Impact of Hands-on Experience of a Cadaver Dissection on the Professional Identity Formation of Health Sciences Students

Background

In Japan, some nursing and health science universities that train nurses and/or clinical laboratory technicians have a curriculum in which students observe medical students performing a cadaver dissection. Observing a cadaver dissection is believed to affect the formation of a student's professional identity. This study aimed to investigate the effects of observing a cadaver dissection on the professional identity of nursing and clinical laboratory science students to find an effective educational support system for developing professional identity.

Methods

Sophomores majoring in nursing science or clinical laboratory science were asked to complete a questionnaire with a professional identity scale before and after hands-on experience of a cadaver dissection performed by medical students. After their hands-on session was complete, they responded to a free-answer question about acquiring a professional identity.

Results

The professional identity score of nursing students significantly decreased after the hands-on experience of the cadaver dissection. No significant change in professional identity score was observed in the clinical laboratory science students. However, the effect size (r) was moderate.

Conclusion

Although professional identity formation fluctuates immediately after the experience of the hands-on experience of a cadaver dissection, the findings do suggest that these hands-on sessions will be effective for developing their professional identity if educational support is provided to help them utilize what they learned through reflection.

The mediating role of psychological capital on the association between workplace violence and professional identity among Chinese doctors: a cross-sectional study

Background: Workplace violence (WPV) and psychological capital (PsyCap) are linked to professional identity, however, little research has examined how WPV is associated with professional identity via PsyCap. This study is aimed to examine the association between WPV and professional identity, and to further explore whether PsyCap can serve as a mediator between WPV and professional identity among Chinese doctors.

Materials and methods: A cross-sectional study was conducted from November to December in Liaoning Province in China, in 2017. The study used a questionnaire consisting of Workplace Violence Scale (WVS), Occupational Identity Scale (OIS), Psychological Capital Questionnaire (PCQ), as well as questions about demographic characteristics. Out of 1200 doctors, 995 (effective response rate of 82.92%) completed the questionnaire survey and became our final subjects. Hierarchical multiple regression and the asymptotic and resampling strategies were conducted to explore the mediating role of PsyCap in the relationship between WPV and professional identity.

Results: After adjusting for demographic characteristics, WPV was negatively associated with professional identity (β=−0.37; P<0.01). Mediation analysis indicated that PsyCap was a mediator in the relationship between WPV and professional identity. Two dimensions of PsyCap: self-efficacy (a*b =−0.04, BCa 95% CI: (−0.08, −0.01); P<0.01) and hope (a*b =−0.04, BCa 95% CI: (−0.08, −0.01); P<0.01) also did exhibit mediating effects in the relationship between WPV and professional identity. The proportion of self-efficacy, hope and PsyCap mediation was 10.73%, 10.77%, 36.22% for professional identity respectively.

Conclusion: These results provided evidence that PsyCap could mediate the association between WPV and professional identity. To increase the level of professional identity, positive interventions targeting PsyCap should be taken, with a focus on self-efficacy and hope.

Legal framework versus moral framework: military physicians and nurses coping with practical and ethical dilemmas

Within military operations, military physicians and nurses experience a dual loyalty to their professional identities. The moral frameworks of the medical and military professions are not similar, and require different kinds of choices and action from its members. But above all, the legal framework in which the healthcare personnel has to operate while deployed is different from the medical moral standards. Military necessity is prioritised over medical necessity. In debates on dual loyalty, legal frameworks should be considered as a more decisive factor in ethical decision-making processes. Legal frameworks, both general and mission-specific, support this prioritisation of military necessity, complicating the work of military physicians and nurses. During the post-Cold War era, in which neutrality and moral supremacy have served as legitimising factors for military peacekeeping or humanitarian missions, this misalignment between the moral and the legal framework is problematic. What is legally correct or justifiable may not be morally acceptable to either the medical professional standards or to the general public. The legal framework should be given more prominence within the debates on dual loyalty and military medical ethics. This paper argues that the misalignment between the legal and moral framework in which deployed healthcare personnel has had to operate complicated ethical decision-making processes, impeded their agency, and created problems ranging from military operational issues to personal trauma and moral injury for the people involved, and ultimately decreasing the legitimacy of the armed forces within society.

Compulsory Interventions Are Challenging the Identity of Psychiatry

Compulsory interventions severely restrict constitutional rights of the patients. They are exceptional measures only to be considered under strict and clearly defined ethical and juridical conditions. They do confront mental health professionals with difficult questions challenging their individual professional identity as well as the identity of psychiatry in general. This complex field is discussed in reference to the conceptual history of psychiatry, to different contemporary approaches to the notion of autonomy, and to three ethically demanding issues: autonomy and care, psychiatry and society, personhood and interpersonal relations. Engaging open mindedly in these debates may be cumbersome for psychiatry, but will yield a substantial return, particularly regarding its identity and acceptance by society.

What Experiences in Medical School Trigger Professional Identity Development?

Phenomenon: This qualitative inquiry used conceptual change theory as a theoretical lens to illuminate experiences in medical school that trigger professional identity formation. According to conceptual change theory, changes in personal conceptualizations are initiated when cognitive disequilibrium is introduced. We sought to identify the experiences that trigger cognitive disequilibrium and to subsequently describe students' perceptions of self-in-profession prior to the experience; the nature of the experience; and, when applicable, the outcomes of the experience. Approach: This article summarizes findings from portions of data collected in a larger qualitative study conducted at a new medical school in the United States that utilizes diverse pedagogies and experiences to develop student knowledge, clinical skills, attitudes, and dispositions. Primary data sources included focus groups and individual interviews with students across the 4 years of the curriculum (audio data). Secondary data included students' comments from course and end-of-year evaluations for the 2013-2017 classes (text data). Data treatment tools available in robust qualitative software, NVivo 10, were utilized to expedite coding of both audio and text data. Content analysis was adopted as the analysis method for both audio and text data. Findings: We identified four experiences that triggered cognitive disequilibrium in relationship to students' perceptions of self-in-profession: (a) transition from undergraduate student to medical student, (b) clinical experiences in the preclinical years, (c) exposure to the business of medicine, and (d) exposure to physicians in clinical practice. Insights: We believe these experiences represent vulnerable periods of professional identity formation during medical school. Educators interested in purposefully shaping curriculum to encourage adaptive professional identity development during medical school may find it useful to integrate educational interventions that assist students with navigating the disequilibrium that is introduced during these periods.

