Professional identity formation through reflection: physicians' sensemaking of past learning experiences and current practices.

Introduction
Professional identity formation (PIF) is a cornerstone of medical education. Residency programs often apply group-based learning approaches to foster PIF. However, little is known about how learning experiences in these settings continue to shape PIF after graduation. This study explores 1) how graduated physicians retrospectively make sense of their experiences with supervised collaborative reflection (SCR), a group-based reflective learning approach used during residency, and 2) how these experiences inform their current professional practice.

Methods
We conducted a qualitative study using an interpretative phenomenological analysis approach. We performed semi-structured interviews with 15 general practitioners and elderly care physicians, recruited from four Dutch training institutes.

Results
Three aspects of SCR were salient in participants' sense-making of their experiences: SCR as a structured educational approach, the small-group setting in SCR, and the role of the supervisor. Participants described SCR experiences as informing their current practice in five aspects: internalising and integrating reflective practice into professional work, developing awareness of personal and others' perspectives, developing relational and reflective communication, navigating emotional development, and maintaining personal wellbeing.

Discussion
This study explored how physicians make sense of SCR learning experiences and how these continue to inform their current practice. Participants described reflective practice as becoming internalised and integrated in their way of working and as meaningful in shaping awareness, relational communication, emotional development, and personal wellbeing. Taken together, these experiences portray the internalisation and integration of reflective practice in professional practice and illustrate how early-career physicians incorporate this reflective practice into their evolving professional identity.