Professional identity and nursing: contemporary theoretical developments and future research challenges

Construction of professional identity in nursing students: qualitative research from the historical-cultural perspective

OBJECTIVE

to analyze the process of professional identity construction in undergraduate nursing students during their education.

METHOD

qualitative research, anchored in the Historical-Cultural framework. Twenty-three undergraduate nursing students took part. Data were collected through individual interviews, with a semi-structured script. Thematic Analysis was used to analyze the data.

RESULTS

the following four themes were obtained, "The subject in movement to become a nurse: from previous experiences to entering the courses"; "The nursing professor in the construction of the undergraduate's professional identity: a two-way mirror"; "Pedagogical relationship: instrument for constructing the student's professional identity" and "Historical-cultural conditions: space for the construction of the student's professional identity".

CONCLUSION

the construction of the students' professional identity is limited to the material conditions of existence, translating appropriation to the intrapsychic scope of elements that occur, first, in the inter-psychological space of interactions. Nursing professors can become a paradoxical mirror, with one face to be imitated and the other, which materializes meanings of a model not to be followed. This construction is also influenced by the conditions of professional practice and university education.

The journey from nurse to advanced nurse practitioner: applying concepts of role transitioning

The advanced nurse practitioner (ANP) role was established in Ireland in 2001 and represents an important nursing role development within Irish healthcare. Currently there are 336 ANPs registered with the Nursing and Midwifery Board of Ireland, working across 40 specialties. This number is increasing exponentially in response to emerging and anticipated future service needs and population demand projecting to a critical mass of 750 by 2021. Health service provision is enhanced by advanced practice performance outcomes. This article explores nurse to advanced nurse practitioner transitional journeys, a concept that has not previously been researched in depth from an Irish perspective. The theories of Benner, Woods, and Bourdieu are reviewed to explore whether an advance practice career trajectory results in unique nurse-to-ANP role transitioning. Contextualising possible personal, professional and educational transitions may enable the promotion of effective career ‘scaffolding’ to enhance a smooth transition for aspiring ANPs into advanced nursing practice roles.

Analysis on professional identity and related factors among Chinese general practitioners: a National Cross-sectional Study

BACKGROUND

Studies on professional identity and related factors among Chinese general practitioners (GPs) are unavailable. The objective of this study was to investigate the professional identity level of GPs in China and explore factors associated with GPs' perceptions of their professional identity.

METHODS

A multistage stratified random sampling method was used to collect data with a structured self-administered questionnaire from 3236 GPs working in community health service institutions (CHIs) in China between October, 2017 and February, 2018. Professional identity was measured by the 13 items scale. Descriptive statistics were calculated and groups' differences were estimated using nonparametric tests. Multiple linear stepwise regression analysis was used to analyze factors associated with professional identity among GPs.

RESULTS

Based on a total score of 65 on the professional identity scale, the average score for GPs' professional identity was 51.23 (SD = 6.56). Multiple linear stepwise regression analysis showed that GPs who practiced in Central China, with an administrative responsibility, at a moderate or higher income level, who frequently worked overtime, had more occupational development opportunities, with a higher level of job satisfaction and older GPs had higher levels of professional identity.

CONCLUSIONS

Professional identity level among GPs in China is high. Region, administrative responsibility, income level, working overtime, occupational development opportunities, age, and job satisfaction were significant predictors of professional identity.

The Influence of Self-Concept on Clinical Decision-Making in Nurses and Nursing Students: A Cross-Sectional Study

The aim of this study is to examine the influence of nurses’ self-concept (NSC) on clinical decision-making (CDM) among nursing students and hospital nurses. A further aim is to examine whether there is a difference in CDM and NSC between hospital nurses with various levels of experience and nursing students. A cross-sectional study was conducted during 2018 in the Faculty of Dental Medicine and Health and the University Hospital Center, in Osijek, Croatia, EU. The respondents consisted of 568 hospital nurses, and 129 BSc nursing students. Data were collected with the clinical decision-making in nursing scale (CDMNS) and the nurses’ self-concept questionnaire (NSCQ). There was no correlation between CDM and NSC in either students or hospital nurses. Hospital nurses generally had significantly higher scores in CDM than nursing students. On the other hand, students had a significantly higher total NSC level. The results of this study suggest that experience has a positive impact on nurses’ CDM skills. The high NSC estimated by students enables them to easily take up their clinical roles and approach the patient in a holistic manner, which is an attitude that gradually develops during studies and with clinical experience.

