Royal College of Surgeons in Ireland
ryan-et-al-2023-professional-identity-formation-professionalism-leadership-and-resilience-pillar-in-medical-students.pdf (286.46 kB)

Professional Identity Formation, Professionalism, Leadership And Resilience (PILLAR) in medical students: methodology and early results

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Objectives: The fundamental role of medical education is the transformation of students to doctors, through a process of education and professional identity formation (PIF), which can be informed by several educational, behavioural and emotional factors. PIF has been deemed to be of equal importance to the acquisition of clinical knowledge and skills and includes constructs such as professionalism, leadership and resilience. We aimed to assess professional identity formation, professionalism, leadership and resilience (PILLAR) in the junior years of medical school in the 2020/2021 academic year and illustrate the potential role of quantitative assessment to demonstrate progression in these areas. In this research, we provide the methods and baseline results for the PILLAR study.

Methods: We implemented a compulsory assessment in pre-clinical years of graduate entry and direct entry medicine at the Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland. Validated scales were used to assess students' PILLAR. Descriptive and univariable statistical techniques were used to compare student scores between respective years.

Results: A total of 1311 students (92% response rate) provided their consent for research. For the psychometric scales, there were no evident trends among the years on these assessment measures. Results indicated significant differences in all measures, however, these did not correspond to ascending years of seniority.

Conclusion: The PILLAR methodology provides important information on the challenges of quantitatively assessing medical students in the four key areas of PIF, professionalism, leadership, and resilience. Our cross-sectional results point to cohort effects, without the expected progression per year in the cross-sectional data, or suggest that the chosen quantitative measures may be problematic for these constructs in pre-clinical students. Therefore, while we believe that PILLAR has potential as a progress test for these constructs, this will only truly be elucidated by repeated measures of each cohort over time.


Deputy Dean for Positive Education | Funder: RCSI | Grant ID: A Hickey Deputy Dean Award

Bons Secours Health System



The original article is available at Pre-print is available on Research Square, and RCSI repository

Published Citation

Ryan A, Hickey A, Harkin D, Boland F, Collins ME, Doyle F. Professional Identity Formation, Professionalism, Leadership And Resilience (PILLAR) in medical students: methodology and early results. J Med Educ Curric Dev. 2023;10:23821205231198921.

Publication Date

6 September 2023

PubMed ID



  • Medical Professionalism
  • Health Psychology
  • School of Population Health
  • Data Science Centre
  • Graduate School of Healthcare Management

Research Area

  • Surgical Science and Practice
  • Vascular Biology
  • Health Professions Education
  • Population Health and Health Services


SAGE Publications


  • Published Version (Version of Record)