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Applying Transformative Learning Theory to Compare Role Transition in Undergraduate-Entry and Post-Baccalaureate
Sin-Yee Patty Kwong1,2, Hui-Ting Wang3,4, Shiuan-Ruey Yu1,2
1Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Medical Education
|July 19, 2026
Summary
Undergraduate-entry medical students (UEMS) and post-baccalaureate medical students (PBMS) experience distinct role transitions. Tailoring educational strategies to UEMS and PBMS learning needs can improve clinical training inclusivity and responsiveness.
Area of Science:
- Medical Education
- Qualitative Research
- Transformative Learning Theory
Background:
- Undergraduate-entry medical students (UEMS) and post-baccalaureate medical students (PBMS) differ in life experience and prior healthcare exposure.
- These differences may influence their transition into early clinical training.
- Mezirow's Transformative Learning Theory (TLT) can examine these role transition experiences.
Purpose of the Study:
- To compare the role transition experiences of UEMS and PBMS during early clinical training.
- To analyze disorienting experiences, reflective processes, and sense of role evolution using TLT.
Main Methods:
- A multi-institutional longitudinal qualitative cohort study from 2023-2025.
- Tracked 81 medical students (53 UEMS, 28 PBMS) from six Taiwanese universities.
- Analyzed semi-structured interviews and audio diaries from 61 participants using thematic analysis and TLT phases.
Main Results:
- Both UEMS and PBMS faced emotional challenges, but with differing intensity and nature.
- UEMS reported anxiety and imposter feelings, relying on peer support.
- PBMS demonstrated better emotional regulation and faster adjustment, leveraging prior experience.
- Five shared TLT-based themes emerged, but differed in timing, depth, and expression between pathways.
Conclusions:
- TLT revealed distinct role-transition patterns for UEMS and PBMS.
- UEMS may benefit from emotional scaffolding and guided reflection.
- PBMS may benefit from autonomy-supportive environments acknowledging prior experience.
- Tailored educational strategies can enhance clinical training inclusivity and development.
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