Professional identity: A concept analysis

The purpose of this study is to give clarity to the concept of professional identity, drawing from health-related fields to help provide a common language and understanding for research and practice. Professional identity, professionalism, professional socialization, and other related terms are often used without a clear definition or with conflicting definitions. This can lead to misunderstandings and assumptions that complicate research and confuse educators and professionals in guiding novice members. Concept analysis. Initially, 737 articles were identified by searching CINAHL, PubMed Central, Google Scholar, Academic Search Complete, PsyINFO, and SocINDEX for the period 2000 to 2019. Finally, 68 studies met the inclusion criteria, 60 of which are discussed in this concept analysis. This concept analysis uses the method described by Walker and Avant. This concept analysis clarifies the definition of professional identity, using literature from health and related professions, as containing the attributes: skills and functions; knowledge values and ethics; personal identity; group identity; and the influence of the context of care. A more clear definition of professional identity will help researchers to have more precision in their analyses and provide mentors and educators with a clear goal.

Psychometric Testing of the Persian Version of Macleod Clark Professional Identity Scale

BACKGROUND

Professional identity (PI) is a key factor behind nurses' ability to provide quality care. PI assessment requires valid and reliable tools.

AIM

This study aimed to translate into Persian the 9-item Macleod Clark Professional Identity Scale (MCPIS) and evaluate its psychometric properties among Iranian nursing students.

METHODS

In this methodological study, SMCPIS was translated into Persian through forward-backward translation. The face and content validity of the translated scale were respectively assessed by 10 nursing students and a panel of 10 experts. Then, 171 nursing students completed MCPIS and Nurse Self-Concept Questionnaire. Collected data were used for construct validity assessment through confirmatory factor analysis and criterion validity assessment through correlation analysis. Reliability assessment was also performed through the internal consistency and the test-retest methods.

FINDINGS

Confirmatory factor analysis revealed good fit model for the scale. Criterion validity, measuring convergent validity, assessment also showed a significant correlation between the scores of MCPIS and Nurse Self-Concept Questionnaire (r = -0.2, P = .07). Cronbach's alpha and test-retest correlation coefficient were .87 and .72, respectively. Students' MCPIS scores ranged from 15 to 54 with a median of 44 (in the possible range of 9-54).

CONCLUSION

The Persian MCPIS is a valid and reliable tool for PI assessment. Further studies are recommended to produce evidence supporting the validity and reliability of the scale.

Quality of contact counts: The development of interprofessional identity in first year students

BACKGROUND

Little is known about how nursing and other healthcare students develop professional and interprofessional identities.

OBJECTIVES

This study a) measures changes in students' professional and interprofessional identities between the start and end of a faculty-wide interprofessional first year programme, and b) identifies factors influencing interprofessional identity strength at the end of the programme.

PARTICIPANTS

One hundred and eight first year nursing, medicine and allied health students.

METHODS

A single-group pre-post-test design was used. Students completed an online survey at the start and end of the year-long programme. The survey comprised measures of professional and interprofessional identity, stereotypes, contact and demographics. The same survey was used twice.

RESULTS

There was a small decline in professional identity and a large decline in interprofessional identity across the year. Nursing students, the only group involved in clinical practicums, were exempt from the large fall in interprofessional identity. Quality of contact with students from other professions and autostereotypes about own profession were predictors of interprofessional identity strength at the end of the programme, consistent with intergroup contact theory.

CONCLUSIONS

Introductory interprofessional education programmes should include opportunities for quality contact with students from other professions, and for students to develop a clear understanding of their own profession.

Communities of practice: A systematic review and meta-synthesis of what it means and how it really works among nursing students and novices

AIMS AND OBJECTIVES

To evaluate the enablers, barriers and impact that communities of practice have on novice nurses and students learning to become registered nurses.

BACKGROUND

Communities of practice have formed the basis for conceptualising the process of learning that occurs among groups of people within a place of work-a mainstay of healthcare practice. There is a dearth of literature that focuses specifically on the outcomes from student and novice engagement with existing communities of practice.

DESIGN

Systematic review and Meta-synthesis.

