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Tracing Professional Identity Development through Mixed-Methods Data Mining of Student Reflections

Alyssa Wise, Sameen Reza & Rujun Han

ICLS 2020

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Professional Identity in Healthcare Professions

As a result, identity is focused as much as competency in healthcare professional education

Efficiently translating knowledge into action

Described as feeling part of an identified group by sharing values and beliefs

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

Internalizing norms of the profession to start thinking, acting and feeling like a physician

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Prior Work on Professional Identity (1 of 2)

  • Two conceptual models of professional identity

“I” as a Professional

Is

Does

Shows

Knows

“Progressive Stages”

“Closing the Gap”

What Do I Aspire to Become?

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

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Prior Work on Professional Identity (2 of 2)

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

Used cross sectional data which precludes analysis of how professional identity develops

Focused on quantitative evaluation of professional identity development

Reported mixed results about when development happens

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Novel Use of Reflective Writing

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

Can identify important elements about how students think and learn over time

Authentic as written by students in response to real situations

Written on ongoing manner provides basis for use in longitudinal studies

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Contributions of the Current Study

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

Uses quantitative approach as a “way into large corpus of text

Uses reflection text to study how students think

Investigates how professional identity development takes place

provides the students’ own perspective on professional identity rather than a “text book” definition

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Research Purpose

RQ1: What are key concepts related to how students think about becoming a dentist?

RQ2: How do these concepts change over time?

Use student own reflections to trace their conception of the profession and their identity as professionals

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

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Research Context

Reflection Categories

  • Course
  • Competency Exams
  • Knowledge
  • Professional Development Statements

Online Portfolio System

Extracted Reflection Data

  • 378 Students over 4 years
  • 284,320 Reflections of all Types
  • 12,564 Professional Development Statements

Professional Development Statement

The past four years have set the foundation for my continuous evolution into a professional. I have gained clinical knowledge and have become competent and proficient in various procedures. I recognize that there are still many gaps in my knowledge and I hope to fill those gaps in knowledge and skill in residency and through other post graduate training. .”

INTRODUCTION

METHODS

IMPLICATIONS

FUTURE WORK

FINDINGS

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Analytic Process

Word Embedding Modelling

(Quant)

Clustering

(Quant)

All Reflection Statements submitted in all Categories

{Course, Competency, Knowledge Inventory & Professional Development Statements}

Concept Characterization

Building Concept Networks

(Quant)

Concept Labelling and

Interpretation (Qual.)

Professional Development Statements

Start

Middle

End

150 sentences per concept

150 sentences per concept

150 sentences per concept

Concept Identification

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

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Word Embedding Model

engine

engineer

battery

charger

Requires large number (~billions) words to train

Captures information about similarity in use

Building Concept Networks

Concept Labelling and Interpretation

Word Embedding Modelling

Clustering

Concept Identification 1

  • Represents words as vectors
  • Allows words with similar meaning to have a similar representation.
  • Can be created from scratch or can use pre trained vectors
  • New models need very large amount of data; pre-trained requires tuning

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

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Word Embedding Model Construction

  • 6,752,282 instances of 11,604 unique words
  • Refined a pre-trained data made available by fastText using all ~6 million words in the reflection data
  • Created a 50 dimensional model

Building Concept Networks

Concept Labelling and Interpretation

Word Embedding Modelling

Clustering

Concept Identification 1

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

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Clustering

  • Removed stopwords, dates, punctuation marks and meaningless characters
  • Selected top 127 words after examining major drops in usage frequency
  • Used Agglomerative Clustering using Ward’s method (Euclidean distance)
  • Produced 13-18 plausible cluster solutions

Building Concept Networks

Concept Labelling and Interpretation

Word Embedding Modelling

Clustering

Concept Identification 2

`

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

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Clustering Results

  • Selected 18 clusters solution after examining constituent words
  • Words in a cluster ranged from 2 to 18 words per cluster
  • A cluster of words = Concept

becoming

ethical

important

believe

professional

us

dentists

respect

responsibility

trust

professionals

Building Concept Networks

Concept Labelling and Interpretation

Word Embedding Modelling

Clustering

Concept Identification 2

`

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

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Concept Characterization Process