Beyond cognitive measures: Empirical evidence supporting holistic medical school admissions practices and professional identity formation

This article was migrated. The article was marked as recommended. Background: Medical schools seek admissions methods that identify applicants who hold promise to become physicians who will navigate and shape the future medical landscape. The focus on traditional cognitive measures for admission has prompted calls for holistic admissions review during the past five years. Yet, empirical evidence linking selection measures to holistic admissions practices has not been fully established, including their relationship with professional identity formation over time. A non-cognitive admissions situational judgment screening test (CASPer) measuring personal and professional characteristics was added to the University of Illinois College of Medicine admissions process two years ago, as we implemented a new curriculum that emphasizes professional identity development. Purpose: This study examined associations among admissions measures (Medical College Admission Test [MCAT], grade point average [GPA], interview, and CASPer), and their predictive relationships with curricular measures of professional identity formation (Professional Identity Essay [PIE]) and moral reasoning (Defining Issues Test [DIT2]). Methods: Data were taken from two entering cohorts ( n = 596; entering class of 2017 and 2018 across 3 regional sites). Correlations and regression analyses were used to examine associations between admissions and professional identity measures. Results: CASPer and in-person admissions interview ratings had significant positive correlations, suggesting that CASPer can contribute to effective screening processes. In addition, CASPer demonstrated statistically significant positive relationships with professional identity (CASPer and PIE, r=.10, p<.05) and a measure of moral reasoning (CASPer and DIT2 type indicator, r=.09, p<.05). Association between CASPer and PIE remained consistent, even after controlling for MCAT, interview, and GPA. Conclusion: Our institutional focus on professional identity formation has provided new ways to conceptualize students' readiness for medical school - demonstrated academic rigor as well as signs of professionalism, ethics, and motivation. Non-academic factors measured in situational judgment tests may promote better alignment of admissions practices and desired educational outcomes.

Dismantling Knowledge Boundaries at NASA: The Critical Role of Professional Identity in Open Innovation

Using a longitudinal in-depth field study at NASA, I investigate how the open, or peer-production, innovation model affects R&D professionals, their work, and the locus of innovation. R&D professionals are known for keeping their knowledge work within clearly defined boundaries, protecting it from individuals outside those boundaries, and rejecting meritorious innovation that is created outside disciplinary boundaries. The open innovation model challenges these boundaries and opens the knowledge work to be conducted by anyone who chooses to contribute. At NASA, the open model led to a scientific breakthrough at unprecedented speed using unusually limited resources; yet it challenged not only the knowledge-work boundaries but also the professional identity of the R&D professionals. This led to divergent reactions from R&D professionals, as adopting the open model required them to go through a multifaceted transformation. Only R&D professionals who underwent identity refocusing work dismantled their boundaries, truly adopting the knowledge from outside and sharing their internal knowledge. Others who did not go through that identity work failed to incorporate the solutions the open model produced. Adopting open innovation without a change in R&D professionals' identity resulted in no real change in the R&D process. This paper reveals how such processes unfold and illustrates the critical role of professional identity work in changing knowledge-work boundaries and shifting the locus of innovation.

Military physicians' ethical experience and professional identity: a Canadian perspective

Military physicians can experience ethical tensions and encounter important dilemmas when acting at the same time as healers, soldiers and humanitarians. In the literature, these are often presented as the result of pressures, real or perceived, from the military institution or role and obligation conflicts that can divert physicians from their primary duty towards their patients. In this article, I present the ethical experiences of 14 Canadian military physicians who participated in operational missions, particularly in Afghanistan. Interestingly, although some dilemmas discussed in the academic literature were raised by Canadian physicians, ethical tensions were less frequent and numerous than what might have been expected. Instead, what emerged were distinctions between the ethical experiences of physicians: generalists experienced more frequent and different ethical challenges than specialists, and these also varied by context, that is, garrison versus on deployment. The main dilemmas during deployment were similar to those encountered by humanitarian physicians and concerned inequalities in the provision of care between coalition soldiers and Afghans (soldiers and civilians), as well as the lack of resources. Surprisingly, participants were evenly divided with regards to how they perceived their professional identity: one group clearly prioritised the medical profession (ie, doctor first and foremost), while the other group identified themselves as military physicians, but without prioritising one profession over the other.

Role-modelling and the hidden curriculum: New graduate nurses' professional socialisation

AIMS AND OBJECTIVES

To explore new graduate nurses' experiences of professional socialisation by registered nurses in hospital-based practice settings, and identify strategies that support professional identity development.

BACKGROUND

Professionalism is reinforced and stabilised in the clinical environment through the "hidden curriculum", with major learning coming from practice role-models. New graduates observe attitudes, behaviours, decision-making and skills, and gain feedback from registered nurses, which they translate into their own practice. Professional socialisation occurs through encounters with desirable and undesirable role-modelling; both are significant in professional identity formation.

DESIGN

Qualitative descriptive design.

METHOD

Data collection was undertaken through semistructured interviews with five new graduate nurse participants. A general inductive approach guided analysis. The meaningful descriptions gained provided insight into their experiences.

RESULTS

Three main themes identified from the data include: "Lessons from the wilderness"; "Life in the wild"; and "Belonging to a wolf pack". The data set highlighted the major transitional process from student identity to registered nurse.

CONCLUSIONS

New graduates' rethinking of beliefs and professional nursing identities were influenced by organisational pressures and experienced nurses' role-modelling practices contrary to professional values. Despite encountering a range of professional behaviours, attitudes and dilemmas, new graduates were capable of moral agency and critical thinking. However, they rapidly acculturated and described compromises to cope. To promote high morale and a sense of belonging, a concerted effort is required by all nurses to facilitate the socialisation process to encourage self-authorship.

RELEVANCE TO CLINICAL PRACTICE

A well-developed professional identity enhances nursing as a profession, contributing towards better healthcare delivery and outcomes. It is critically important how professional values are learnt within the culture of nursing. Tensions in clinical practice need to be understood better to avoid moral distress caused by dissonance between expectation and experience. It is advantageous to increase early positive socialisation.

Anatomy integration: Effective change or change of affect?

Anatomy is fundamental to clinical practice, is considered a rite of passage in becoming a physician and is key to professional identity formation. The anatomy course that began the medical curriculum at the University of New Mexico School of Medicine was recently dissolved to address content and process gaps in the pre-clinical curriculum. Anatomy was integrated into the organ system blocks to make room for new courses to address content gaps. Previous reports of anatomy integration document more positive attitudes and perceptions to teaching anatomy in context, as compared to an independent course. The current prospective study compared two medical student cohorts to determine the effects of teaching anatomy in and out of context on the cognitive and affective domains of learning. In a pre, post, and follow-up design, methods included content assessments, confidence probes, and attitude surveys informed by focus groups. Results indicated that anatomical knowledge and student confidence was gained and mastered in both curricula. Initial acquisition of content was higher in the integrated curriculum, but not maintained. Students in the integrated curriculum displayed a different relationship to learning anatomy, appearing more concerned with their personal progression than with the connection of anatomy to medical practice or patient care. These students also agreed less with statements related to working in teams, reflective practices and professional identity formation. Further studies will determine if this difference will diminish with continued exposure to anatomy and may inform future curricular adjustments. Anat Sci Educ. © 2018 American Association of Anatomists.