METHODS

MEDLINE, PubMed, EMBASE, CINAHL, ProQuest, Scopus and PsycINFO databases were accessed between 1997-2019. The screening and selection of studies were based on eligibility criteria and methodological quality assessment using the Critical Appraisal Skills Programme tool for qualitative research. Meta-synthesis was grounded in the original experiences and collectively synthesised into meaningful themes. The review follows the PRISMA reporting guidelines and PRISMA checklist.

RESULTS

The findings highlight three major themes and included enablers for successful communities of practice, barriers to successful communities of practice, and success in action as described by students and novice nurses.

DISCUSSION

We suggest successful communities of practice occur when safe and supported spaces ensure students and novices feel comfortable to experiment with their learning, and we emphasise the benefits of having more novice nurses situated within close proximity and under the direct influence of the established practices of more experienced or core group of peers.

RELEVANCE TO CLINICAL PRACTICE

Communities of practice that function successfully create an environment that prioritises the embedding of novices into the broader group. In so doing, students and novice nurses feel supported, welcomed, empowered, and able to make the transition from student to colleague and novice nurse to more experienced nurse. It allows them to experiment with ever new ways of fulfilling the role, while aiding better clinical outcomes.

Practical nursing students' discursive practices on smoking in Finland

Purpose: Based on focus groups, we analyse how practical nursing students deal with being as smokers and future healthcare workers. The way they justify their smoking is discussed within a group of peers.

Methods: The study has a qualitative design with an inductive approach using focus group interviews (FGIs) for data collection. A total of 29 students were interviewed in five groups of five and one group of four participants.

Results: In the analysis, we found four different discursive practices the students utilized for rationalizing their own smoking and coping with the moral dilemma of smoking in a context of health care where smoking is forbidden: (1) students normalized smoking with references to its prevalence within their social circles, (2) the students asserted that their smoking was under control, (3) students considered themselves responsible smokers, and (4) students identified smoking as a part of their identity.

Conclusion: Training should support the growth of professional identity and address the smoker’s identity right from the start of education. Smokers need special attention in the formulation of professional identity, however, without being stigmatized any further.

Professional identity and its influencing factors of first-year post-associate degree baccalaureate nursing students: A cross-sectional study

BACKGROUND

Professional identity is an important and universal concept in the field of nursing because it not only affects nurses' perceptions of their role in nursing, but it also affects retention rates. However, the influential factors that impact the professional identity of nursing students currently are not well known.

PURPOSE

This exploratory study aims to investigate the concept of professional identity and confirm its influencing factors among post-associate degree baccalaureate nursing students in China.

METHODS

We conducted a cross-sectional study of 198 first-year post-associate degree baccalaureate nursing students enrolled in full-time study at two provincial medical colleges in China. We used paper and pencil questionnaires to conduct the survey and obtain the results used in this study.

RESULTS

The overall mean score for 'professional identity' of the sample was 3.63 ± 0.62 on a scale of 1 through 5, with the means for the five dimensions of professional identity ranging from 3.29 to 4.02. A clinical learning experience that is longer than eight months (ref. = 8 months) (β = 0.138, p < 0.036) and a positive perception of the clinical learning environment (β = 0.476, p < 0.001) are the dominant factors that we found to be positively associated with professional identity.

CONCLUSIONS

Nurse educators should investigate the factors that influence professional identity among their students to help develop a stable and satisfied nursing workforce.

The hidden curriculum: Undergraduate nursing students' perspectives of socialization and professionalism

BACKGROUND AND AIM

Nursing students form a professional identity from their core values, role models, and past experiences, and these factors contribute to the development of their professional identity. The hidden curriculum, a set of ethics and values learned within a clinical setting, may be part of developing a professional identity. Nursing students will develop a professional identity throughout school; however, their identity might be challenged as they attempt to balance their core values with behaviors learned through the hidden curriculum. The purpose of this project was to educate students on the hidden curriculum in the development of their professional identity.

MATERIALS AND METHODS

A sample of 112 senior nursing students was recruited from a northeastern university in the United States for this study. Pre-post survey design was used, and an educational session was administered prior to the post-survey. Descriptive statistics and a valid percentage were used to describe the data within the surveys.

ETHICAL CONSIDERATION

Study was approved by the author's University Institutional Review Board.

FINDINGS

A significant finding was for advocacy as students would speak up if witnessing inappropriate behavior toward patients or families with a mean score increase from 2.50 (pre-survey) to 1.45 (post-survey). Also, over 95% (n = 106) found the educational session beneficial as they learned they had the ability to advocate and speak up for their patients.