Edge weight: Sentence based frequency of word co-occurrence

Building Concept Networks

Concept Labelling and Interpretation

Word Embedding Modelling

Clustering

Concept Characterization 1

  • Used reflection sentences submitted at start middle and end of program
  • Node & Edges based of sentence based word frequency and word co-occurrence
  • Concept networks built for each of 18 concepts, at three points in time
  • Start: 3,772 sentences; Middle: 4,160 sentences: End: 12,531 sentences

Node Size: Sentence based frequency of word

Clustering Results

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

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Concept Labelling and Interpretation (1 of 2)

  • Sample of 150 sentences for each concept at start, middle and end of program
  • Used network structure to extract sample of sentences
  • Examination Within a concept : overall -> in each time period
  • Between concepts for distinguishing and characterizing

“The other aspect of becoming a professional…” (Middle)

“I believe that becoming a professional ….” (Start of Program)

“I realize how becoming a professional requires” .. (End)

Building Concept Networks

Word Embedding Modelling

Clustering

Concept Characterization 2

Concept Labelling & Interpretation

INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

METHODS

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Concept Characterization Process (2 of 2)

Concept Characterization 2

  • Sample of 150 sentences for each concept at start, middle and end of program
  • Used network structure to extract sample of sentences
  • Examination Within a concept : overall ->in each time period
  • Between concepts for distinguishing and characterizing

Concept Labelling & Interpretation

Building Concept Networks

Word Embedding Modelling

Concept #

Concept Network

Examples from Year 1

Examples from Year 3

Examples from Year 4

Concept Themes & Description

1

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blank

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blank

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2

blank

blank

blank

blank

blank

3

blank

blank

blank

blank

blank

4

blank

blank

blank

blank

blank

blank

blank

blank

blank

blank

18

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INTRODUCTION

IMPLICATIONS

FUTURE WORK

FINDINGS

Clustering

METHODS

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RQ1. Key Concepts of Professional Identity (1 of 13)

COMPETENCE AND PROFESSIONALISM

  • Becoming a Professional
  • Field of Dentistry
  • Become a Competent Dentist
  • Gain Knowledge and Skills
  • Life Vision

WHAT IT MEANS TO BE A DENTIST

  • Providing Best Patient Care
  • Responsibility as Professionals
  • Promoting Oral Health

DEVELOPING SELF-AWARENESS

  • Confidence Through Progress
  • Knowing Oneself as a Dentist

COMMUNITY AND CULTURE

  • Becoming Part of Community
  • Collaborative Environment

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (2 of 13)

COMPETENCE AND PROFESSIONALISM

  • These 5 concepts together describe:
  • Values associated with the dental profession
    • Becoming a Professional
    • Field of Dentistry
  • Reflection on their life long goals
    • Life Vision
  • Strategy to attain competence and knowledge
    • Become a Competent Dentist
    • Gain Knowledge and Skills

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (3 of 13)

  • These 5 concepts together describe:
  • Values associated with the dental profession
    • Becoming a Professional
    • Field of Dentistry
  • Reflection on their life long goals
    • Life Vision
  • Strategy to attain competence and knowledge
    • Become a Competent Dentist
    • Gain Knowledge and Skills

”Being a professional means the standards of ethics, and doing good for your patients and living your professional and personal life serving your patients and the community”

COMPETENCE AND PROFESSIONALISM

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (4 of 13)

  • These 5 concepts together describe:
  • Values associated with the dental profession
    • Becoming a Professional
    • Field of Dentistry
  • Reflection on their life long goals
    • Life Vision
  • Strategy to attain competence and knowledge
    • Become a Competent Dentist
    • Gain Knowledge and Skills

“… would like to become a competent and skillful dentist, I want to be proficient, both in procedure and patient interaction so I can develop meaningful patient relationships”

COMPETENCE AND PROFESSIONALISM

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (5 of 13)

WHAT IT MEANS TO BE A DENTIST

These 3 concepts together describe:

  • Broad responsibilities of dental health professionals
    • Responsibility as Professionals
  • Specific role as care providers
    • Provide the Best Patient Care
    • Promoting Oral Health

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (6 of 13)

The last several years have given me a real perspective on the trust that is placed on us as professionals to do right by our patients.”