The gaming healthcare practitioner: How practices of datafication and gamification reconfigure care

This article explores how datafication, as an increasing use of quantified performance data (e.g. performance indicators, rating sites), and social media are enacted in everyday healthcare practice. Drawing on the literature about the quantified self, this article shows that datafication evokes practices of gamification: the application of frames of play and rewards to the healthcare setting. We discern three (intermingling) practices of gamification: adapting, ignoring and changing. ‘Adapting’ refers to the incorporation of quantifying features in healthcare, while ‘ignoring’ sheds light on how practitioners seek to circumvent quantifying mechanisms. Change refers to how practitioners actually embrace quantifying mechanisms in order to extend (and improve) their work and to highlight their quantified professional self. We elucidate how datafication of healthcare ‘opens up’ and reconfigures established practices of organizing care and caring – not only for the patient but also to (re)craft the professional clinical identity.

Impediments to the formation of intensive care nurses' professional identify

BACKGROUND

Nurses face challenges regarding professional identify. Being unaware of these challenges and not owning positive professional identify leads to a lack of self-confidence. Thus, nurses face problems in interpersonal communication and lose their attachment to their profession. Few studies have engaged with impediments to forming positive professional identity in relation to intensive care nurses.

OBJECTIVE

The purpose of this study is to investigate the impediments to forming positive professional identity in nurses working in intensive care unit.

RESEARCH DESIGN

In this study, the conventional content analysis method was used in order to obtain the impediments to forming positive professional identities in nurses. Data were collected through 15 semi-structured interviews and 2 focus group interviews from March 2015 to June 2016. Purposive sampling was used and participants were recruited until data saturation was reached; they were then analyzed using the conventional content analysis method.

PARTICIPANTS AND RESEARCH CONTEXT

In total, 24 intensive care unit nurses from one hospital in Northern Iran were selected through purposive sampling.

ETHICAL CONSIDERATION

This study was approved by the Ethics Committee of Shiraz University of Medical Sciences.

FINDINGS

Four main themes of professional identity challenges were extracted from the analysis of the data: neglect of professional status of nursing; distrust of nursing knowledge; unprofessional performance; and low professional attraction.

DISCUSSION AND CONCLUSION

Nurses stated that the neglect of the professional status of nursing and distrust of nursing knowledge have always been a hindrance in forming a positive professional identity. They also mentioned that unprofessional performance and low professional attraction are the other influencing factors in this regard. Thus, detecting these factors can guide nurses and their managers towards creating positive professional identity, and as a result, will improve their job satisfaction, professional advancement, and durability.

Developing a Dental Scrubs Ceremony to define professional identity and teach professionalism to dental undergraduates; lessons learned

INTRODUCTION

The UK General Dental Council stipulates that professionalism is a key aspect of the teaching and training of dental students. However, dental educators highlight that teaching dental student's professionalism can be challenging and students often rate this teaching activity negatively. This article documents a teaching initiative at one UK Dental School that aimed to strengthen the professionalism curriculum by introducing a Dental Scrubs Ceremony for second-year students.

MATERIALS AND METHOD

The Dental Scrubs Ceremony is inspired by the White Coat Ceremonies that medical students have in universities in North America. It marks the students' first step in their professional and clinical development, with the signing of a pledge of conduct and public presentation of dental scrubs to each student. We report student feedback questionnaire data over a three-year period together with reflections on the merits and limitations of this alternative approach to teaching professionalism.

RESULTS

Student evaluation data show that the perceived usefulness and worthwhileness of a Dental Scrubs Ceremony have grown since its inception in 2015. Most students enjoyed the symbolism of the ceremony, receiving their dental scrubs in a formal event. However, there was mixed evaluation for its effectiveness to teach professionalism.

CONCLUSION

A Dental Scrubs Ceremony is a useful addition to the formal curriculum of professionalism in a dental school. It provides dental students with an opportunity to be inducted into the dental profession as novice dental students starting out on their professional career.

Re-entry Adjustment and Job Embeddedness: The Mediating Role of Professional Identity in Indonesian Returnees

The present study examined the relationship between difficulty in re-entry adjustment and job embeddedness, considering the mediating role of sense of professional identity. The online data on demographic characteristics, difficulty on re-entry adjustment, sense of professional identity, and job embeddedness were collected from 178 Indonesian returnees from multiple organizations. The results showed that difficulty in re-entry adjustment was a significant predictor of a sense of professional identity; a sense of professional identity was a significant predictor of job embeddedness. Furthermore, sense of professional identity is an effective mediating variable, bridging the relationship between post-return conditions to the home country and work atmosphere. Finally, the key finding of this study was that sense of professional identity mediated the effect of difficulty in re-entry adjustment on job embeddedness. The theoretical and practical implications, study limitations, and future research needs of our findings are noted.

The Influence of Professional Identity, Job Satisfaction, and Work Engagement on Turnover Intention among Township Health Inspectors in China

Health inspectors are part of the public health workforce in China, and its shortage has been identified as an urgent priority that should be addressed. Turnover is one of the main contributors to the shortage problem. This research assessed the influence of professional identity, job satisfaction and work engagement on turnover intention of township health inspectors and explored the intermediary effect of job satisfaction and work engagement between professional identity and turnover intention among township health inspectors in China. Data were collected from 2426 township health inspectors in Sichuan Province, China. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. Results showed that a total of 11.3% of participants had a high turnover intention and 34.0% of participants had a medium turnover intention. Job satisfaction had a direct negative effect on turnover intention (β = −0.38, p < 0.001), work engagement had a direct negative effect on turnover intention (β = −0.13, p < 0.001), and professional identity had an indirect negative effect on turnover intention through the mediating effect of job satisfaction and work engagement. Our results strongly confirmed that professional identity, job satisfaction and work engagement were strong predicators of turnover intention. According to the results, desirable work environment, quality facilities, fair compensation and adequate advancement opportunities should be emphasized to improve job satisfaction. The turnover intention of health inspectors could be reduced through improving professional identity, enhancing job satisfaction and work engagement.

Becoming the 'good doctor': medical students' views on altruism and professional identity

This article was migrated. The article was marked as recommended. Background and Purpose Professionalism is central to modern medical practice and altruism is one of the humanistic qualities thought to underpin professionalism. However, there has been limited exploration of medical students' perceptions of altruism and if/how it is incorporated in to their professional identity. This study explores medical students' understanding of altruism and whether they felt it was an important part of being a 'good' doctor. Methodology Semi-structured qualitative one-on-one interviews with nine students from Leeds University Medical School began by asking participants to provide their own definition of altruism and then explored students' views of altruism in clinical practice and the importance of altruism to being 'good' doctors. Students were encouraged to reflect on their clinical experiences. Interview responses were audio-recorded, transcribed and analysed thematically. Results Definitions of altruism varied and were often easily shaken upon questioning. Students conceptualised altruism as a spectrum, ranging from a pure to a more pragmatic form. Generally students did not consider altruism as essential to the role of a doctor and saw it as going "above and beyond" duty. However, almost all participants expressed a preference to work with or be an altruistic doctor. Students also repeatedly referred to the idea of the "right balance of altruism" to avoid self-sacrifice to the point of burnout. Discussion and Conclusions The variability in medical students' definitions of altruism echoes the variability of definitions within literature, which may indicate students' relatively shallow understanding of the concept. Introducing guided reflection on professionalism within the medical curriculum may help to address this by helping students to develop a deeper understanding of professionalism and how it impacts their practice. Our paper supports a move away from the term altruism towards 'pro-social behaviour', which places importance on the benefits of an action without encouraging self-sacrifice. This may continue to provide students with the motivation they associate with altruism, whilst encouraging self-care and work-life balance.

