Professional identity: A concept analysis

Translating Technology Into Speech-Language Pathology Practice: Qualitative Interviews Using Transcranial Magnetic Stimulation as a Case Study

BACKGROUND

Technologies such as videofluoroscopy, therapy applications, and telehealth have been translated into the clinical toolkit of many speech-language pathologists (SLPs). Transcranial magnetic stimulation (TMS) is an emerging technology that shows therapeutic promise for communication and swallowing disorders and, once suitable for clinical use, SLPs will likely be responsible for delivering this treatment. As such, it is critical that SLP opinions and attitudes towards TMS, as well as broader translation issues facing the profession, are considered early in the TMS research and translation process.

AIMS

(1) To explore in-depth the determinants of SLP behaviour that could influence translation of TMS into speech-language pathology practice; and (2) to examine these behavioural determinants within the context of profession-wide research-to-practice gaps.

METHODS AND PROCEDURES

Semi-structured interviews were conducted with 10 SLPs, who were classified into novice, intermediate, or expert TMS knowledge/experience levels. Reflexive thematic analysis conventions were used to inductively and deductively code interview data. The refined Theoretical Domains Framework (rTDF) informed study design, analysis, interpretation, and reporting, and served as a theoretical lens through which recommendations were developed.

OUTCOMES AND RESULTS

Four main themes were derived from interview data, representing four overarching determinants of SLP behaviour: actual knowledge/experience; perceptions of professional role and capabilities; optimism/pessimism mindset and emotions; and environmental factors. Results within each theme were categorised as TMS-specific (aim 1) or profession-wide (aim 2).

CONCLUSIONS AND IMPLICATIONS

Many TMS-specific behavioural determinants could impact the translation of TMS into speech-language pathology, however these exist against the backdrop of larger, profession-wide translation issues. A taxonomy of nine recommendations for bridging technology translation gaps in speech-language pathology is provided, with a view to facilitating future implementation of TMS and other technologies.

WHAT THIS PAPER ADDS

What is already known on the subject Transcranial magnetic stimulation (TMS) might one day be used as a treatment for communication and swallowing disorders, and speech-language pathologists (SLPs) will likely be responsible for delivering this treatment. Previous research has investigated SLPs' opinions and attitudes towards TMS to identify determinants of SLP behaviour that could impact translation of TMS into practice. However, more in-depth investigation is required within the context of profession-wide translation issues. What this paper adds to the existing knowledge The present study highlights behavioural determinants that could impact translation of TMS, as well as profession-wide research-to-practice gaps. We suggest important strategies and lines of enquiry to bridge translation gaps for use of technologies in speech-language pathology, which are summarised as a taxonomy of nine recommendations. What are the potential or actual clinical implications of this work? Results from this study may help SLPs to acknowledge and characterise translation issues in their own practice and across the broader profession. Our taxonomy of recommendations can be used in clinical, research, and implementation science settings to address technology translation issues in speech-language pathology, facilitating future integration of TMS and other technologies into practice.

Effect of clinical learning environment on professional identity in intern nursing students: A parallel multivariable mediation model

BACKGROUND

The significance of the clinical learning environment for professional identity is increasingly acknowledged. However, few studies have explored the bidirectional effects of the clinical learning environment on professional identity.

OBJECTIVE

This study aimed to examine the relationship between the clinical learning environment and the professional identity of nursing interns, particularly the parallel mediating roles of perceived professional benefit and role stress.

METHODS

The study was conducted in three first-class general hospitals in China. A total of 377 nursing interns participated. A questionnaire was administered, which included socio-demographic information, the Clinical Learning Environment Scale, the Nurses' Perceived Professional Benefit Scale, the Role Stress Scale, and the Professional Identity Questionnaire. T-tests, analysis of variance, and multiple linear regression were used to analyze the influencing factors of professional identity. And correlation analysis and mediation tests were performed to explore the factors influencing professional identity and potential mediating roles of perceived professional benefit and role stress.

RESULT

Professional identity was positively related to the clinical learning environment (r = 0.533, p < 0.01), perceived professional benefit (r = 0.643, p < 0.01) and negatively related to role stress (r = -0.348, p < 0.01). Furthermore, perceived professional benefit and role stress played parallel mediators between the clinical learning environment and professional identity.

CONCLUSION

This study emphasized the importance of focusing more on enhancing nursing students' sense of professional benefit and reducing role stress in the clinical learning environment to promote their professional identity.