CONCLUSION

Students were able to use their core values and advocate for their patients and families which allows for safer patient care.

Professional transition and identity formation of surgical care practitioners: a phenomenological interpretation of their lived experiences

Surgical care practitioners are non-medical members of the surgical team, who provide direct surgical care to patients, delegated by consultant surgeons. The surgical care practitioners' professional role is within the new non-medical or nursing workstream, practising under the medical model of care in response to staff shortages and the rising expectations that are affecting the National Health Service. This article seeks to contribute to a better understanding of the phenomenon of the emergent professional identity of surgical care practitioners. Six surgical care practitioners were purposively sampled for in-depth, semi-structured interviews whereupon their concepts of professional transition and professional identity formation from their individual points of view were explored using a phenomenological approach. Transcripts and reflective texts were subject to repeated interpretation in a hermeneutic circle of understanding. Interpretation of the results in context allowed for a discussion informed by self-interpreted constructions and revolved around eight cluster themes that emerged explicating how surgical care practitioners experienced professional transition and professional identity formation. In addition, a notion of 'journey' in the development of professional identity (narratives about professional identity formation: the hero's journey) was embedded in the reflections of the participants and their narratives produced rich accounts of the phenomenon under investigation.

Challenges and facilitators of professional socialization: A systematic review

AIMS

This current study aimed to present a review of the challenges and facilitators of professional socialization among undergraduate nursing students.

DESIGN

Systematic review.

METHODS

A literature search was conducted in Embase, Google Scholar, PubMed and Scopus in April and May 2018 for studies published in the English language. Four thousand three hundred fifty-two articles were retrieved. We conducted further screening for full-text articles after discarding duplicates and irrelevant studies. Finally, eight studies were included. The Joanna Briggs appraisal tools were used to appraise and evaluate study quality. The PRISMA guidelines were followed and a narrative synthesis used for data analysis.

RESULTS

Challenges and facilitators of professional socialization were identified and categorized into two major themes. Under each theme, results were grouped into three sub-themes: professional, personal and educational challenges/facilitators.

Nurse Practitioner Role Transition and Identity Development in Rural Health Care Settings: A Scoping Review

AIM

The purpose of this scoping review was to explore the literature regarding the nurse practitioner (NP) role transition and professional identity development at rural health care settings.

BACKGROUND

Because of the shortage of primary care providers, NPs are meeting the demand for primary care in rural areas.

METHOD

Arksey and O'Malley's six-stage methodological framework for scoping reviews guided this systematic literature review, which resulted in selection of 145 sources.

RESULTS

Three major themes emerged: NPs in rural clinical practice, defining NP professional identity, and role transition to an NP identity.

CONCLUSION

Further research is needed to guide education program leaders on curriculum development. Rural health care facilities and nursing programs should partner in the orientation and continuing education needs of NPs to prepare and support their role transition and professional identity development. NPs will be instrumental in providing access to quality primary health care in rural communities.

Two-Year Institution Part-Time Nurse Faculty Experiences During Role Transition and Identity Development: A Phenomenological Study

AIM

This study explored two-year institution part-time nurse faculty's perceptions of their experiences during their role transitions from nurses in clinical practice to part-time clinical instructors.

BACKGROUND

Part-time nurse faculty enter academia as expert clinicians, but most have little or no training in the pedagogy of effective student learning.

METHOD

A phenomenological study was used to explore the faculty role transition experiences.

RESULTS

Findings support the proposition that six participants transitioned from their expert clinician to instructor identities; however, two continue in the process. Critical to this process are relationships with individuals in their environments, past and present experiences, the incentive to learn to be better instructors, and the importance of support and training.

CONCLUSION

A model emerged, Process of Role Transition and Professional Identity Formation for Part-Time Clinical Instructors at Two-Year Institutions, that is potentially useful for administrators in developing individualized orientation and professional development programs.

The Relationship Between Experiences of Lateral Violence and Career Choice Satisfaction Among Nursing Students

This article explores associate degree nursing students' experiences with lateral violence and its impact on career choice satisfaction. Lateral violence has been linked to decreased professional identity, increased errors, and poor self-esteem, leading to a negative culture and attrition. A nonexperimental, quantitative, cross-sectional, correlational design was used; 13.4 percent of respondents (n = 32) met the criteria for intermittent bullying. Analysis confirmed a significant negative correlation between experiences of lateral/vertical violence and career choice satisfaction (r = - .140, p < .05) even after controlling for affect and support. Improved efforts are needed to prevent lateral violence.