Helping, mediating, and gaining recognition: The everyday identity work of Romanian health social workers

Health social work is a field with challenges, opportunities, and ways of professing social work that may vary between different national contexts. In this article, we look at how Romanian health social workers construct their professional identity through their everyday identity work. Drawing on a qualitative study based on interviews with 21 health social workers working in various organizational contexts, we analyze what health social workers say they do and how this shapes their self-conception as professionals. Four main themes emerged from participants' descriptions: being a helping professional, being a mediator, gaining recognition, and contending with limits. Through these themes, participants articulated the everyday struggles and satisfactions specific to working as recently recognized professionals in Romanian health and welfare systems not always supportive of their work.

Gender, money and professional identity: medical social work and the coming of the British National Health Service

The arrival of the British National Health Service (NHS) in 1948 heralded significant changes for all health workers, but the establishment of a 'free' health service was especially meaningful for the hospital almoners-or medical social workers, as they were starting to be known-who had previously been responsible for the assessment and collection of patient payments. It was on this basis they had gained a foothold in the hospital, capitalising on gendered assumptions of financial understanding and behaviour. Yet what might have caused an identity crisis was embraced. This was a dual strategy of both repositioning the profession in alignment with the planned NHS and of asserting an enhanced professional status by distancing themselves from the handling of payment. It was an episode in the history of this distinctly female profession that speaks to women's historic relationship with money.

Social Worker Identity: A Profession in Context

Social work is a broad field encompassing micro, mezzo, and macro areas of practice. Consequently, the field lacks a unifying professional identity due to the expansiveness of the profession. Professional identity is conceptualized as an extension of social identity, vis-à-vis the embodiment of three qualities: connectedness, expansiveness, and effectiveness. This study used 12 in-depth, individual interviews with practicing social workers to explore these qualities. Findings from interviews reveal six primary themes and 21 subthemes pertaining to social worker identity. Themes and subthemes are organized according to three broad families (social work in context, professional trajectories, and external influences). Implications for policy, practice, and future research are presented.

Impact of Pre-Pharmacy Work Experience on Development of Professional Identity in Student Pharmacists

Objective. To determine the benefit of pharmacy work experience on the development of student pharmacists' professional identity. Methods. Students in all four professional years were surveyed using a validated Professional Self-identity Questionnaire (PSIQ). They were also asked about pharmacy experience prior to matriculation and their performance on Drug Information tests given midway through the P1 year and at the beginning of the P3 year. PSIQ responses and test results were compared based on pharmacy experience. Results. The PSIQ was completed by 293 student pharmacists, for a 67% response rate, with 76% of respondents reporting pharmacy experience prior to matriculation. Statistically higher scores on responses to 6 of the 9 PSIQ Likert-type items were observed from students in the first professional year for those with pharmacy experience; however, only one item in the second year showed differences with none in the third and fourth years. No impact of experience was observed on Top 100 or Top 300 grades. Conclusion. Pre-matriculation pharmacy experience may increase development of professional identity early in the student experience but may have little impact on academic readiness. Schools and colleges of pharmacy hoping to recruit students with an early sense of professional identity should consider adding such experience to their admissions requirements.

INTRODUCTION TO THE MOVEMENT SYSTEM AS THE FOUNDATION FOR PHYSICAL THERAPIST PRACTICE EDUCATION AND RESEARCH

In 2013, the American Physical Therapy Association (APTA) adopted an inspiring new vision, "Transforming society by optimizing movement to improve the human experience." This new vision for our profession calls us to action as physical therapists to transform society by using our skills, knowledge, and expertise related to the movement system in order to optimize movement, promote health and wellness, mitigate the progression of impairments, and prevent the development of (additional) disability. The guiding principle of the new vision is "identity," which can be summarized as "The physical therapy profession will define and promote the movement system as the foundation for optimizing movement to improve the health of society." Recognition and validation of the movement system is essential to understand the structure, function, and potential of the human body. As currently defined, the "movement system" represents the collection of systems (cardiovascular, pulmonary, endocrine, integumentary, nervous, and musculoskeletal) that interact to move the body or its component parts. By better characterizing physical therapists as movement system experts, we seek to solidify our professional identity within the medical community and society. The physical therapist will be responsible for evaluating and managing an individual's movement system across the lifespan to promote optimal development; diagnose impairments, activity limitations, and participation restrictions; and provide interventions targeted at preventing or ameliorating activity limitations and participation restrictions.

LEVEL OF EVIDENCE

5.

Understanding the Struggles to Be a Medical Provider: View Through Medical Student Essays

BACKGROUND

The clinical learning environment helps to shape the professional identity of medical students. This process begins from existing personal identity and is influenced by various factors, including clinical experiences and clinical learning environment.

OBJECTIVE

The purpose of this study was to examine medical students' reflections as a way to identify and better characterize the modern struggles that medical students face, in order to inform the development of professional identity.

METHODS

Students rotating in their emergency medicine clerkship wrote reflections on dilemmas that highlighted common struggles of becoming a doctor. Qualitative analysis was performed to determine common themes from the essays. The research team coded 173 reflections and identified themes and major domains.

RESULTS

The first domain was Patient-Provider Conflict, including challenging patient (34%), difficult communication (25%), competing priorities between patients' interest and trainees need to learn (19%), and bias (13%). The second domain was Provider-Specific Issues, such as the "gray zone," in which there is not a clear standard of practice (29%), end-of-life care (14%), emotional struggle (6%), and fear of litigation (5%). The final domain was Systems Issues, such as cost of care (12%) and role of the emergency department (6%).

CONCLUSIONS

The reflections point to a wide variety of challenges that students confront in practice that will contribute to how they develop into physicians.

Professional identity and the Clinical Research Nurse: A qualitative study exploring issues having an impact on participant recruitment in research

AIMS

The aim of this study was to explore the experiences of Clinical Research Nurses, with an emphasis on factors that may have an impact on successful study delivery.

BACKGROUND

The Clinical Research Nurse workforce is pivotal to improving health outcomes through supporting research-active health economies. Investment in research infrastructure has led to nurses and midwives increasingly undertaking extended roles to deliver clinical research. Despite such opportunities, the recruitment of sufficient participants into research studies remains problematic. A growing body of literature is exploring barriers to successful study delivery, indicating the emergence of a caring-recruiting dichotomy in clinical research staff.

DESIGN

This qualitative study investigates the experiences of Clinical Research Nurses delivering research in the United Kingdom National Health Service.

METHODS

Four Focus groups (total 19 participants) were conducted in a large North East National Health Service Foundation Trust from November 2015 - February 2016.

FINDINGS

Thematic analysis identified perceptions of the role in the wider context of professional identity. Role transition, altered relationships and workload complexity, affected participants' practice, leading to inconsistency between core clinical values and perceived identities as research delivery staff. A duty of care as patient advocates contrasted elements of the work reflecting that of salespeople. The emotional labour of approaching patients and unease regarding peer perceptions of the Clinical Research Nurse role, affected the positive aspects of research delivery.

