Authors
Sin-Yee Patty Kwong, Hui-Ting Wang, Shiuan-Ruey Yu, Yu-Che Chang, Ming-Der Perng, Hsu-Min Tseng, Chung-Hsien Chaou
Published in
Medical education. Jul 19, 2026. Epub Jul 19, 2026.
Abstract
Medical students entering through undergraduate-entry (UEMS) and post-baccalaureate (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.
This multi-institutional 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-entry and post-baccalaureate 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-structured 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.
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-like 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-reflection 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.
Applying TLT revealed distinct role-transition patterns in UEMS and PBMS. UEMS may benefit from early emotional scaffolding, structured orientation and guided reflection, whereas PBMS may benefit from autonomy-supportive 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.
PMID:
42472989
Bibliographic data and abstract were imported from PubMed on 20 Jul 2026.
Read full publication at:
Please sign in
to see all details.
Advertisement
Stats
- Recommendations n/a n/a positive of 0 vote(s)
- Views 6
- Comments 0