Formation of Characteristics of a Self-Actualizing Personality among Medical Students

Improving the quality of physician training includes the development of professionally important qualities during the period of study at a university. Psychological and pedagogical support for medical university students has not been sufficiently developed and is rarely implemented. The work is aimed at studying the formation of the qualities of a self-actualizing personality among medical university students. The authors developed and substantiated a model of psychological and pedagogical support for the formation of a complex of personal protective skills for future doctors. The authors presented the results of an empirical study obtained on a sample of 180 5th year medical university students with specialties in General Medicine and Dentistry (90 people – experimental group participating in the experimental program, 90 people – control group). The researchers used the self-actualization test technique of E. Shostrom in adaptation of L.Ya. Gozman and M.V. Crozat. The results obtained indicate that indicators of the characteristics of a self-actualizing personality change statistically significantly after participation in the experimental program. These studies can be used as an effective means of professional development for future and practicing doctors.

Introduction

The period of study in a higher education institution marks a critical stage in the professional formation of an individual, during which the development of professionally important qualities (PIQs) for future specialists begins [1]. The formation and development of PIQs are influenced by the requirements of the Federal State Educational Standards (FSES) and the "social order." As the evaluation of a doctor's competence and professionalism has become increasingly complex and pervasive, the higher professional education system faces the challenge of implementing effective training methods to ensure specialists meet both professional and societal expectations [25]. In the medical field, the cultivation of significant professional qualities is crucial for the effective performance of a specialist [22; 23]. However, the selection of applicants to medical universities currently relies solely on academic performance, disregarding the personal qualities of future doctors—a situation that is similarly observed in other countries [26].

The selection of essential professional qualities is based on the functional composition of medical activities. This involves complex types of labor within the "human-human" system, necessitating a broad education, a drive for professional growth, and the ability to perform diverse and intricately structured methods and techniques. These professional activities place specific demands on the worker [13, p. 130].  The study addresses the problem of a discrepancy between the need to develop a set of Professionally Important Qualities (PIQs) for future doctors and the lack of psychological and pedagogical support for this process in medical schools. The study hypothesizes that psychological and pedagogical support for medical students will transform their self-perception as professional practitioners and foster traits associated with a self-actualizing personality, such as self-acceptance, self-esteem, synergy, and spontaneity.

Numerous normative documents, particularly the concept for developing continuous medical and pharmaceutical education in the Russian Federation up to 2025, emphasize promoting professional and personal growth through educational programs and independent intellectual activities (self-education, informal, or spontaneous education). The objective of personal growth and self-realization is highlighted. Besides developing infrastructure and technologies for continuous adult education to ensure personal growth and self-realization across various adult categories, it is crucial that specialists are motivated to engage in individual cognitive activities and strive for professional improvement [19].

According to E.A. Klimov's classification, medical activity belongs to the socionomic type due to its foundation in the complex "doctor-patient" relationship, encompassing professional, moral, ethical, aesthetic, economic, and legal dimensions. Key components include a creative mind, the ability to predict and model various probable outcomes due to non-standard situations and the unstructured nature of medical work, and the ability to listen and understand others. This requires observation, responsiveness, and tact, reflecting high competence in communication and deontological qualities. Additionally, a developed mindset, high cognitive motivation, a desire for knowledge, and qualities like humanism, duty, and altruism are essential [10; 11].

Self-actualization refers to the capacity to independently make life choices and achieve goals. According to E.E. Vakhromov, its goal is the fullest development of abilities and psychological growth, achievable only through socially oriented activities [3]. I.A. Ankindinova defines self-actualization as realizing one's abilities and personal potential, driving both professional and personal growth [2].

Independent activity and the pursuit of one's highest potential lead to self-realization, an ethically meaningful, eudemonic lifestyle. Personal growth and fulfillment are central aspects of this process, achievable through self-directed efforts and realizing professional potential [28].  Self-actualizing personality traits empower future doctors to interact actively and creatively with their environment, develop a humane approach to patients, and offer avenues for personal and professional growth. For physicians, important self-actualizing traits include self-acceptance, self-esteem, synergy, and spontaneity within the PIQ complex. These traits, identified through theoretical analysis and confirmed by practical research, enhance the effectiveness of doctors in the expert group who possess them [5].