CONCLUSION

Professional-identity and self-concept appear to have an impact on practice in a research delivery role. Further research should explore these issues further, to enlighten the basis on which such feelings are positioned and to work towards practical solutions.

The Influence of Field Teaching Practice on Pre-service Teachers' Professional Identity: A Mixed Methods Study

The current study used mixed methods to research pre-service teachers’ professional identity. Ninety-eight pre-service teachers were investigated and twelve teachers were interviewed in China. The results were as follows: (1) The results of quantitative data showed that compared with before the field teaching practice, pre-service teachers’ professional identity increased after the field teaching practice—specifically, intrinsic value identity increased, and extrinsic value identity did not significantly change; (2) The results of qualitative data validated and elaborated the results of quantitative data in more detail with regard to changes in professional identity. Specifically, compared with before the field teaching practice, intrinsic value identity including work content, work pattern, etc., increased and extrinsic value identity including work environment, income, and social status, etc., did not significantly change after experiencing teaching practice; (3) The results of qualitative data also showed that mentor support at field school promoted the development of pre-service teachers’ professional identity. Moreover, the development of pre-service teachers’ professional identity during field teaching practice further promoted their professional commitment; that is, it promoted their emotional evaluation and belief in the teaching profession. The study discussed these results and proposed solutions and suggestions for future studies.

State Definitions of Social Work Practice: Implications for our Professional Identity

PURPOSE

For over a century, the social work profession has been concerned with describing the unique and specific characteristics that define its core functions in society; however, the profession has yet to agree to a single definition of social work. In the absence of a unifying definition, 51 different statutory definitions of social work have been created by each state and the District of Columbia.

METHODS

Using qualitative methods, each statutory definition of social work was analyzed to gain an understanding of how social work is defined and understood across the United States.

RESULTS

Findings indicate that 57% of the statutory language blend the full range of micro to macro social work practice skills into their definition. However, even within these and those remaining, there are vast differences in definitions.

DISCUSSION

Implications for state licensing laws, are considered, along with how this impacts education, the work force, and professional identity.

Nurturing virtues of the medical profession: does it enhance medical students' empathy?

OBJECTIVES

To examine if the empathy levels of first-year medical students are amenable to didactic interventions idealized to promote values inherent to medical professional identity.

METHODS

This is a pretest-posttest study designed to assess the empathy levels of first-year medical students (n=166) comprising two consecutive classes of a Brazilian medical school, performed before and after a didactic intervention. Students attended a course based on values and virtues related to medical professional identity once a week over four months. Every didactic approach (interviews with patients and physicians, supervised visits to the hospital, and discussion of videotaped simulated consultations) was based on "real-world" situations and designed to promote awareness of the process of socialization. Students filled out the Jefferson Scale of Physician Empathy (JSPE) on the first and last days of this course, and the pretest-posttest analysis was performed using the Wilcoxon Signed Rank Test.

RESULTS

The mean pretest JSPE score was 117.9 (minimum 92, maximum 135) and increased to 121.3 after the intervention (minimum 101, maximum 137). The difference was significant (z=-5.2, p<.001.), with an effect size of 0.40. The observed increase was greater among students with lower initial JSPE scores.

CONCLUSIONS

Empathy is a fundamental tool used to achieve a successful physician-patient relationship, and it seems to permeate other virtues of a good physician. This study's results suggest that medical students' empathy may be amenable to early curricular interventions designed to promote a positive development of their professional identity, even when empathy is not central in discussion.

Loss of idealism or realistic optimism? A cross-sectional analysis of dental hygiene students' and registered dental hygienists' professional identity perceptions

OBJECTIVES

The dental hygiene profession in the U.S. is in the process of establishing a direct access model of care and contributing to the creation of the profession of a dental therapist. The objectives were to analyse the professional role perceptions of dental hygiene students and registered dental hygienists in these times of change. Specifically, it was explored whether dental hygiene students' current professional identities differ (i) from their expected future identities, and (ii) from dental hygienists' current and (iii) past identities.

METHODS

Survey data were collected from 215 dental hygiene students concerning their present and future role perceptions, and from 352 registered dental hygienists concerning their present and past professional identity perceptions.

RESULTS

Students' future professional identity perceptions were even more positive than their very positive current perceptions of their professional role components. Students' current perceptions of professional pride, professional ambition, work ethic and patient relations were more positive than dental hygienists' current perceptions of these professional role components. A comparison of students' current perceptions with dental hygienists' current and retrospective descriptions showed that students were more positive than dental hygienists in each case.

CONCLUSIONS

The fact that dental hygienists had less positive role perceptions than dental hygiene students might lead to the conclusion that a loss of idealism occurs over the course of a professional lifespan. However, dental hygienists actually improved their role perceptions over time and students' future descriptions were more positive than their current descriptions, supporting the interpretation that realistic optimism dominates professional role perceptions in these times of change.

Constructing a nursing identity within the clinical environment: The student nurse experience

BACKGROUND

Nursing identity is an important element of being a nurse. Student nurses begin the construction of their nursing identity during their clinical placements.

AIM

The aim of this research was to examine how the student nurses of a regional Australian university construct their identity when on off-campus clinical placement.

METHODS/DESIGN

Using a constructivist approach an online survey was used to elicit data in response to the question 'What elements are needed during the work integrated learning experience to enable undergraduate nursing students to construct their nursing identity?'

RESULTS/FINDINGS

Findings reveal five key elements to the construction of students' nursing identity; positive role models, belonging, peer support, critical thinking abilities and confidence.

CONCLUSION

Such findings are important as they provide information for student nurses, preceptors and educators in guiding clinical placement experiences that are able to facilitate the development of the nursing identity.

Cognitive-Processing Bias in Chinese Student Teachers with Strong and Weak Professional Identity

Professional identity plays an important role in career development. Although many studies have examined professional identity, differences in cognitive-processing biases between Chinese student teachers with strong and weak professional identity are poorly understood. The current study adopted Tversky’s social-cognitive experimental paradigm to explore cognitive-processing biases in Chinese student teachers with strong and weak professional identity. Experiment 1 showed that participants with strong professional identity exhibited stronger positive-coding bias toward positive profession-related life events, relative to that observed in those with weak professional identity. Experiment 2 showed that participants with strong professional identity exhibited greater recognition bias for previously read items, relative to that observed in those with weak professional identity. Overall, the results suggested that participants with strong professional identity exhibited greater positive cognitive-processing bias relative to that observed in those with weak professional identity.

Attitudes of the first cohort of student groups trained together at the University of Portsmouth Dental Academy towards dental interprofessional education

OBJECTIVE

This study explored, and compared, the attitudes of student groups trained at the University of Portsmouth Dental Academy (UPDA) in 2010/2011 towards dental interprofessional education (IPE).