[From clinical practice to nursing research: Auto-ethnography as a tool for analyzing the researcher’s identity transitions]

The scientific legitimacy of nursing research depends on its adherence to different scientific criteria. Despite the lack of consensus on predetermined criteria, reflexivity is widely discussed as a strategy to establish rigour in qualitative research. Unfortunately, with the exception of tools such as the reflexive journal, little is said about how reflexivity can be completed. Several recent studies suggest the relevance of autoethnography to support the reflexive approach of nurse researchers. Inspired by the findings of an autoethnography and a narrative literature review, this article examines how this approach can contribute to the reflexivity of the nurse researcher. Autoethnography seems particularly adapted to the professional and academic context in which many nurses evolve. As a reflective tool, autoethnography can promote the development of the researcher's self-awareness, provide analytical tools to help better understand the influence of previous experiences on the relationship to research and report on the transition between different professional identities. In order to contribute to the debate on the use of autoethnography in qualitative research, central elements to this approach are discussed.

BETWEEN THOSE WHO THINK AND THOSE WHO DO: PRACTICE AND THEORY IN NURSE TEACHING

ABSTRACT Objective: to identify the opinions of professors about the relationship between theory and practice in nursing. Method: descriptive analytical, qualitative study. Eighteen professors from two universities (one federal and one private) from the southern region of the country participated. Data collection took place between July and September 2014, through semi-structured interviews. Open and axial coding as proposed by Strauss and Corbin, with the help of Atlas ti® 7 software was used for data collection. Results: the following categories emerged: The centrality of the practice for teaching and The specialist x generalist dichotomy: contrasting discourses. Conclusion: the opinions of professors about theory and practice in nursing are widely conflicting. In areas considered of greater complexity, mastery of content is prefered and considered advantageous. The relationships that nurses and nursing professors maintain with knowledge influence the disconnection between theory and practice.

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.

Dietetics students' experiences of dietetics workforce preparation and preparedness: a systematic review and qualitative synthesis

BACKGROUND

Dietetics students are a widely researched group. As emerging dietitians, they can provide valuable insights to inform how dietetics education programmes may be enhanced to meet contemporary healthcare needs. This review aimed to systematically synthesise dietetics students' experiences of dietetics workforce preparation.

METHODS

MEDLINE, CINAHL, Embase, PsycINFO, ERIC, Informit and ProQuest Dissertations and Theses Global were searched to identify research published until June 2017. Studies investigating dietetics students' experiences of dietetics workforce preparation, and employing qualitative data collection and analysis methods were included. Data analysis was guided by thematic synthesis, where themes were constructed through an iterative and inductive process. Study quality was appraised using the RATS Qualitative Research Review Guidelines.

RESULTS

From the 3301 records identified, five studies met the inclusion criteria and the views of 120 dietetics students from two countries over a 9-year period were synthesised. The overarching theme of 'navigating through the ups and downs' was underpinned by four main themes: enduring hurdles; reconciling expectations; transforming self; and making and breaking connections. Quality appraisal results rated selection bias as being inadequate/inappropriate across all studies.

CONCLUSIONS

Dietetics students undertake a transformational journey through dietetics education. They are inspired by seeing what is possible through meaningful encounters with practitioners in diverse settings. However, they are challenged by competitive environments and perceived ideals that are embedded in the profession. Strategies that focus on exposing dietetics students to inspirational practitioners, increasing and celebrating diversity in academic/placement settings, and incentivising collaboration across dietetics education, could act as catalysts to enhance the experience of future dietetics students and the nutrition-related health of those they will serve.