WHAT IT MEANS TO BE A DENTIST

These 3 concepts together describe:

  • Broad responsibilities of dental health professionals
    • Responsibility as Professionals
  • Specific role as care providers
    • Provide the Best Patient Care
    • Promoting Oral Health

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (7 of 13)

“It is very important to understand patients' concerns, needs, and expectations in order to provide a satisfactory result without compromising much of the ideal treatment objectives”

WHAT IT MEANS TO BE A DENTIST

These 3 concepts together describe:

  • Broad responsibilities of dental health professionals
    • Responsibility as Professionals
  • Specific role as care providers
    • Provide the Best Patient Care
    • Promoting Oral Health

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (8 of 13)

DEVELOPING SELF-AWARENESS

These 2 concepts together describe:

  • Growing awareness of the kind of dentist they wish to become
    • Know Oneself as a Dentist
  • Increasing confidence in abilities
    • Confidence With Progress

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (9 of 13)

DEVELOPING SELF-AWARENESS

These 2 concepts together describe:

  • Growing awareness of the kind of dentist they wish to become
    • Know Oneself as a Dentist
  • Increasing confidence in abilities
    • Confidence With Progress

“I have been able to think through these situations and come to understand that when it comes to health care there should not be any gray zone in ethics.”

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (10 of 13)

DEVELOPING SELF-AWARENESS

These 2 concepts together describe:

  • Growing awareness of the kind of dentist they wish to become
    • Know Oneself as a Dentist
  • Increasing confidence in abilities
    • Confidence With Progress

“Professional progress is becoming more exciting and I feel more confident about certain procedures, for example, I was terrified about…,however I feel more confident during these procedures.”

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (11 of 13)

COMMUNITY AND CULTURE

These 2 concepts together describe:

  • Belonging to a broader community of professionals
    • Become Part of a Community
  • Close connection with faculty, peers and colleagues
    • Collaborative Environment

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (12 of 13)

These 2 concepts together describe:

  • Belonging to a broader community of professionals
    • Become Part of a Community
  • Close connection with faculty, peers and colleagues
    • Collaborative Environment

COMMUNITY AND CULTURE

“Being part of the dental profession gives me a strong sense of pride and professional community, therefore I will strive to give back to this community as well as to keep up with the latest advancements.”

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ1. Key Concepts of Professional Identity (13 of 13)

COMMUNITY AND CULTURE

These 2 concepts together describe:

  • Belonging to a broader community of professionals
    • Become Part of a Community
  • Close connection with faculty, peers and colleagues
    • Collaborative Environment

“I have learned how to brainstorm ideas with my colleagues and my faculty over complicated treatment plans, and have learned to work with dental hygienists and dental assistants so that we can more efficiently provide the best care”

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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What Concepts Were Important to Dental Students’ Professional Identity at the End of Their Program? (1 of 3)

Concept Prevalence Indexed by Proportion of Sentences Containing Top 2 Concept Words

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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What Concepts Were Important to Dental Students’ Professional Identity at the End of Their Program? (2 of 3)

Concept Prevalence Indexed by Proportion of Sentences Containing Top 2 Concept Words

-Know Oneself as Dentist

-Field of Dentistry

-Gain Knowledge and Skills

-Become a Competent Dentist

-Confidence Through Progress

MODERATE PREVALENCE CONCEPTS

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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What Concepts Were Important to Dental Students’ Professional Identity at the End of Their Program? (3 of 3)

Concept Prevalence Indexed by Proportion of Sentences Containing Top 2 Concept Words

-Providing the Best Patient Care

-Becoming a Professional

HIGH PREVALENCE CONCEPTS

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ2: How Do the Concepts Change Over Time? (1 of 4)