METHODS

The study population consisted of fifth-year student dentists (n = 80) from King's College London Dental Institute, second- and third-year dental hygiene and therapy (n = 38) and first-year dental nursing (n = 14) students from UPDA. A 19-item, validated and dentally modified questionnaire, 'Readiness for Inter-Professional Learning Scale (RIPLS)', was administered. RIPLS contains three subscales: teamwork and collaboration, professional identity and roles and responsibilities. Mean (x¯) and standard deviation (SD) of the scores were calculated, following reversal of negative items. All the analyses were carried out using SPSS version 20 and STATA version 11.

RESULTS

An overall response rate of 71% (n = 94) was achieved. In reference to teamwork and collaboration, all groups strongly indicated that IPE can contribute to learning teamwork skills (x¯ = 24.98, SD = 3.5) and improving relationships with team members (x¯ = 12.93, SD = 1.63); however, the scores did not differ between the groups (P = 0.09 and P = 0.16, respectively). Concerning professional identity, student dentists had significantly higher preference for a discipline-based approach (P = 0.002); were more likely to agree that 'it is not necessary for undergraduate dental and dental care professional students to learn together' (P = 0.01); and perceived that 'clinical problem-solving skills can only be learnt effectively with other students from their own discipline' (P = 0.02) than dental hygiene and therapy students. In relation to roles and responsibilities, participants demonstrated a strong sense of their own professional role. Student dentists reported that they had 'to gain more knowledge and skills' than dental hygiene and therapy (P = 0.01) and dental nursing (P = 0.01) students. Dental hygiene and therapy students were less likely than student dentists to agree that 'the role of dental nurses and hygienists was to mainly provide support for dentists' (P = 0.001).

CONCLUSION

The findings suggest that IPE was perceived as beneficial in relation to teamwork; however, the study raises issues regarding professional identity and roles. Educators should consider differing perceptions of professional roles and identities when planning and delivering interprofessional programmes.

The Effects of Trivialization of Workplace Violence on Its Victims: Profession and Sex Differences in a Cross-Sectional Study among Healthcare and Law Enforcement Workers

BACKGROUND

Workers from the law enforcement and healthcare sectors tend to normalize or mute their victimization from workplace violence (WPV).

OBJECTIVES

This study aims to assess the impact of the trivialization of WPV on psychological consequences for workers who have been affected by a WPV incident. The second aim is to assess the moderating effect of sex on the trivialization of WPV. The third and overarching aim is to assess the moderating effect of professional identity on the relations between individual and organizational factors and psychological consequences following a WPV incident.

METHODS

The findings are based on a convenience sample of 377 (204 female and 173 male) workers from the law enforcement and healthcare sectors. Individual factors (sex, age, professional identity, prior victimization, witnessing WPV, injuries, and trivialization of violence) and perceived support factors (colleagues' support and employer's support) were used as predictor variables of psychological consequences in hierarchical linear regression models. Sex was used as a moderator of trivialization while professional identity was used as a moderator of all predictors.

FINDINGS

When individual and social support factors were controlled for, normalizing violence was negatively associated with psychological consequences while perceiving a taboo associated with complaining about WPV was positively associated for all participants. When these relations were moderated by the sex of the participants and then by their professional identity, normalization was found to decrease psychological consequences only for male healthcare workers.

IMPLICATIONS

To help employees cope with WPV, organizations should promote strategies adapted to profession and sex differences. For male healthcare workers, normalization as a cognitive coping strategy should be formally recognized. For both professions and sexes, organizational strategies that counter the perceived taboo of complaining about violence should be reinforced.

Developing Professional Identity in Undergraduate Pharmacy Students: A Role for Self-Determination Theory

Professional identity development, seen as essential in the transition from student to professional, needs to be owned by the universities in order to ensure a workforce appropriately prepared to provide global health care in the future. The development of professional identity involves a focus on who the student is becoming, as well as what they know or can do, and requires authentic learning experiences such as practice exposure and interaction with pharmacist role models. This article examines conceptual frameworks aligned with professional identity development and will explore the role for self-determination theory (SDT) in pharmacy professional education. SDT explains the concepts of competence, relatedness and autonomy and the part they play in producing highly motivated individuals, leading to the development of one’s sense of self. Providing support for students in these three critical areas may, in accordance with the tenets of SDT, have the potential to increase motivation levels and their sense of professional identity.

The Irrelevance Narrative: Queer (In)Visibility in Medical Education and Practice

How might heteronormativity be reproduced and become internalized through biomedical practices? Based on in-depth, person-centered interviews, this article explores the ways heteronormativity works into medical education through the hidden curriculum. As experienced by my informants, case studies often reinforce unconscious heteronormative orientations and heterosexist/homophobic stereotypes about queer patients among straight and queer medical students alike. I introduce the concept of the irrelevance narrative to make sense of how queer medical students take up a heteronormative medical gaze. Despite recognizing that being queer affects how they interact with patients, my informants describe being queer as irrelevant to their delivery of care. I conclude with a discussion of how these preliminary findings can inform research on knowledge production in biomedical education and practice with an eye toward the tensions between personal and professional identity among biomedical practitioners.

How do psychiatrists in India construct their professional identity? A critical literature review

Psychiatric practice in India is marked by an increasing gulf between largely urban-based mental health professionals and a majority rural population. Based on the premise that any engagement is a mutually constructed humane process, an understanding of the culture of psychiatry including social process of local knowledge acquisition by trainee psychiatrists is critical. This paper reviews existing literature on training of psychiatrists in India, the cultural construction of their professional identities and autobiographical reflections. The results reveal a scarcity of research on how identities, knowledge, and values are constructed, contested, resisted, sustained, and operationalized through practice. This paper hypothesizes that psychiatric training and practice in India continues to operate chiefly in an instrumental fashion and bears a circular relationship between cultural, hierarchical training structures and patient-carer concerns. The absence of interpretative social science training generates a professional identity that predominantly focuses on the patient and his/her social world as the site of pathology. Infrequent and often superfluous critical cultural reflexivity gained through routine clinical practice further alienates professionals from patients, caregivers, and their own social landscapes. This results in a peculiar brand of theory and practice that is skewed toward a narrow understanding of what constitutes suffering. The authors argue that such omissions could be addressed through nuanced ethnographies on the professional development of psychiatrists during postgraduate training, including the political economies of their social institutions and local cultural landscapes. Further research will also help enhance culturally sensitive epistemology and shape locally responsive mental health training programs. This is critical for majority rural Indians who place their trust in State biomedical care.

Emerging Roles for Librarians in the Medical School Curriculum and the Impact on Professional Identity

This article discusses the impact on professional identity for health sciences librarians participating in the curriculum revision and development process. A qualitative survey, designed to examine the current roles, values, and self-identification of health sciences librarians involved in curricular revision, was conducted. The respondents discussed how they had participated in the planning, implementation, and rollout phases of revised curricula. They identified skills and values essential to successful participation and described the impact of expanded professional relationships on new identities as educators, change agents, and problem solvers. The study may add to the knowledge base of skills and attitudes needed for successful practice in these newly emerging roles.

How Do Pharmacists Construct, Facilitate and Consolidate Their Professional Identity?