Methods

In our study devoted to psychological and pedagogical support of the formation of professionally important qualities of the personality of future doctors, conducted from 2016 to 2020, under the concept of a set of professionally important qualities of the personality of a future doctor [7], we proposed a set of personal and volitional qualities, traits of self-actualizing personality, and value orientations.

In order to implement the formation of the above-mentioned traits, we have developed and justified a model of psychological and pedagogical support for the formation of a set of professionally important personality traits in future doctors. The characteristic feature of this model is the presence of a clear structure of components that are related to each other and ordered. The model outlines the following components: the goal, which is to develop a set of professionally important qualities in future doctors; specific tasks; the targeted qualities, which include personal traits, characteristics of a self-actualizing personality, volitional qualities, and a value orientation towards serving others; the approaches used to cultivate these qualities; the psychological and pedagogical conditions required; the content and tools—specifically, the program for psychological and pedagogical support; the forms and methods of implementation; and the expected outcomes [6].

As part of the study, a formative experiment was conducted with 180 fifth-year medical university students (average age 24.7, SD = 3.41; 102 women and 78 men) from the Faculties of Medicine and Dentistry. The experimental group, consisting of 90 randomly selected students (59% women and 41% men, including 45 from the Faculty of Medicine and 45 from the Faculty of Dentistry), participated in a 144-hour program of psychological and pedagogical support aimed at developing professionally important qualities (PIQs) in future doctors. The control group also included 90 students (54% women and 46% men) but did not participate in the program. Diagnostics of self-actualization levels were conducted for both groups one week before the program began. The experimental group attended classes twice a week for three academic hours over six months, while the control group did not participate. The program, designed by the authors, comprised three blocks: educational, corrective-developmental, and consultative, each employing specific forms and methods of work [6]. Through their participation, students developed an understanding of PIQs and their roles as effective professionals. Activities such as trainings, reflective exercises, case studies, and situational tasks encouraged the development of self-esteem, sensitivity, interpersonal skills, flexible behavior, creativity, spontaneity, and synergy. At the end of the cycle, both the experimental and control groups were re-diagnosed to assess the level of self-actualization and its various characteristics using the E. Sjostrom Self-Actualization Test (SAT) adapted by L.Y. Gozman and M.V. Kroz.[8]. The reliability of the results was verified using mathematical statistics methods (Wilcoxon and Mann-Whitney criteria).

Results

Before the experiment, researchers observed no statistically significant differences in self-actualization indicators between the control and experimental groups.

Table 1 presents the indicators of a self-actualizing personality before and after participation in a program designed to help future doctors develop essential career-related personality traits.

Statistical analysis using the Wilcoxon criterion revealed significant improvements in self-actualizing personality indicators such as self-acceptance (Z = -3.625; p≤0.01), self-esteem (Z = -4.359; p≤0.01), and synergy (Z = -4.524; p≤0.01). There were also notable trends for spontaneity (Z = -3.602; p≤0.1), contact (Z = -1.762; p≤0.1), and creativity (Z = -3.662; p≤0.1).

Qualitative analysis showed that participation in the psychological and pedagogical support program significantly increased the number of students with high scores in self-acceptance, rising from 13% to 40%.

The percentage of students with high self-esteem in the experimental group increased from 27% to 67%.

As a result of the experiment, the proportion of future doctors with high synergy scores rose from 40% to 70%.

Additionally, 87% of students exhibited high levels of spontaneity after the program, compared to 73% before the experiment.

Participation in the support program also increased the number of future doctors with high scores in contact skills, essential for communicative abilities and competence, from 43% to 60%.

The number of students in the experimental group with high creativity scores significantly rose from 50% to 77%.

Table 1. Dynamics of indicators of self-actualizing personality (in %) in students before and after participation in the program of psychological and pedagogical support of the formation of a set of professionally important qualities of personality of future doctors

 Researchers used the Mann-Whitney criteria to compare self-actualization indicators in the control and experimental groups before and after the experiment. Table 2 presents sample indicators with significant statistical differences and a tendency toward differences.