Moderately Prevalent Concepts

Start

Middle

End

Knowing Oneself as a Dentist

31%

35%

33%

Confidence Through Progress

17%

26%

28%

Become a Competent Dentist

26%

17%

16%

Gain Knowledge and Skills

20%

15%

15%

Field of Dentistry

16%

11%

14%

Highly Prevalent Concepts

Start

Middle

End

Providing Best Patient Care

32%

38%

37%

Becoming a Professional

36%

35%

36%

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ2: How Do the Concepts Change Over Time? (2 of 4)

  • broad abstract definitions to concrete views, inclusion of ethical perspective as well as personal perspective

Becoming a Professional:

Start of Program

requires excellent knowledge, societal responsibility, sincere concern, compassion for others

End of Program

“..important component is taking responsibility for our patients and try to respect and understand patients' point of view without compromising to provide standard treatment care”

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ2: How Do the Concepts Change Over Time? (3 of 4)

  • Shift in focus from self as provider to incorporating patients needs

Providing the Best Patient Care:

Start of Program

“acquire the skills to provide excellent quality care to patients as a well-rounded confident dentist

End of Program

“important to understand patients' concerns, needs, and expectations in or order to provide a satisfactory result

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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RQ2: How Do the Concepts Change Over Time? (4 of 4)

  • Transition from using third person “them” to first person “us”, and “we”

Responsibility as Dentists

Start of Program

“healthcare professionals who all work together for the betterment of their patients

End of Program

We won't just be titled as dentists in dental office, but society will see us as healthcare professionals so we must act the part

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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Alignment with and Redefinition of

“Closing the Gap”

FINDINGS

Gain Skills and Knowledge

...

“field of dentistry entails showing up to appointments on time, treating patients with respect, …ability to provide competent care

Field of Dentistry

...

to become a competent and skillful dentist, I want to be proficient, both in procedure and patient interaction”

Become a Competent Dentist

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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New Finding

Personal Perceptions of Professional Identity

FINDINGS

“I have been able to think through these situations and come to understand that when it comes to health care there should not be any gray zone in ethics.”

Know Oneself as a Dentist

“During my residency next year I plan on further establishing my competence in being an ethical professional.”

Becoming a Professional

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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New Indicators of Professional Identity Development

FINDINGS

“important to understand patients' concerns, needs, and expectations in order to provide a satisfactory result…”

Providing the Best Patient Care

“..Professional progress is becoming more exciting and I feel more confident about certain procedures, for example…”

Confidence Through Progress

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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Broader Definitions of Responsibility as Dentists

FINDINGS

“The last several years have given me a real perspective on the trust that is placed on us as professionals to do right by our patients..”

Responsibility as Professionals

“…I have learned how to emphasize on educating and promoting oral health to every patient that I treat, since I feel that this is the duty of a dental professional”

Promoting Oral Health

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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Important Conclusions

  • Students see themselves as “closing the gap” to become a professional in multiple and varied ways
  • Students redefine and reconstruct the gap based on evolving personal views of becoming a professional
  • Patient centered care is an important component of professional identity
  • Increased confidence is an important indicator of development

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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Implications for Practice

  • Need more nuanced ways to observe and evaluate professional identity than a single scale
  • A multidimensional model can help identify small developments as they take place in different aspects
  • Teachers and mentors can use this information to leverage support in focused areas
  • Teachers and mentors can support professional identity development in personal ways

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

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QUESTIONS?

Thank You

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS

Alyssa Wise, Sameen Reza and Rujun Han

alyssa.wise@nyu.edu

@alywise

sr4918@nyu.edu

@SameenReza

@NYU_LEARN

https://nyu.edu/learn-analytics

rujunhan@usc.edu

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Future Work

FINDINGS

  • Examination of trajectories of identity development by individual students
  • Provide individual feedback and support to each student
  • Parallel work using other reflection text to identify and support the important process of identity development across disciplines

IMPLICATIONS

FUTURE WORK

FINDINGS

INTRODUCTION

METHODS