The pharmacy profession continues to experience change regarding roles and responsibilities. The supply of medicines still remains a central function, but patient-facing, clinical roles are now becoming more commonplace, where pharmacists use their expert knowledge to maximise patient use of medicines. This transitional state from supplier of medicines to medicines expert raises questions over the contemporary professional identity of pharmacists. This literature-informed commentary highlights the current situation regarding how pharmacists’ identity is formed and reinforced. The authors suggest that the profession needs to be clearer in articulating what pharmacy does, and advocate the need for strong branding that the profession, public and other healthcare practitioners understand.

Teaching Professionalism: Using Role-Play Simulations to Generate Professionalism Learning Outcomes

For a constructively aligned curriculum in veterinary professionalism, there is a need for well-designed higher order learning outcomes to support students' professional identity formation. A lack of uniformly accepted definitions of veterinary professionalism necessitates the defining and refining of current concepts of professionalism to inform teaching and assessment. A potential method for achieving such learning outcomes is to generate these from simulated professionalism teaching scenarios. A workshop was designed in which veterinary educators used role play to resolve a professional dilemma. Following discussion of the appropriate management approach, participants were asked to reflect on the learning outcomes that were required to resolve the scenario and that students would achieve by going through the same classroom-based process. Workshop participants identified several professionalism learning outcomes that are not currently defined in the literature: realizing that there is not a single correct answer to a professional dilemma, making a decision despite this uncertainty, communicating differences of opinion, and understanding the effect of differences in professional identity. Although the process described runs counter to traditional curricular design, it may offer a valuable contribution to the discourse surrounding professionalism learning outcomes. Furthermore, it has generated higher level learning outcomes than have been obtained through other methods.

Rethinking Compassion Fatigue Through the Lens of Professional Identity: The Case of Child-Protection Workers

Compassion fatigue is currently the dominant model in work-related stress studies that explain the consequences of caring for others on child-protection workers. Based on a deterministic approach, this model excludes the role of cognition a priori and a posteriori in the understanding of the impact of caregiving or providing social support. By integrating the notion of professional identity, this article adds a subjective perspective to the compassion fatigue model allowing for the consideration of positive outcomes and takes into account the influence of stress caused by accountability. Mainly, it is argued that meanings derived from identity and given to situations may protect or accelerate the development of compassion fatigue or compassion satisfaction. To arrive at this proposition, the notions of compassion fatigue and identity theory are first reviewed. These concepts are then articulated around four work-related stressors specific to child-protection work. In light of this exercise, it is argued that professional identity serves as a subjective interpretative framework that guides the understanding of work-related situations. Therefore, compassion fatigue is not only a simple reaction to external stimuli. It is influenced by meanings given to the situation. Furthermore, professional identity modulates the impact of compassion fatigue on psychological well-being. Practice, policy, and research implications in light of these findings are also discussed.

After the Biomedical Technology Revolution: Where to Now for a Bio-Psycho-Social Approach to Social Work?

In the late twentieth century, the bio-psycho-social framework emerged as a powerful influence on the conceptualisation and delivery of health and rehabilitation services including social work services in these fields. The bio-psycho-social framework is built on a systems view of health and well-being ( Garland and Howard, 2009). The systems perspective encourages medical and allied health professions, including social work, to recognise and to respond to the multiple systems impacting on individual health and well-being ( Engel, 2003). This paper analyses how advances in biomedical technology, particularly in the fields of neuroscience and human genomics, are challenging the bio-psycho-social approach to practice. The paper examines the pressures on the social work profession to embrace biomedical science and points to the problems in doing so. The conclusion points to some tentative ways forward for social workers to engage critically with biomedical advances and to strengthen the bio-psycho-social framework in the interests of holistic and ethical approaches to social work practice.

Contributing to an integrated profession: a model-based examination of the A-ONE

Yerxa's [1] model of an integrated profession depicts a circular scholarly process whereby ideas formed in practice are subjected to research and then returned to practice through education. This knowledge-generating cycle supports occupational science and the development of our professional identity. The aim of this article is to demonstrate how Yerxa's model was used to evaluate if three developmental cycles of the ADL-Focused Occupation-Based Neurobehavioral Evaluation (A-ONE) sufficiently represented all necessary model components required for implementation into practice. The three cycles were historical, educational and measurement. The necessary components included: (a) dilemmas in practice, (b) new ideas that emerged from those practice issues, (c) research to test those ideas and (d) education designed to integrate new knowledge into practice. The results of this analysis of the A-ONE supported adequate research related to ideas from practice being implemented back into practice. Through using the model of an integrated profession to reflect on ideas ignited within practice, and then implementing research to explore the potential contribution of those ideas to knowledge generation, we gain the power to influence the future development of occupational science and the profession.

Hospice nurses' emotional challenges in their encounters with the dying

The purpose of this study was to explore nurses’ emotional challenges when caring for the dying in hospices. The study has a qualitative design, and knowledge was developed through a dialectical exchange between theory and data. Ten individual in-depth interviews were conducted with nurses recruited from two hospices in Denmark. Although all of the nurses said that they experienced emotional challenges or felt emotionally touched during their work, the study found a variety of opinions related to the extent to which their emotional reactions should be revealed in their role as a hospice professional. The participants described their emotional challenges as being simultaneously draining and enriching experiences leading to personal and professional growth and development. The study may contribute to increased awareness of emotional challenges for hospice nurses, which involve continuous reflection and balancing between meeting the dying as a human being and meeting the dying as a hospice professional.

An exploratory study into the application of psychological theories and therapies in Australian mental health occupational therapy practice: Challenges to occupation-based practice

BACKGROUND

While legitimate practice tools have been the subject of debate within the profession, little attention has been paid to psychological frames of reference (PFsOR). Hence, this article explores the ways psychological theories and therapies shape occupation-based practice in mental health settings.

METHODOLOGY

Narrative inquiry methods and thematic analysis were used to explore the career stories of nine occupational therapists who had worked in mental health practice for more than five years.

FINDINGS

Respondents found it difficult to hold onto their occupational focus in the psychology-dominated world of mental health practice. The main themes to emerge were (i) tension between occupation and psychology; (ii) overwhelming pressures to adopt PFsOR; (iii) resistance to PFsOR; and (iv) using PFsOR to enhance professional repertoires. Findings pointed to the need to ensure PFsOR include occupational considerations for occupation-based practice in mental health.

CONCLUSION

A occupation-based perspective means balancing PFsOR with occupation-based considerations, so service-user issues are holistically addressed. There is a need to critically review occupational therapists' use of PFsOR lest their most visible practical actions appear psychologically based rather than occupation based.

Exploring self-perception of community pharmacists of their professional identity, capabilities, and role expansion

Objective:

The principal aim of this study was to explore the self-perception of community pharmacists of their professional identity and roles and how they think patients and doctors perceive them. The study also aimed at exploring their opinions regarding role expansion and how they assess their capabilities.

Methods:

This is an exploratory study that employed qualitative method. Individual, in-depth interviews were conducted with a purposive sample of 50 community pharmacists working in Khartoum State, Sudan, from October to November 2015. Each interview was recorded, transcribed, and coded into themes. Thematic analysis was carried out.

