Not all reflection is equal: Reflective practice, not self‐reflection, correlates with Indonesian medical students' professional identity formation

BACKGROUND: Professional identity formation (PIF) plays a significant role in the development of medical students, with reflection expected to help learners align their personal values with the expectations of the profession. While theoretical models propose that reflection and PIF advance hand in hand, empirical studies suggest that the various types of reflection may evolve independently. In this study, we aimed to (a) investigate the levels of PIF, reflective practice and self-reflection and insight across academic years, and (b) assess whether reflective practice and self-reflection and insight are significant predictors of medical students' PIF. METHODS: We conducted a cross-sectional quantitative study that included 1401 medical students from four universities in Indonesia. Participants completed a demographic questionnaire along with the Professional Identity Formation (PIF) questionnaire, Reflective Practice Questionnaire (RPQ) and Self-reflection and Insight Scale (SRIS). We used one-way ANOVA to examine the differences of PIF, RPQ and SRIS across the academic years; Pearson correlations to examine the association between PIF, RPQ and SRIS; and regression analysis to assess the predictive value of RPQ and SRIS on PIF. RESULTS: Both PIF (F = 32.221, p < 0.001) and reflective practice (F = 6.796, p < 0.001) increased across academic years, while self-reflection and insight remained stable (F = 1.683, p = 0.136). Reflective practice correlated with PIF (r = 0.420; p < 0.001), while self-reflection and insight did not (r = -0.017; p = 0.528). Reflective practice was a significant predictor of PIF in the regression analysis (B = 0.674, p < 0.001). CONCLUSION: Reflection on practice associates with professional identity formation in medical students, but self-reflection and insight do not.