In the control group, repeated measurements showed no significant differences (p≥0.05).

Table 2. Comparative analysis of sample indicators of self-actualizing personality in the control and experimental groups before and after the experimental work

 Discussion of results

Self-acceptance is an important condition for the self-actualization of a future doctor's personality, as it indicates the ability to accept oneself, taking into account one's own shortcomings and weaknesses, the adequacy of self-esteem, and confidence in decisions concerning patient management tactics. According to F. Perls, every individual from birth tries to actualize himself "as they are," i.e., to actualize the "image of themselves" and use their own growth potential [15]. "Be your true self," thereby becoming fully human, as C. Rogers believed [16]. Self-realized people are completely content with themselves as they are, full of quirks, imperfections, and flaws. It reconciles them with their own selves and their relationships with people [24].

Self-esteem, the ability to recognize and appreciate one's positive traits, plays a crucial role in forming a doctor's "self-concept" [12]. The strength of self-concept, self-respect, self-esteem, self-importance, and self-sufficiency are key personal resources that help doctors overcome professional stress [4].

The complex set of professionally important qualities (PIQ) for future doctors includes synergy, which enables them to perceive the world and people holistically. This holistic perception will help them to understand the relationship between opposites, such as the spiritual and the physical, within a person. It is crucial for doctors to analyze often contradictory information, interpret results, and understand the impact of the psyche on disease and vice versa. The founder of the theory of self-actualization, A. Maslow, refers to the characteristics of self-actualizing people as an adequate perception of reality, finding the new in the known, and a sense of community with humanity as a whole [17]. A high level of synergy allows individuals to effectively utilize their strengths, abilities, skills, and resources in unique situations to achieve both external and internal harmony [18]. Modern foreign authors also note that the "spirituality" of doctors is associated with the interpretation of patients' illnesses and can act as a bridge that promotes the development of relationships with the patient [27].

The data on increased spontaneity indicators do not show that we lack the ability to think about purposeful action. It reveals the possibility of not calculating in advance the type of behavior necessary when assisting patients in emergency and urgent situations and taking responsibility for changing tactics. Spontaneity is the suddenness and unpredictability associated with self-realization and expression. E. Sjostrom, among the characteristics of a self-actualizing personality ("actualizer"), notes such characteristics as honesty, openness, sincerity, and freedom of expression of one's potentials [21].

Sensitivity, a key aspect of self-actualization, indicates how well a future doctor understands their own needs and feelings, as well as their capacity for reflection. It also demonstrates their ability to respond to various stimuli in their future professional activities.

A doctor's behavioral flexibility determines their ability to adapt to changing circumstances and approach problem-solving creatively. This flexibility shines most during professional stress or unexpected events that require new behaviors. It reflects how well future doctors can implement their values in their actions, interact with others, and respond promptly and appropriately to evolving situations. And to do this, a technologically equipped doctor should not only treat, but also be able to talk to his patient, and this is something that has to be learned [9]. In the context of self-actualization, contactability is considered not only as a communicative ability or skill of effective communication but also as a prosocial attitude of a person.

Creativity, as a quality of self-actualizing personality, stipulates the ability of future doctors to analyze information, understand cause-and-effect relationships, make non-standard inferences, go beyond standard models, and develop and apply innovative methods and techniques in their work [20]. This concerns the expression of creative orientation in future doctors' personalities.

Conclusions

Psychological and educational support during medical school significantly improved future doctors' self-actualization indicators, which are part of their Professional Important Qualities (PIQ). The experimental group showed statistically significant improvements in these indicators, demonstrating the effectiveness of the author's support program. Although these results affirm the program's success, further confirmation using the self-actualization method is necessary to validate the effectiveness of psychological and pedagogical support for students. 

The professionally important characteristics of the self-actualizing personality of future doctors are the personal striving for maximum identification and presentation of individual abilities, as well as for further self-development and education. Personality development stimulates the transformation of professional activity, filling it with new meaning through the process of personalization [14]. These indicators reveal the personality orientation of future doctors. They provide a model for their interactions with patients, as well as their professional and personal characteristics. 

