I am so grateful to have been awarded the ERC Research Paper Award 2021 following presentation of one of the central studies of my thesis at ASME ASM 2021 in the ERC Research Paper Award Finalists session. Before I offer an overview of my research, I must take a moment to draw attention to the important and impressive work of the other finalists: Mr Matt Byrne and the MedEd Collaborative for their study “Examining medical student volunteering during COVID-19 as a prosocial behaviour” and Dr George Choa for their study “Understanding impacts of accreditation on medical teachers and students: A systematic review and meta-ethnography.”

The study I presented was entitled “An international, qualitative analysis of identity performances within Longitudinal Integrated Clerkships.” For those unfamiliar, Longitudinal Integrated Clerkships (LICs) are a model of clinical education where medical students participate in the care of patients over an extended period.

Numerous benefits have been associated with the model, including recruitment and retention to underserved areas, increased empathy, and advocacy for patients. Although the model is increasingly well established, it is not well understood why the model gives rise to such benefits. Professional identity development has been related to career choice within medicine yet, identity research within LICs is relatively novel. This research conducted an in-depth, longitudinal qualitative exploration of medical student identity performances within longitudinal clinical placements at four sites internationally, with the aim of casting light on the process of identity development within LICs, a potential conceptual mechanism underpinning the model's reported benefits.

The core finding of this research concerns the importance of relationships. Students who developed longitudinal relationships with patients voiced an increased sense of responsibility towards their care. Particularly prominent were discussions of the ways in which students developed as advocates for patients, often between care settings where they facilitated communication, health care access, and empowered patients to take more active roles in their own care. Relationships with others also shaped students' performances of their moral identities as future doctors. Though students often began their placements stereotyping patients, there was evidence that the relationships facilitated by the LIC model encouraged students to challenge negative judgements they may have made, which could increase empathy.

Though continuity is lauded as the cornerstone of LICs, this work suggests that it is interpersonal relationships that truly matter. Identity development holds weight as a conceptual mechanism for the potential benefits of the LIC model, and this development occurs through relationships. Suggestions that relationships should drive medical education curricula reform are relatively tentative, though relationships have been explored within specific domains, for example, empathy, interprofessional education. This research emboldens previous observations of scholars researching relationships in the field into a call to action—a call for clinical education to be remoulded in the pursuit of relationship-based education. Given the impact of relationships on identity and their potential association with the numerous benefits of the LIC model such as advocacy and empathy, relationships should direct medical education curricula design and delivery.

ETHICS STATEMENT

Ethical approval was obtained at each site for the empirical research. No ethical approval was necessary for this commentary.

CONFLICT OF INTEREST

No conflicts of interest or funding to declare.

ACKNOWLEDGEMENT

Thank you to my thesis advisor Professor Gabrielle Finn, without whom this research would not have been possible. Thank you also to my collaborators at each site - Dr Andrew O'Regan, Dr Maggie Bartlett, Dr Catherine Ard, and Professor Jennifer Adams. Once again I must acknowledge the wonderful research of Mr Matthew Byrne, the MedEd Collaborative, and Dr George Choa for creating such an engaging and thought-provoking finalists session.