A Phenomenological Investigation of the Interplay Among Professional Worth Appraisal, Self-Esteem and Self-Perception in Nurses: The Revelation of an Internal and External Criteria System

Nurses’ professional self-concept is strongly associated with professional worth appraisal, which encompasses their feelings and perceptions regarding their task efficacy and value of input to clinical outcomes. Professional self-concept and professional worth appraisal are incorporated in one’s overall professional role perception. Data show that the way nurses think and feel about themselves personally and professionally, is associated with their well-being, the quality of provided patient care, their job satisfaction and retention. Although researchers indicate that professional self-concept is a different entity from personal self-concept, however, a clear differentiation and possible interaction between these constructs has not been yet adequately described in nursing literature. Personal self-concept mirrors the way people interpret them-selves, incorporating their self-awareness and personal effectiveness. Following purposeful sampling and informed consent, a phenomenological approach based on Munhall’s methodology was employed to explore the living experience of professional role perception in 16 critical and emergency nurses, with special focus on their perceptions and feelings about personal and professional-role worth appraisal. Data and theoretical saturation criteria were implemented, along with all nine Munhall’s criteria for the rigor and trustworthiness of phenomenological studies. The participants’ narratives suggested a possible interaction between professional attitude and personality traits, illuminating as the core theme an interplay among self-perception, personal and professional worth appraisal process. Additionally, the present study emphasized the way self-evaluation criteria system may be associated with the personal and professional self-concept in nurses. In particular, it was highlighted that the way nurses think and feel about themselves is associated with the way they experience their professional role and vice versa, and that professional role-based self-concept and professional worth perception can be linked with their well-being. Furthermore, positive feelings about the self and personal competencies seemed to enhance the perception of effectiveness in clinical settings and adequacy of professional skills, resulting in empowered professional identity and vice versa. Overall, the present findings are discussed in relation to nurses’ experience of work-related stressors and relevant interventions. Further exploration of the effectiveness of interventions for facilitating adaptive personal and professional self-appraisal are suggested.

Registered nurse experiences of nursing professional identity: a qualitative systematic review protocol

REVIEW QUESTION/OBJECTIVE

The objective of this review is to identify, appraise and synthesize the best available evidence related to registered nurses' experiences of nursing professional identity in nursing care settings.

Understanding perceptions of nursing professional identity in students entering an Australian undergraduate nursing degree

Developing a professional identity is an essential transition for nursing students as they move through their undergraduate degree. Professional identity is described as a person's perception of themselves within a profession or the collective identity of the profession. The formation of a professional identity is an evolving process, shaped by the media, educational experiences and role modelling. The aim of this study was to develop a greater understanding of the perceptions that students, about to embark on their undergraduate nursing degree, had of the nursing profession. A drawing and mind mapping exercise was conducted with a convenience sample of commencing nursing students to explore how they viewed their future profession. The data underwent thematic analysis and then grouped into sub-themes and themes. Four key themes were identified, 'To be a nurse, I have to look the part', 'To be a nurse, I have to perform in a variety of roles', 'To be a nurse, I have to connect with others', and 'To be a nurse, I have to care for myself.' The formation of a strong pre-professional identity is important for nursing students due to the link between future job satisfaction and the development of a robust nursing workforce.

Caring characters and professional identity among graduate nursing students in China-A cross sectional study

BACKGROUND

Caring is recognized as the essence of nursing and the core of nursing practice while a positive professional identity can lead to personal, social and professional fulfillment. Analyzing caring characters and professional identity yields important indications for the improvement of teaching methods. This study aims to explore the graduate nursing students' professional identity and caring characters in China, and analyze their correlation.

METHOD

A descriptive cross-sectional study was used to collect data from 216 graduate nursing students between January and February 2017 in China.

RESULTS

Graduate nursing students perceived they possessed positive caring characters while their professional identity was at a low level. A significant positive correlation was found between the Nursing Caring Characters Assessment Tool and Professional Identity Scale for Nursing Students.

CONCLUSION

Graduate nursing students' professional identity was not satisfactory and one strategy to improve this is to internalize caring into the education process. Nursing educators should focus more on the formation of the students' professional identity and caring as a contributing factor to it.

Professional self-concept and professional values of senior students of the nursing department

Aim:

This study was carried out in order to determine professional self-concept and professional values in the students, who were studying in the final year of the nursing department in schools providing undergraduate education in the Inner Anatolia Region.

Method:

This cross-sectional study was conducted on a total of 619 senior students of nursing departments in the Inner Anatolia Region. Data were collected using a Student Information Form, Professional Self-Concept Scale for the Student Nurses, and The Nurses’ Professional Values Scale. Descriptive statistics, the Shapiro–Wilk test, the t-test, analysis of variance, and the Bonferroni tests were used for data analysis.

Ethical Considerations:

A written consent was obtained from Ethics Board of Erciyes University Faculty of Medicine and from nursing schools participating in the study. Prior to data collection, students were informed about the purpose of the study and gave written and verbal consents. Participation in the study was on voluntary basis.

