The professional identity formation of undergraduate and postgraduate medical students: An umbrella review

INTRODUCTION: Professional Identity Formation (PIF) is a dynamic and essential process in medical education, involving the integration of personal and professional values throughout the educational continuum. This umbrella review aimed to synthesise evidence on theories, influencing factors, educational strategies, and assessment tools related to PIF. METHODS: This review was conducted following the Joanna Briggs Institute (JBI) guidelines and a protocol registered with PROSPERO. Meta-analyses, systematic and scoping reviews with quantitative and qualitative analyses, published in English, Portuguese, or Spanish, were included. The search was performed in databases such as PubMed, Embase, and Cochrane, with no restrictions on date of publication or location. Study screening and selection were carried out by independent reviewers and the methodological quality was assessed using the JBI checklist. RESULTS: Thirteen reviews were included, encompassing 1,442 primary studies. The evidence was organised into four categories: foundations of PIF, processes and influential factors, educational approaches, and assessment of PIF. Strategies such as mentorship, guided reflective practice, longitudinal clinical clerkships, and role modelling demonstrated effectiveness in promoting PIF. Assessment methods, including portfolios and reflection scales, were identified, but robust psychometric evidence remains limited. DISCUSSION: This review is the first umbrella review to synthesise knowledge on PIF, highlighting its dynamic and iterative nature, involving cycles where professional values integrate into personal beliefs during training. PIF is increasingly recognised as essential, but further studies are needed on diverse global contexts, demographic influences, and methodological rigour in assessment. Theoretical frameworks are increasingly hybrid, combining constructive theories that stress social mediation with personality models to maximise educational impact. Reflective practice, authentic clinical experiences, positive role modelling, mentoring, and integrated professionalism teaching consistently promote value internalisation and successful student-to-physician transition. We propose that assessment rigour should align with PIF's nature, urging future research to use methods capable of capturing its complexity.