One Profession, Two Ways of Thinking: Challenges in Developing Australia's Nursing Workforce

Professional education for licensed nurses in Australia is a complicated matter involving two education systems-vocational education and training, and higher education-each characterized by a different curriculum model. The contribution of the two systems follows a division of the workforce into Enrolled Nurses and Registered Nurses, with vocational education serving the first division and higher education the second. Although the systems are intended to provide connecting educational and career pathways, it results in a binary education landscape featuring two distinct forms of curriculum and contrasting assumptions about knowledge. This discursive discussion analyses the impact of the competency-based curriculum on Enrolled Nurses' education, entry to the profession of nursing, and their aspirational educational pathways towards registered nursing. Many Enrolled Nurses successfully articulate to become Registered Nurses; however, we argue that traversing between the two distinct curriculum approaches creates barriers to these transitions. We also argue that apart from undermining the learning trajectories of nurses, the influence of the competency-based curriculum model threatens the coherence of the profession at a time when conditions of work are both intensified and globalized, calling for a solution in the form of curriculum harmonization.

Stirring the Sleeping Giant? an Evaluation of a Planetary Health Political Action Sequential Simulation for Nursing Students

The need for nurses to be political is as great as ever, however, nursing has a complicated relationship with politics and political action. This paper examines the impact of a sequential simulation learning activity that sought to transform students' values and attitudes towards political action in addressing Planetary Health issues. Adult and adult mental health nursing students from two British universities participated in the Political Action Sequential Simulation which had three scenarios related to either water or air pollution. Scenario one was clinical, while scenarios two and three were community- and policy-based, respectively. We used a pre-post design to gauge attitudes and values both before and after the intervention. Outcomes measures included Nurse Professional Value Scale-3, Political Efficacy - Short Scale, Perceived Political Self-Efficacy Scale - Short Form, Social Justice Scale and Internal Environmental Locus of Control scale. Of the 256 students who undertook the activity, 75 completed both pre and post-measures. Significant shifts across all scales except the social justice scale were found, meaning that students' attitudes towards political action, their beliefs in their ability to take political action, and in particular, action related to the environment shifted significantly after the sequential simulation. We discuss these results in the context of the broader literature, reflect on some of the reasons why these shifts occurred and consider the implications for nursing education and practice.

Part II: Beyond Broken Histories: Reframing Professional Identity and the Historical Genesis of Manual Therapy. Interviews across professions

BACKGROUND

Perspectives on the historical genesis of manual therapy for chiropractic, manual medicine, osteopathy, and physiotherapy are limited.

OBJECTIVE

This study sought to identify themes and narratives related to the genesis of manual therapy; the potential of a common root for manual therapy in 19th century Northern Europe; and the potential impact of a current 'broken history' for manual therapy.

METHODS

An exploratory phenomenological approach was utilized, based upon structured one-hour interviews of 21 professionals across four professions who had previously completed a survey on the historical genesis of manual therapy.

RESULTS

Descriptive and hermeneutic themes were developed based upon the lived experience of individuals relating to interview questions and a presented historical narrative. Support for a common genesis in Northern Europe was present within physiotherapists, but for all other professions North America was primary. Multiple themes and quotes of significance were developed from the study, including the importance of history within professional identity. An archetypal analysis was completed to answer specific assumptions related to the historical genesis of manual therapy including points of genesis for manual therapy and scientific necessity within manual therapy.

CONCLUSION

The findings of this study provide new perspectives to consider on the value, criticality, and impact of manual therapy, and its history's for the four professions in practice, education, and regulations.

Occupational Therapy Professional Identity: Learning From the Muriel Driver Memorial Lectures

BACKGROUND

Given the well-documented professional identity challenges experienced by occupational therapists, reinforcing the profession's identity (collective and individual) is crucial for navigating changing environments and optimizing its contribution. The Muriel Driver Memorial Lectureship is an important component of the collective identity of the profession in Canada.

PURPOSE

A professional identity lens was used to trace the evolution of the profession's collective identity in Canada through this lectureship.

METHOD

Using sociological professional identity theory, a documentary longitudinal analysis was conducted on the 43 published lectureship articles (1975-2023), identifying key messages, values, knowledge, and practices.

FINDINGS

Eight main themes were identified: professional identity, epistemology, axiology, change and leadership, contribution, history, quality, and technology. The analysis revealed an evolving common base of values (occupation, client-centred, social justice) and knowledge (occupation-centred). Persistent challenges included defining theoretical foundations, resisting the biomedical model, and realizing the social vision in practice. The lectures highlighted occupational therapists' evolving roles and ability to contribute to and lead change.

CONCLUSION

The lectures provide insights into the evolution of occupational therapy's collective identity in Canada. Despite ongoing challenges, the contemporary context appears to be increasingly favourable for occupational therapists to practise consistent with the collective identity trends identified.

The relationship between psychological capital, stress, micro-learning environment, and professional identity in nursing interns: a structural equation modeling study

Background

Nursing interns play a crucial role in shaping the future nursing workforce, as their professional identity is closely linked to workplace retention rates and patient outcomes. Thus, investigating the factors that influence nursing interns' professional identity is important.