Findings:

In the study, students’ total and sub-dimension scores from the Professional Self-Concept Scale for the Student Nurses and total scores from the Nurses’ Professional Values Scale were moderately high. It was detected that women received higher scores than men from the sub-dimension of professional attributes; the students who had positive perception of the nursing image and voluntarily selected their department received high scores from professional satisfaction, professional competence, and professional attributes sub-dimensions of the Professional Self-Concept Scale for the Student Nurses ( p < 0.001).

Implication:

In order to improve students’ perceptions of professional self-concept and professional values, it is thought that students’ awareness should be increased on these topics.

Humanitarian nursing with Médecins Sans Frontières: Foregrounding the listening guide as a method for analysing oral history data

AIMS

To demonstrate how the listening guide contributed to oral history data analysis. To better understand the continuing inclination of nurses to engage in humanitarian work, foregrounding the nurses' lives.

BACKGROUND

The voice-centred relational method or listening guide is a method of qualitative data analysis used to analyse oral history data.

DESIGN

A conventional approach to oral history interviews was adopted; intervention into the "flow" of participants' narrative was kept to a minimum. A small number of prompts, how they came into nursing, recruitment to, life with and since Médecins Sans Frontières, were used.

METHODS

Oral history interviews were conducted with seven nurses who had worked for Médecins Sans Frontières. Interviews were digitally recorded. This paper will demonstrate the application of the listening guide to historical data analysis and critique its applicability and value. The listening guide advocates four readings (listenings) of the text. Firstly, locating the plot in the narrative; secondly, actively listening for the use of "I?" ("we", or "you"), the "self" in context of the story being told and "I poem" development; thirdly, listening for relationships and finally, locating accounts in relation to wider social, political and societal contexts.

RESULTS

Analysis revealed: "becoming", "being" and "leaving" Médecins Sans Frontières as chronological thematic areas. At one extreme creating "I poems" foregrounded individual voices while cross-referencing to contemporaneous records of world events locates this in an International context.

CONCLUSION

It is argued that subjecting historical data to the listening guide can enable legitimate, creative exploration and analysis of data.

PESQUISA EM ENFERMAGEM: BRASIL E PORTUGAL NA CONSTRUÇÃO DA IDENTIDADE PROFISSIONAL

RESUMO Objetivo: compreender a construção da identidade profissional na pesquisa em enfermagem de Brasil e de Portugal segundo a percepção de seus pesquisadores, adotando-se Gaston Bachelard como referencial teórico. Método: pesquisa descritiva, exploratória, de abordagem qualitativa, realizada no Brasil e Portugal. Adotou-se entrevista semiestruturada com 17 enfermeiros pesquisadores de ambos os países, com experiência em pesquisa científica e título de doutorado e/ou pós-doutorado. A análise dos dados obedeceu a seguinte ordem: fase exploratória, seleção das unidades de significado e processo de codificação das unidades de análise com a respectiva construção de categorias não-apriorísticas. Resultados: emergiram duas categorias para discussão: Objeto e linhas de pesquisa em enfermagem; e, Atitude política dos pesquisadores. Conclusão: as fragilidades na construção da identidade profissional precisam ser rompidas a partir do desenvolvimento de investigações experimentais, com respostas imediatas aos serviços de saúde e que atendam às demandas sociais. Profissional satisfeito é o maior marketing da profissão. Por meio da qualificação profissional na enfermagem será possível ocupar melhores cargos e desenvolver com maior propriedade o papel de liderança e a atitude política.

The creation and integration of a nurse educator position in two hospitals in Haiti

BACKGROUND

Continuing education is an integral part of nursing professional development and improving healthcare delivery, but literature on continuing education initiatives in low-resource settings is limited.

PURPOSE

To describe the creation and integration of a nurse educator (NE) position in two Haitian hospitals and highlight barriers and facilitators experienced by the NEs in their role.

METHODS

Four NEs and three support staff involved in the creation and integration of the NE positions were interviewed. Supplementary data were gathered through participant observation and document review. Data were compiled and summarized.

DISCUSSION

NEs were hired to assess learning needs, evaluate skills, train and mentor nurses, and provide ongoing support to assure application of new knowledge. Barriers included lack of specialized training and limited informational resources to develop education activities, role confusion and heavy workload, poor attendance and disparate education needs of nurses, and insufficient hospital resources and support to implement practice changes. Facilitators included previous management experience, peer support, and a perception of being valued by patients and colleagues and making a difference regarding nursing care and patient outcomes.

