{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:09:17Z","timestamp":1790168957680,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]}],"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>Professional identity formation (PIF) is increasingly understood not only as becoming a physician but as a matter of being and belonging within the profession. The development of a holistic professional identity can enhance a physician's confidence, wellbeing and performance. Assessment is a central site of the socialisation through which PIF occurs, yet how learners experience assessment when it is felt to be biassed or exclusionary, and what this means for their identity formation, is not well understood. We aimed to explore if and how medical students experience identity\u2010related challenges, including microaggressions, through assessment and how these experiences shape their developing professional identities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a constructivist qualitative study using semi\u2010structured interviews, analysed through reflexive thematic analysis. Medical students at a single Canadian institution who self\u2010identified in response to an emailed invitation as having had uncomfortable, unsettling or identity\u2010related experiences with assessment were interviewed. Interpretation was guided by identity\u2010threat and identity\u2010safety as sensitising concepts and by an intersectional reading of participants' accounts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We interviewed 22 students (16 pre\u2010clerkship and 6 clerkship), 18 of whom identified as members of underrepresented communities. Participants described assessment as an identity\u2010laden encounter that could threaten belonging and shape professional identity formation. Students from underrepresented communities described experiencing microaggressions through assessment. However, even participants who did not report microaggressions described negative assessment experiences that eroded their sense of belonging. Participants also described how assessment could reinforce harmful biases with the potential to affect patient care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Negative experiences with assessment may be a barrier to trainees' socialisation into the medical profession and can affect patient care through reinforcing harmful stereotypes. Education about microaggressions, professional development on constructing assessment and structuring feedback, access to mentors and safe spaces to debrief may help mitigate these impacts on professional identity formation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/medu.70321","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:56:51Z","timestamp":1790168211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Scripted success, unscripted consequences: How assessments in undergraduate medical education shape physician identity formation"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4319-1011","authenticated-orcid":false,"given":"Justin","family":"Boyle","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Department of Medicine University Health Network  Toronto Ontario Canada"},{"name":"Department of Medicine Mount Sinai Hospital  Toronto Ontario Canada"},{"name":"Wilson Centre for Research in Education University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4595-6650","authenticated-orcid":false,"given":"Shiphra","family":"Ginsburg","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Department of Medicine University Health Network  Toronto Ontario Canada"},{"name":"Department of Medicine Mount Sinai Hospital  Toronto Ontario Canada"},{"name":"Wilson Centre for Research in Education University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000700"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0b013e3182604968"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5334\/pme.1803"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1438082"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.21.5.90"},{"key":"e_1_2_10_7_1","volume-title":"Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care","author":"Smedley BD","year":"2003"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003\u2010066X.62.4.271"},{"issue":"5","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1097\/ACM.0000000000000200","article-title":"Harassment and discrimination in medical training: a systematic review and meta\u2010analysis","volume":"89","author":"Fnais N","year":"2014","journal-title":"Acad Med"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.19.2103"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.7457"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40037\u2010019\u20100516\u20103"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.2723"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnma.2020.11.009"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022\u20103514.69.5.797"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003\u2010066X.52.6.613"},{"key":"e_1_2_10_17_1","first-page":"379","volume-title":"Advances in Experimental Social Psychology","author":"Steele CM","year":"2002"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010009\u20101221\u20104"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000003628"},{"issue":"10","key":"e_1_2_10_20_1","first-page":"1028","article-title":"Who are you and who do you want to be? 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