Background. Simulation has become a valuable tool in medical education, providing standardized clinical experiences without jeopardizing patient safety. Simulation may also help promote students’ professional identity formation (PIF) and patient ownership.

Methods. A mixed-methods study was performed to explore the relationship between simulation, PIF, and patient ownership among third-year medical students in between their clerkship rotation blocks. Data were collected from 76 students after a simulated emergent case. A priori codes were developed and categorized into individual and contextual elements, and latent content analysis was conducted on the responses. Quantitative analysis identified how clerkship rotations and prior clinical experience affected students’ PIF and feelings of patient ownership.

Results. Students exhibited both PIF and feelings of patient ownership as a result of the simulation. Students who completed an in-patient clerkship block described individual elements more frequently than students who completed the out-patient clerkship block (p = 0.017). Students who had no clinical experience prior to medical school remarked on individual elements more frequently than students who did have prior clinical experience (p = 0.017).

Conclusions. When medical students felt like a physician, they took ownership of their patients. When they took ownership of their patients, they felt like a physician. Simulation has long been recognized as a valuable tool for developing clinical skills and teamwork behaviors, but it also fosters PIF and a sense of patient ownership. By introducing simulation activities earlier in medical education, students will have opportunities to develop patient ownership and professional identity earlier, allowing for a fuller, more mature development process.