CONCLUSION

The NE is a leadership role and a promising, sustainable initiative for developing the nursing profession in Haiti.

Peer support systems and professional identity of student nurses undertaking a UK learning disability nursing programme

This practitioner based action research examines the implementation of the peer assisted study scheme (PASS) and individual peer mentoring in a cohort of first year undergraduate nursing students. It arose out of the desire of a small number of students in one UK university to transfer from the learning (intellectual) disabilities nursing field to other fields. The number of learning disabilities nurses is falling in England, and nursing shortages and student nurse retention generally is an international concern. The peer support was evaluated by 21 completed questionnaires. All the students had found the sessions they attended useful. Four themes emerged from the study. Students reported gains in knowledge around academic skills, placements and their chosen field of nursing; students felt more confident as a result of attending the sessions; students felt supported, and the importance of the peer mentor's interpersonal skills was highlighted; and finally students had valued meeting other students in their chosen field. These findings are discussed with reference to relevant literature.

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.

New Graduate Nurses' Professional Commitment: Antecedents and Outcomes

PURPOSE

This study examines the factors that increase new graduate nurses' professional commitment and how this professional commitment in turn affects professional turnover intentions, anxiety, and physical health symptoms.

DESIGN

The study was carried out in association with the nursing undergraduate's affiliation of Quebec, Canada. A three-wave longitudinal design was employed among nursing students. Nurses were surveyed before they entered the labor market, and then twice after they started working.

METHODS

Participants were contacted by post at their home address. The hypotheses were tested using structural equation modeling.

FINDINGS AND CONCLUSION

Professional commitment explains why good work characteristics and the provision of organizational resources related to patient care reduce nurses' anxiety and physical symptoms, and increase their professional turnover intentions. Pre-entry professional perceptions moderate the effects of work characteristics on professional commitment such that when participants hold positive pre-entry perceptions about the profession, the propensity to develop professional commitment is higher.

CLINICAL RELEVANCE

There is a worldwide shortage of nurses. From a nurse training perspective, it is important to create realistic perceptions of the nursing role. In hospitals, providing a good work environment and resources conducive to their professional ethos is critical for ensuring nurses do not leave the profession early on in their careers.

Studying the old masters of nursing: A critical student experience for developing nursing identity

In the past professional identity in nursing was inculcated in students alongside institutional pride. A strong sense of professional identity is key to staff retention and recruitment and key to the delivery of quality nursing care. With the wholesale transfer of pre-registration nursing education to the third level sector, however, the reality is that students now divide their affiliations between university and healthcare institutions and professional identity development may be stymied. For this reason, there is need to explore alternative means of developing professional identity. Exposure to nursing history may counteract this tendency. Based on adult nursing students' reflections of a visit to the Florence Nightingale Museum, we discuss the potential of this activity in aiding development of critical professional identity.

Professional identity development: Learning and journeying together

BACKGROUND

Pharmacy students start to develop their professional values through engagement with the course, practice exposure, staff and fellow students. Group working is an element of pedagogy which draws on the social aspects of learning to facilitate knowledge and skills development, but its potential role in facilitating professional identity formation has as yet been under researched.

OBJECTIVES

This study aimed to explore the potential of mutual learning through group work to contribute not only to academic knowledge and understanding, but also to the development of students' professional values and selves.

METHODS

Semi-structured interviews were conducted with 17 home and international first year undergraduate pharmacy students in a UK School of Pharmacy, to explore their experiences of interacting for learning with other students on the course.

FINDINGS

Thematic analysis of the interview data highlighted four main benefits of mutual learning, which are that it: promotes friendly interactions; aids learning about the subject and the profession; opens the mind through different opinions and ways of thinking; and enables learning about other people. Through working together students developed their communication skills and confidence; reflectively considered their own stance in the light of others' experiences and healthcare perspectives; and started to gain a wider worldview, potentially informing their future interactions with patients and colleagues. Some difficulties arose when group interactions functioned less well.

CONCLUSIONS

Opportunity for collaboration and exchange can positively influence development of students' professional outlook and values. However, careful management of group working is required, in order to create a mutually supportive environment wherein students feel able to interact, share and develop together.