From leadership research to district action: Moral development in personal and professional identity formation: Longitudinal impact of teaching the role of medicine during the Holocaust in health professions education

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Abstract Objectives: Critically reflecting on history of medicine during Nazism and the Holocaust (MNH) which included egregious ethical violations such as genocide complicity is a powerful platform for scaffolding Professional Identity Formation (PIF) with contemporary relevance for health professions education (HPE), clinical and research practices, and public policy. The study explored the longitudinal impact of MNH curriculum with an Auschwitz Memorial study trip on personal and PIF including moral development as a key PIF component. Methods: The authors used immersion-crystallization qualitative thematic analysis to analyze medical and psychology students’ reflective writings at 6 weeks (N=10) and 1.5 to 2 years (N=24) post 2019 MNH curriculum with study trip. Results: Four distinct themes were identified, ie. curriculum and study trip impact on me as a 1) person, 2) student & future health professional, 3) member of a health profession (and health system), and 4) global citizen & part of humanity (philosophical/existential aspects). Each theme included five subthemes, ie. moral sensitivity, moral judgment, moral motivation, moral character, and moral outcome. Themes/subthemes were mapped to a conceptual framework for a moral development model within personal and PIF. Conclusions: This curriculum catalyzed critically reflective learning/meaning-making supporting history-informed personal and PIF, and moral development within HPE. Students described compelling and relevant impact of the MNH curriculum on their perspectives and behavior within their studies, the health care system, and society. MNH curriculum is proposed as a fundamental HPE component cultivating attitudes, values, and behaviors for empathic, morally courageous leadership within inevitable healthcare and societal challenges. Keywords: Professional Identity Formation, moral development, medical education, medicine during National Socialism, medicine during the Holocaust

Study methods

The study was conducted as a follow-up study after a 3-year interprofessional curriculum at Witten/Herdecke University (UW/H) entitled “Cultivating Medical Awareness and Ethics through the Example of Medicine in National Socialism” [11], [54]. Students were able to participate in any or all years of the course which is a special study module (“Studium Fundamentale”) for all UW/H students. We have previously described the course objectives [11]. In addition to history seminars, the curriculum included individual and small group reflection on survivor documentaries, assigned readings [55], [56], [57] and study trips to memorial sites (e.g. Auschwitz Memorial, Buchenwald Memorial, Hadamar Memorial). The 2019 study program included a study trip to the Auschwitz Memorial with additional implementation of interactive RW to support meaning-making and transformative learning [58].

Limitations

Limitations of our study include some suboptimal elements of RW5 session with scheduling issues and some students unable to attend, and no behavioral indicator for real life moral behavior. Data was solely from students’ voluntary RWs after the study trip and obtained from one institution in one country (Germany) with self-selected students for the module, thus raising a question of transferability.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one school improvement question with teachers. Protect a short shared planning cycle, agree an instructional change and use a common rubric for examining student work. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Review implementation fidelity, teacher time and independently scored student work against a recorded baseline. Examine access differences and competing explanations before attributing changes to leadership. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Hedy S Wald; Madelin S Riesen; Claudia Kiessling. Moral development in personal and professional identity formation: Longitudinal impact of teaching the role of medicine during the Holocaust in health professions education. GMS Journal for Medical Education (2026-03-23). https://doi.org/10.3205/zma001830

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.