BMC medical education · 2026
Professional socialization as a complex adaptive process: a systematic scoping review and integrative theory of professional identity formation.
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Goh Suzanne Pei Lin, Akbar Mikail Faris, Teo Anton Zhi Hao, A Priyadarshini, Leong Jun Rey, Sinnathamby Annushkha, Ong Eng Koon, Murugam Vengadasalam, Lim Ying Yin, Lim Crystal, Shaik Muhammad Amin, Krishna Lalit Kumar Radha
Аннотация
BACKGROUND: Professional socialization is central to professional identity formation (PIF), shaping how physicians think, act, and feel within their roles. Despite sustained scholarly attention and curricular innovation, there remains limited understanding of how professional socialization actually operates, or why individuals exposed to similar training environments develop markedly different professional identities.
METHODS: To examine this, we conducted a systematic scoping review using an AI-supplemented modified Systematic Evidence-Based Approach (mSEBA) to examine current theories of professional socialization. Searches across major databases and grey literature identified 46 empirical and theoretical articles, encompassing 43 theories across medicine, nursing, pharmacy, and allied health professions. A multi-stage analytic process involving thematic analysis, content analysis, and triangulation was used to synthesize findings.
RESULTS: Across included theories, professional socialization consistently emerged as a non-linear, context-sensitive process characterized by individual variation and feedback-driven adaptation. Synthesis of the literature revealed recurring patterns highlighting the importance of belief integration, identity coherence, and contextual navigation in shaping PIF. Viewed collectively, existing theories align with key features of complex adaptive systems but do not fully explain the inner processes through which individuals integrate experiences and develop stable professional identities.
CONCLUSION: This review therefore reframes professional socialization as a belief-mediated complex adaptive process, and introduces the Krishna Theory of Socialization, an integrative framework that links system-level influences with belief-mediated identity work and a longitudinal trajectory of socialization. This theory offers a coherent account of how professional identities form, stabilize, and adapt over time, providing a conceptual foundation for future research, educational design, and learner support across health professions.
METHODS: To examine this, we conducted a systematic scoping review using an AI-supplemented modified Systematic Evidence-Based Approach (mSEBA) to examine current theories of professional socialization. Searches across major databases and grey literature identified 46 empirical and theoretical articles, encompassing 43 theories across medicine, nursing, pharmacy, and allied health professions. A multi-stage analytic process involving thematic analysis, content analysis, and triangulation was used to synthesize findings.
RESULTS: Across included theories, professional socialization consistently emerged as a non-linear, context-sensitive process characterized by individual variation and feedback-driven adaptation. Synthesis of the literature revealed recurring patterns highlighting the importance of belief integration, identity coherence, and contextual navigation in shaping PIF. Viewed collectively, existing theories align with key features of complex adaptive systems but do not fully explain the inner processes through which individuals integrate experiences and develop stable professional identities.
CONCLUSION: This review therefore reframes professional socialization as a belief-mediated complex adaptive process, and introduces the Krishna Theory of Socialization, an integrative framework that links system-level influences with belief-mediated identity work and a longitudinal trajectory of socialization. This theory offers a coherent account of how professional identities form, stabilize, and adapt over time, providing a conceptual foundation for future research, educational design, and learner support across health professions.