[1] Band, I., & Chokshi, K. (2025). Confronting the gap between classroom ideals and the reality of clinical culture: A student’s perspective. Voices in Bioethics, 11. https://doi.org/10.52214/vib.v11i.13876

[2] Beadle, E. S., Walecka, A., Sangam, A. V., Moorhouse, J., Winter, M., Munro Wild, H., ... & Casarin, A. (2024). Triggers and factors associated with moral distress and moral injury in health and social care workers: A systematic review of qualitative studies. PLoS One, 19(6), e0303013. https://doi.org/10.1371/journal.pone.0303013

[3] Beck, J., Falco, C. N., O’Hara, K. L., Bassett, H. K., Randall, C. L., Cruz, S., ... & Senturia, K. (2023). The norms and corporatization of medicine influence physician moral distress in the United States. Teaching and Learning in Medicine, 35(3), 335-345. https://doi.org/10.1080/10401334.2022.2056740

[4] Berger, J. T. (2014). Moral distress in medical education and training. Journal of General Internal Medicine, 29 (2), 395-398. https://doi.org/10.1007/s11606-013-2665-0

[5] Buchbinder, M., Browne, A., Berlinger, N., Jenkins, T., & Buchbinder, L. (2024). Moral stress and moral distress: Confronting challenges in healthcare systems under pressure. The American Journal of Bioethics, 24(12), 8-22. https://doi.org/10.1080/15265161.2023.2224270

[6] Camp, M., & Sadler, J. (2019). Moral distress in medical student reflective writing. AJOB Empirical Bioethics, 10(1), 70-78. https://doi.org/10.1080/23294515.2019.1570385

[7] Čartolovni, A., Stolt, M., Scott, P. A., & Suhonen, R. (2021). Moral injury in healthcare professionals: A scoping review and discussion. Nursing Ethics, 28(5), 590-602. https://doi.org/10.1177/0969733020966776

[8] Chandran, L., Iuli, R. J., Strano-Paul, L., & Post, S. G. (2019). Developing “a way of being”: Deliberate approaches to professional identity formation in medical education. Academic Psychiatry, 43(5), 521-527. https://doi.org/10.1007/s40596-019-01048-4

[9] Cho, C., Ko, W. Y., Ngan, O. M., & Wong, W. T. (2022). Exploring professionalism dilemma and moral distress through medical students’ eyes: A mixed-method study. International Journal of Environmental Research and Public Health, 19(17), 10487. https://doi.org/10.3390/ijerph191710487

[10] Cruess, R. L., Cruess, S. R., Boudreau, J. D., Snell, L., & Steinert, Y. (2014). Reframing medical education to support professional identity formation. Academic Medicine: Journal of the Association of American Medical Colleges, 89(11), 1446-1451. https://doi.org/10.1097/acm.0000000000000427

[11] Dean, W., Morris, D., Manzur, M. K,, & Talbot, S. (2024). Moral injury in health care: A unified definition and its relationship to burnout. Federal Practitioner: For the Health Care Professionals of the VA, DoD, and PHS, 41(4), 104-107. https://doi.org/10.12788/fp.0467

[12] Deschenes, S., Gagnon, M., Park, T., & Kunyk, D. (2020). Moral distress: A concept clarification. Nursing Ethics, 27(4), 1127-1146. https://doi.org/10.1177/0969733020909523

[13] Dzeng, E., & Wachter, R. M. (2019). Ethics in conflict: Moral distress as a root cause of burnout. Journal of General Internal Medicine, 35(2), 409-411. https://doi.org/10.1007/s11606-019-05505-6

[14] Griffin, B. J., Purcell, N., Burkman, K., Litz, B. T., Bryan, C. J., Schmitz, M., ... & Maguen, S. (2019). Moral injury: An integrative review. Journal of Traumatic Stress, 32(3), 350-362. https://doi.org/10.1002/jts.22362

