Identifying Medical Students' Attitudes to Socialization in Clinical Settings: A Qualitative Study

Abstract

Background: Professional socialization is a process through which students acquire norms and values in the medical profession. However, this process can, under the influence of some environmental factors, lead to the acceptance of unethical and uncommitted behaviors of students. For this purpose, the study was designed to identify medical students' attitudes towards the instances, causes, and consequences of negative socialization in clinical settings. Methods: This qualitative study was conducted on medical students in the clinical program of Isfahan University of Medical Sciences. Sampling was purposive and took into account maximum diversity. Data were collected through 31 in-depth semi-structured interviews and analyzed using the framework analysis method. Findings: Examples of negative socialization were categorized into two categories: “lack of commitment and inappropriate communication” (including failure to comply with informed consent, inappropriate treatment, and discrimination in care) and “ethical and professional misconduct” (including unhealthy competition, imitation of unprofessional behavior, and falsification of medical information). The causes of this phenomenon were identified in five subcategories: strict hierarchies, time and competitive pressures, lack of ethical oversight, unsupportive organizational culture, and gender norms. The consequences of negative socialization also affected three areas: decreased empathy for patients, creating professional cynicism, and students facing personal consequences such as conflict with personal values, reduced motivation, and emotional exhaustion. Conclusion: Negative socialization in clinical medical education arises from the interaction of systemic and cultural factors and is a significant threat to the development of ethical professionalism and the quality of patient care. Addressing this challenge requires structural interventions such as strengthening ethical oversight, reforming the prevailing educational culture, training faculty, and creating support systems for students. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.