Findings:

The study revealed nine different identities of community pharmacists including supplier of medicines, medicines maker, dispenser, patient counselor, medicines expert, clinical practitioner, health promoter, monitor of medicines use, and family practice identity. Participants described that most of the patients value their professional role while doctors perceive them as merely dispensers. Most of participants believe that they are capable to fulfill their roles; however, they identified the need for continuous education. The study revealed that community pharmacists are thirst to role expansion.

Conclusion:

The study concluded that community pharmacists are aware of the different identities of their profession. The good recognition of their role by patients reflects good service provided while lack of integrated primary health care system that join doctors and pharmacists resulted in lack of pharmacists’ recognition by doctors. Continuous educational program is needed for community pharmacists, and role expansion will allow for better self-perception and better profession contribution in healthcare.

Professional identity acquisition process model in interprofessional education using structural equation modelling: 10-year initiative survey

The mandatory interprofessional education (IPE) programme at Gunma University, Japan, was initiated in 1999. A questionnaire of 10 items to assess the students' understanding of the IPE training programme has been distributed since then, and the factor analysis of the responses revealed that it was categorised into four subscales, i.e. "professional identity", "structure and function of training facilities", "teamwork and collaboration", and "role and responsibilities", and suggested that these may take into account the development of IPE programme with clinical training. The purpose of this study was to examine the professional identity acquisition process (PIAP) model in IPE using structural equation modelling (SEM). Overall, 1,581 respondents of a possible 1,809 students from the departments of nursing, laboratory sciences, physical therapy, and occupational therapy completed the questionnaire. The SEM technique was utilised to construct a PIAP model on the relationships among four factors. The original PIAP model showed that "professional identity" was predicted by two factors, namely "role and responsibilities" and "teamwork and collaboration". These two factors were predicted by the factor "structure and function of training facilities". The same structure was observed in nursing and physical therapy students' PIAP models, but it was not completely the same in laboratory sciences and occupational therapy students' PIAP models. A parallel but not isolated curriculum on expertise unique to the profession, which may help to understand their professional identity in combination with learning the collaboration, may be necessary.

Developing professional values: perceptions of francophone occupational therapists in Quebec, Canada

Objective Recent literature shows growing interest in the values displayed by occupational therapists. Yet, none of these writings has so far examined the factors that contribute to the development of occupational therapists' professional values. These factors are important, since values play a pivotal role in forging professional identity, which in the case of some occupational therapists remains somewhat ambiguous. This article proposes possible answers to the following question: What do Quebec Francophone occupational therapists perceive as the building blocks of their professional values? Methods Using a phenomenological qualitative method, the subjective experience of occupational therapists in Quebec, Canada was examined. Twenty-six occupational therapists took part in the study. Results As intended, their professional experience was varied. According to the participants, four factors contributed significantly to their professional values: professional experience, university training, personal experience, and professional development. However, fewer than 50% of the participants cited six other factors (workplace, family upbringing, personal development, personality and abilities, professional normative framework, and sociocultural background). Conclusions Most of these results are consistent with those documented in existing works. They point to the relevance of discussing professional values during university training and continuing professional development, as well as encouraging occupational therapists to become exemplars for their colleagues and interns. This study constitutes an initial step in understanding how occupational therapists' axiological identity is formed.

Student learning in interprofessional practice-based environments: what does theory say?

Student learning in interprofessional practice-based environments has garnered significant attention in the last decade, and is reflected in a corresponding increase in published literature on the topic. We review the current empirical literature with specific attention to the theoretical frameworks that have been used to illustrate how and why student learning occurs in interprofessional practice-based environments. Our findings show there are relatively few theoretical-based studies available to guide educators and researchers alike. We recommend a more considered and consistent use of theory and suggest that professional identity and socio-cultural frameworks offer promising avenues for advancing understandings of student learning and professional identity development within interprofessional practice-based environments.

Professionalization in Pharmacy Education as a Matter of Identity

Little research exists on the formation of professional identity in higher education health programs. Such programs may approach the teaching, learning, and assessment of professionalism based upon a suite of attitudes, values, and behaviors considered indicative of a practicing professional. During this transition, professional identity formation can be achieved through student engagement with authentic experiences and interaction with qualified professionals. This paper examines the shift toward identity formation as an essential element of professional education and considers its implications for pharmacy curriculum design.

Professional Identity Development Through Service Learning: A Qualitative Study of First-Year Medical Students Volunteering at a Medical Specialty Camp

OBJECTIVE

To describe the experience of medical students volunteering at a camp for children with a variety of medical conditions.

METHODS

Rising second-year medical students who had served as counselors for 1 week at a medical specialty camp were invited to participate. We conducted a 2-part qualitative study using on-site focus groups and follow-up individual interviews.

RESULTS

Nine medical students participated. Students described their experience as motivating and career reinforcing. It helped them "move beyond the textbook" and deepened their commitment to serving future patients with compassion. One theme that emerged was the idea that their camp experience fostered the development of their professional identities.

CONCLUSIONS

A 1-week, immersive community service experience at a medical specialty camp played a role in influencing the early formative professional identities of rising second-year medical students. Medical schools could use camps as a promising community service-learning experiences to foster professional identity.

Nut clusters and crisps: atrocity stories and co-narration in interviews with approved mental health professionals

The article explores the telling of co-narrated atrocity stories in accomplishing professional identity. Building on previous work, it is argued that group membership is a prerequisite for such stories to be told. Extracts from empirical data from interviews with social work approved mental health professionals are analysed using an ethnomethodological approach. The findings show how atrocity stories can be co-narrated, not only by longstanding colleagues, but also by two unacquainted persons who share the same professional identity. The article concludes that the ethnomethodological concepts of vulgar competency, unique adequacy, indexicality and the documentary method of interpretation are key to understanding the accomplishment of co-narrated atrocity stories.

The role of professional and team commitments in nurse-physician collaboration

AIM

To analyse the effect of both professional and care unit commitments on attitudes towards interprofessional collaboration between nurses and physicians.

BACKGROUND

The effects of both professional and care unit commitment on inter-professional collaboration have not been taken into account together, and previous research has analysed only one profession at a time, neglecting the nurse-physician comparison.

METHOD

A cross-sectional survey of 138 physicians and 359 nurses was used.

RESULTS

For physicians, professional commitment decreased attitudes towards interprofessional collaboration whereas care unit commitment had a positive influence. Conversely, for nurses, the professional commitment had a significant positive effect on attitudes towards interprofessional collaboration whereas care unit commitment had no significant effect.

CONCLUSION

Intergroup relations affect the extent to which nurses and physicians are inclined to engage in interprofessional collaboration. Professional and care unit commitments had different effects on attitude toward the inter-professional collaboration of nurses and physicians.

IMPLICATION FOR NURSING MANAGEMENT

Inter-professional collaboration is affected by the relationship between physicians and nurse at the professional group level. Managers who want to change and improve inter-professional collaboration should pay close attention to the interplay between changes they are introducing and well-established identities and practices between professionals.