[15] Griffin, B. J., Weber, M. C., Hinkson, K. D., Jendro, A. M., Pyne, J. M., Smith, A. J., ... & Maguen, S. (2023). Toward a dimensional contextual model of moral injury: A scoping review on healthcare workers. Current Treatment Options in Psychiatry, 10(3), 199-216. https://doi.org/10.1007/s40501-023-00296-4

[16] Hawking, M., Kim, J., Jih, M., Hu, C., & Yoon, J. D. (2020). “Can virtue be taught?”: A content analysis of medical students’ opinions of the professional and ethical challenges to their professional identity formation. BMC Medical Education, 20(1), 380. https://doi.org/10.1186/s12909-020-02313-z

[17] Hegarty, S., Lamb, D., Stevelink, S. A., Bhundia, R., Raine, R., Doherty, M. J., ... & Wessely, S. (2022). ‘It hurts your heart’: Frontline healthcare worker experiences of moral injury during the COVID-19 pandemic. European Journal of Psychotraumatology, 13(2), 2128028. https://doi.org/10.1080/20008066.2022.2128028

[18] Jameton, A. (2017). What moral distress in nursing history could suggest about the future of healthcare. AMA Journal of Ethics, 19(6), 617-628. https://doi.org/10.1001/journalofethics.2017.19.6.mhst1-1706

[19] Kim, D. T., Applewhite, M. K., & Shelton, W. (2024). Professional identity formation in medical education: Some virtue-based insights. Teaching and Learning in Medicine, 36(3), 399-409. https://doi.org/10.1080/10401334.2023.2209067

[20] Krishnasamy, N., Hasamnis, A. A., & Patil, S. S. (2022). Developing professional identity among undergraduate medical students in a competency-based curriculum: Educators’ perspective. Journal of Education and Health Promotion, 11(1), 361. https://doi.org/10.4103/jehp.jehp_329_22

[21] Litz, B. T. (2025). Moral injury: State of the Science. Journal of Traumatic Stress, 38(2), 187-199. https://doi.org/10.1002/jts.23125

[22] Lönn, A., Weurlander, M., Seeberger, A., Hult, H., Thornberg, R., & Wernerson, A. (2023). The impact of emotionally challenging situations on medical students’ professional identity formation. Advances in Health Sciences Education, 28(5), 1557-1578. https://doi.org/10.1007/s10459-023-10229-8

[23] Mæland, M. K., Tingvatn, B. S., Rykkje, L., & Drageset, S. (2021). Nursing education: Students’ narratives of moral distress in clinical practice. Nursing Reports, 11(2), 291-300. https://doi.org/10.3390/nursrep11020028

[24] McCarthy, J., & Gastmans, C. (2015). Moral distress: A review of the argument-based nursing ethics literature. Nursing Ethics, 22(1), 131-152. https://doi.org/10.1177/0969733014557139

[25] Mewborn, E. K., Fingerhood, M. L., Johanson, L., & Hughes, V. (2023). Examining moral injury in clinical practice: A narrative literature review. Nursing Ethics. 30(7-8), 960-974. https://doi.org/10.1177/09697330231164762

[26] Monrouxe, L., Shaw, M., & Rees, C. (2017). Antecedents and consequences of medical students’ moral decision making during professionalism dilemmas. AMA Journal of Ethics, 19(6), 568-577. https://doi.org/10.1001/journalofethics.2017.19.6.medu1-1706

[27] Morley, G., Field, R., Horsburgh, C. C., & Burchill, C. (2021). Interventions to mitigate moral distress: A systematic review of the literature. International Journal of Nursing Studies, 121, 103984. https://doi.org/10.1016/j.ijnurstu.2021.103984

[28] Murray, E., Krahé, C., & Goodsman, D. (2018). Are medical students in prehospital care at risk of moral injury? Emergency Medicine Journal: EMJ, 35(10), 590-594. https://doi.org/10.1136/emermed-2017-207216

[29] Nemiroff, S., Blanco, I., Burton, W., Fishman, A., Joo, P., Meholli, M., & Karasz, A. (2024). Moral injury and the hidden curriculum in medical school: Comparing the experiences of students underrepresented in medicine (URMs) and non-URMs. Advances in Health Sciences Education, 29(2), 371-387. https://doi.org/10.1007/s10459-023-10259-2

