expectations. PBMS, drawing on prior academic or professional experience, demonstrated greater emotional regulation and faster adjustment to workplace routines. Five themes mapped onto TLT phases captured their developmental trajectories: (1) disorienting dilemmas and emotional disruption, (2) critical self\u2010reflection and role reorientation, (3) social integration and coping strategies, (4) evolving motivation and career aspirations and (5) integration into a new role. While themes were shared, their timing, depth and expression differed between pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Applying TLT revealed distinct role\u2010transition patterns in UEMS and PBMS. UEMS may benefit from early emotional scaffolding, structured orientation and guided reflection, whereas PBMS may benefit from autonomy\u2010supportive learning environments that acknowledge and leverage prior experience. Tailoring educational strategies to each pathway's learning needs may foster more inclusive and developmentally responsive clinical training.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/medu.70261","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T03:05:47Z","timestamp":1784516747000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Applying Transformative Learning Theory to Compare Role Transition in Undergraduate\u2010Entry and Post\u2010Baccalaureate Medical Students"],"prefix":"10.1111","author":[{"given":"Sin\u2010Yee Patty","family":"Kwong","sequence":"first","affiliation":[{"name":"Chang Gung Medical Education Research Centre Chang Gung Memorial Hospital  Taoyuan Taiwan"},{"name":"Chang Gung University College of Medicine  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0854-8786","authenticated-orcid":false,"given":"Hui\u2010Ting","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine National Sun Yat\u2010sen University  Kaohsiung Taiwan"},{"name":"Department of Emergency Medicine Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiuan\u2010Ruey","family":"Yu","sequence":"additional","affiliation":[{"name":"Chang Gung Medical Education Research Centre Chang Gung Memorial Hospital  Taoyuan Taiwan"},{"name":"Chang Gung University College of Medicine  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5735-8490","authenticated-orcid":false,"given":"Yu\u2010Che","family":"Chang","sequence":"additional","affiliation":[{"name":"Chang Gung Medical Education Research Centre Chang Gung Memorial Hospital  Taoyuan Taiwan"},{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital Linkou and Chang Gung University College of Medicine  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1884-3714","authenticated-orcid":false,"given":"Ming\u2010Der","family":"Perng","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Life Sciences and Medicine National Tsing Hua University  Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6197-121X","authenticated-orcid":false,"given":"Hsu\u2010Min","family":"Tseng","sequence":"additional","affiliation":[{"name":"Chang Gung Medical Education Research Centre Chang Gung Memorial Hospital  Taoyuan Taiwan"},{"name":"Department of Health Care Management Chang Gung University  Taoyuan 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