The research and data generated are powerful tools for the professional development of medical students, residents, and practitioners at all stages of their careers.

1. Adziev R.S. Neobkhodimost' v upravlyaemom formirovanii professional'no vazhnykh psikhologicheskikh kachestv lichnosti budushchego medika [The need for controlled formation of professionally important psychological qualities of the personality of a future physician]. Molodoi uchenyi [Young scientist], 2019, no. 43, pp. 223–225. (In Russ.).
2. Akindinova I.A. Vozmozhnosti samoaktualizatsii prepodavatelya i studentov v protsesse obucheniya kursu «Psikhologicheskoe konsul'tirovanie» [Possibilities for self-actualization of teachers and students in the process of teaching the course “Psychological Counseling”]. Obrazovanie na rubezhe vekov: traditsii i innovatsii. Tezisy dokladov 2-i Mezhdunarodnoi nauchno-prakticheskoi konferentsii [Education at the turn of the century: traditions and innovations. Abstracts of reports of the 2nd International Scientific and Practical Conference]. Saint-Petersburg, 1999, pp. 114–119. (In Russ.).
3. Valeeva M.A. Samoaktualizatsiya lichnosti kak komponenta professional'noi podgotovki budushchego spetsialista [Self-actualization of personality as a component of professional training of a future specialist]. Sotsial'no-gumanitarnye znaniya [Social and humanitarian knowledge], 2010, no. 1, pp. 137−145. (In Russ.).
4. Vodopyanova N.E. Sindrom vygoraniya [Burnout syndrome]. Moscow, 2024. 299 p.
5. Gerasimova T.V. Vzaimosvyaz' kompleksa professional'no vazhnykh kachestv lichnosti vracha s effectivnost'yu professional'noy deyatel'nosti [The relationship between a complex of professionally important qualities of a doctor and the effectiveness of professional activity]. Naukosfera [Scientosphere], 2022, no. 9-2, pp. 80–84. (In Russ.).
6. Gerasimova T.V., Kornilova O.A. Opyt realizatsii modeli psikhologo-pedagogicheskogo soprovozhdeniya formirovaniya kompleksa professional'no vazhnykh kachestv lichnosti budushchikh vrachei v meditsinskom vuze [Elektronnyi resurs] [Experience in implementing a model of psychological and pedagogical support for the formation of a complex of professionally important personality traits of future doctors in a medical university]. Mir pedagogiki i psikhologii: mezhdunarodnyi nauchno-prakticheskii zhurnal [World of Pedagogy and Psychology: international scientific and practical journal], 2022, no. 09(74), pp. 24–32. Available at: https://scipress.ru/pedagogy/articles/opyt-realizatsii-modeli-psikhologo-pedagogicheskogo-soprovozhdeniya-formirovaniya-kompleksa-professionalno-vazhnykh-kachestv-lichnosti-budushhikh-vrachej-v-meditsinskom-vuze.html (Accessed 05.11.2023). (In Russ.).
7. Gerasimova T.V., Kornilova O.A. Razvitie lichnostno-motivatsionnykh komponent professional'no vazhnykh kachestv studentov-medikov v protsesse obucheniya [Elektronnyi resurs] [Development of personal and motivational components of professionally important qualities of medical students in the learning process]. Mir nauki. Pedagogika i psikhologiya [World of Science. Pedagogy and psychology], 2021, no. 3. Available at: https://mir-nauki.com/PDF/09PSMN321.pdf (Accessed 05.11.2023). (In Russ.).
8. Gozman L.Ya. Samoaktualizacionny`j test [Self-actualization test]. Moscow, 1995. 43 p. (In Russ.).
9. Golovchenko S.G. Sovershenstvovanie obrazovatelnykh tehnologij [Improving educational technologies for professional training of dentists]. Fundamental'nye issledovaniya [Basic research], 2014, no. 10-6, p. 1085–1088. (In Russ.).
10. Klimov E.A. Psikhologiya professionala [Psychology of a professional]. Moscow, 1996. 400 p. (In Russ.).