[30] Ong, R. S. R., Wong, R. S. M., Chee, R. C. H., Quek, C. W. N., Burla, N., Loh, C. Y. L., ... & Krishna, L. R. (2022). A systematic scoping review of moral distress among medical students. BMC Medical Education, 22(1), 466. https://doi.org/10.1186/s12909-022-03515-3

[31] Quaintance, J. L., Ngo, T. L., Wenrich, M. D., Hatem, D., Keeley, M. G., Lewis, J. M., ... & Sardesai, M. G. (2025). Competence, mattering and belonging: An evidence-based and practical approach to understanding and fostering medical student professional identity formation. Medical Teacher, 47(12), 2033-2044. https://doi.org/10.1080/0142159x.2025.2500568

[32] Rabin, S., Kika, N., Lamb, D., Murphy, D., Am Stevelink, S., Williamson, V., ... & Greenberg, N. (2023). Moral injuries in healthcare workers: What causes them and what to do about them?. Journal of Healthcare Leadership, 15, 153-160. https://doi.org/10.2147/jhl.s396659

[33] Ribeiro, D. L., Costa, M., Helmich, E., Jaarsma, D., & de Carvalho‐Filho, M. A. (2021). ‘I found myself a despicable being!’: Medical students face disturbing moral dilemmas. Medical Education, 55(7), 857-871. https://doi.org/10.1111/medu.14447

[34] Rosen, A., Cahill, J. M., & Dugdale, L. S. (2022). Moral injury in health care: Identification and repair in the COVID-19 era. Journal of General Internal Medicine, 37(14), 3739-3743. https://doi.org/10.1007/s11606-022-07761-5

[35] Sanderson, C., Sheahan, L., Kochovska, S., Luckett, T., Parker, D., Butow, P., & Agar, M. (2019). Re-defining moral distress: A systematic review and critical reappraisal of the argument-based bioethics literature. Clinical Ethics, 14(4), 195-210. https://doi.org/10.1177/1477750919886088

[36] Sarraf-Yazdi, S., Teo, Y. N., How, A. E. H., Teo, Y. H., Goh, S., Kow, C. S., ... & Krishna, L. K. R. (2021). A scoping review of professional identity formation in undergraduate medical education. Journal of General Internal Medicine, 36(11), 3511-3521. https://doi.org/10.1007/s11606-021-07024-9

[37] Schrepel, C., Jauregui, J., Brown, A., Shandro, J., & Strote, J. (2019). Navigating cognitive dissonance: A qualitative content analysis exploring medical students’ experiences of moral distress in the emergency department. AEM Education and Training, 3(4), 331-339. https://doi.org/10.1002/aet2.10380

[38] Scott, E. K., Stickrath, C., & Rowh, M. A. (2026). ‘Practice not ignoring hard things’: Navigating moral distress, burnout symptoms, and resilience among medical students working in underserved clinical settings. Medical Teacher, 48(2), 280-288. https://doi.org/10.1080/0142159x.2025.2536695

[39] Wald, H. S. (2015). Professional identity (trans) formation in medical education: Reflection, relationship, resilience. Academic Medicine: Journal of the Association of American Medical Colleges, 90(6), 701-706. https://doi.org/10.1097/ACM.0000000000000731

[40] Webb, E. L., Ireland, J. L., Lewis, M., & Morris, D. (2024). Potential sources of moral injury for healthcare workers in forensic and psychiatric settings: A systematic review and meta-ethnography. Trauma, Violence & Abuse, 25(2), 918-934. https://doi.org/10.1177/15248380231167390

[41] Williamson, V., Murphy, D., Phelps, A., Forbes, D., & Greenberg, N. (2021). Moral injury: The effect on mental health and implications for treatment. The Lancet Psychiatry, 8(6), 453-455. https://doi.org/10.1016/s2215-0366(21)00113-9