Uncovering transformative processes: Critical events shaping professional identity during advanced pharmacy practice...

Professional identity formation (PIF) is precipitated by experiences that influence students' views, and prompt reflection and change. Understanding these experiences and how they support PIF are essential if pharmacy educators are to help learners navigate their PIF journey. This study aims to identify key critical events that influence PIF during advanced pharmacy practice experiences (APPEs).

Using a critical event narrative inquiry approach, one-on-one semi-structured interviews were conducted with pharmacy students from three universities who had completed at least one direct patient care APPE. Interviews were coded and analyzed using narrative analysis. After inductive analysis, self-authorship theory (SAT) and self-determination theory (SDT) were applied to further elucidate the PIF processes in participants' narratives.

Twenty-two students described 35 critical events involving patient or provider interactions, internal cognitive processes, or observations of preceptors. Students entered APPEs with preconceptions about pharmacist roles. Critical events disrupted these assumptions, enabling students to develop insights into the enactment of pharmacist role elements (e.g., patient-centered care, interprofessional collaboration, professional autonomy and responsibility, clinical decision-making, safeguarding medications). Students' narratives reflecting early SAT identity-forming phases discussed the impact of observing role models on their practice. Later identity-forming SAT phase students took on greater independence, actively enacting their emerging professional identities. SDT highlighted the role of autonomy, competence, and relatedness during critical events in enhancing motivation and internalization of identity.

APPE-related critical events shaped pharmacy students' professional identities by challenging early assumptions, supporting movement toward self-authorship, and strengthening confidence, identity, and clarity in their intended career paths.