11. Klimov E.A. Razvivayushhijsya chelovek v mire professij [A developing man in the world of professions]. Moscow: MSU. Obninsk: Printer, 1993. 57 p. (In Russ.).
12. Leshchinskii L.A. Deontologiya v praktike terapevta [Deontology in therapist practice]. Moscow, 1989. 208 p. (In Russ.).
13. Markova A.K. Psikhologiya professionalizma [Psychology of professionalism]. Moscow: Znanie, 1996. 308 p. (In Russ.).
14. Zubkova A.A., Felker E.V., Baroyan M.A., Vinokur A.V. Osobennosti vospitatel'nogo processa pri obuchenii studentov-medikov [Elektronnyi resurs] [Features of the educational process when training medical students]. Sovremennye problemy nauki I obrazovaniya [Modern problems of science and education], 2017, no. 2. Available at: https://science-education.ru/ru/article/view?id=26271
15. Perlz F. Opyty psikhologii samopoznaniya [Experiments in the psychology of self-knowledge]. Troitsk: Gil'-Estel', 1993. 240 p. (In Russ.).
16. Rodzhers K. Vzglyad na psixoterapiyu. Stanovlenie cheloveka [A look at psychotherapy. The formation of man]. Moscow: Progress, Univers, 1994. 480 p. (In Russ.).
17. Sadykova A.Ya. Fenomen samoaktualizacii A. Maslow v sovremennom mire [The phenomenon of self-actualization by A. Maslow in the modern world]. Symvol nauki [Symbol of Science], 2020, no. 2, p. 66– (In Russ.).
18. Solovy`x O.V. O teoreticheskix aspektax samoaktualizacii lichnosti [On the theoretical aspects of personality self-actualization]. Vestnik of Orenburg State University [Bulletin of Orenburg State University], 2011, no. 6(125), p. 25– (In Russ.).
19. Strategiya razvitiya nepreryvnogo meditsinskogo i farmatsevticheskogo obrazovaniya v Rossiiskoi Federatsii na period do 2025 goda. Proekt / Ministerstvo zdravookhraneniya Rossiiskoi Federatsii [Strategy for the development of continuing medical and pharmaceutical education in the Russian Federation for the period until 2025. Project / Ministry of Health of the Russian Federation]. Moscow, 2017. (In Russ.).
20. Turkova I.V. Samoaktualizatsiya lichnosti studentov v period obucheniya v meditsinskom vuze. Avtopef. diss. … kand. psikhol. nauk. [Self-actualization of the personality of students during their studies at a medical university. PhD (Psychology) Thesis]. Saint-Petersburg, 2005. 24 p. (In Russ.).
21. Shostrom E. Chelovek-manipulyator. Vnutrennee puteshestvie ot manipulyatsii k aktualizatsii [Manipulator. The inner journey from manipulation to actualization]. Moscow: Eksmo, 2002. 240 p. (In Russ.).
22. Yas'ko B.A. Psixologiya lichnosti i truda vracha: kurs lekcij [Psychology of personality and work of a doctor: a course of lectures]. Rostov on Don: Phoenix, 2009. 304 p. (In Russ.).
23. Yas'ko B.A. Ekspertnyi analiz professional'no vazhnykh kachestv vracha [Expert analysis of the professionally important qualities of a doctor]. Psikhologicheskii zhurnal [Psychological Journal], 2004, no. 3(25), pp. 71–81. (In Russ.).
24. How physicians can become self-actualized [Elektronic resource]. URL: https://www.kevinmd.com/2019/12/how-physicians-can-become-self-actualized.html
25. Kalet A., Chow C.L. Remeditation in medical education: a mid-course correction. Springer; 2nd edition, 2023. 786 p.
26. Powis D. et al. Why is it so hard to consider personal qualities when selecting medical students? Medical teacher, 2020. Vol. 42, no. 4, pp. 366–
27. Raghuveer P. et al. A cross-sectional study on assessment of spiritual health and its associated factors among undergraduate students in a medical college in Mangalore, Karnataka. F1000Research, 2022. Vol. 11.
28. Schoofs L., Hornung S., Glaser J. Prospective effects of social support on self-actualization at work–The mediating role of basic psychological need fulfillment. Acta psychological, 2022. Vol. 228, p. 103649.