Objective

To evaluate the relationship between psychological capital, stress, micro-learning environment, and professional identity among nursing interns.

Methods

This was a cross-sectional study. The sample consisted of 388 nursing interns from 8 comprehensive teaching hospitals across five cities in Hubei Province between March and April 2024. Data were collected using a Descriptive Information Questionnaire, the Psychological Capital Questionnaire, the Student Nurse Stress Index scale, the Healthcare Education Micro Learning Environment Measure, and the Professional Identity Scale. The structural equation model was applied to explore the influencing factors of nursing interns' professional identity.

Results

The mean total score for professional identity was 35.57 ± 7.47. Psychological capital positively influenced professional identity directly (β = 0.16, P < 0.01), while stress as measured using the student nurse stress index had a negative impact (β = -0.20, P < 0.01). High scores on the healthcare education micro-learning environment measure positively contributed to the development of professional identity (β = 0.69, P < 0.001). Furthermore, psychological capital was identified as a mediator in the association between the healthcare education micro learning environment and professional identity, as well as between the student nurse stress index scores and professional identity.

Conclusion

The study suggests that a higher level of psychological capital, low stress levels, and a satisfied micro-learning environment are essential in fostering professional identity among nursing interns. It recommends collaboration between nursing schools and clinical departments to enhance nursing interns' psychological capital and stress management skills, creating a positive and safe working environment, thereby fostering professional identity among nursing interns.

Psychometric validation and cultural adaptation of the Italian version of the ambulance nurse competence scale

INTRODUCTION

This study aimed to examine the validity and reliability of the Italian translation of the Ambulance Nurse Competence Scale (I-ANC) through a rigorous psychometric validation process. Ambulance nurses play a critical role in delivering emergency care, making a reliable, culturally adapted tool to assess their competencies essential. In Italy, where nursing practice in pre-hospital settings is expanding, there was a need for a validated tool reflecting the specific competencies of ambulance nurses.

METHODS

The validation process used a three-phase approach. First, linguistic and cultural adaptation involved forward and backward translation to align with the Italian healthcare context. Second, a panel of experts assessed content and face validity. Finally, construct validity was tested through confirmatory factor analysis (CFA) with a sample of 212 nurses, and reliability was evaluated using Cronbach's alpha.

RESULTS

The I-ANC demonstrated strong performance in linguistic translation and cultural adaptation. Content and face validity assessments showed high levels of agreement among experts, confirming the tool's relevance. CFA supported the original four-component structure: (1) professional value-based nursing care, (2) professional development and research, (3) management of community events, and (4) management of serious events. These components explained a significant portion of the variance in the data, and Cronbach's alpha values for each factor exceeded 0.70, confirming internal consistency.

CONCLUSIONS

The I-ANC is a valid and reliable tool for assessing the competencies of Italian ambulance nurses. Its use can enhance self-assessment, professional development, and the quality of pre-hospital emergency care.

Do media stories about medical workers' arduousness scare medical students? Insights from a cross-sectional study

BACKGROUND

Under the combined influence of the aftermath of the epidemic and aging, the shortage of health workforce has become increasingly serious across the globe, posing constraints to the achievement of Universal Health Coverage. Improving the professional identity of medical students can ensure a steady supply of potential medical workers, which can mitigate the shortage of medical workers. This study focuses on sad news about medical workers' arduousness, a dominant news type in public crises, and examines how it affects medical students' professional identity, which is regarded to be important in the development of medical education and public health.

METHODS

This study employed a paper-and-pencil survey and recruited 1441 medical students in a Chinese university. Structural equation modeling (SEM) analysis with SmartPLS 3.0 was used to analyze the data.

RESULTS

The results reveal that media stories have multi-layered impacts on medical students' professional identity. Their exposure of sad news about medical workers' arduousness not only has direct impacts on professional identity, but also exerts indirect impacts via the provision of online emotional support.

CONCLUSION

This study has both theoretical and practical implications. In theory, the findings highlight the importance of media stories in the construction of professional identity and propose a theoretical framework for explaining the impacts of sad news exposure. In practice, this study contributes to the improvement of medical education, hospital management and public health governance in the digital age.

Do we have a lost generation of junior doctors: Effects of the COVID-19 pandemic on junior doctors' resilience status, medical knowledge and medical skills

BACKGROUND

At the onset of the COVID-19 pandemic, strict measures suspended face-to-face teaching at German universities, posing significant challenges for medical education. Practical, patient-centered training couldn't be fully replaced by online formats, leading to skill deficits and increased stress among students. To date, no study has examined the impact of COVID-19 on the resilience and the competence of medical graduates so far. This study aims to address this knowledge gap by investigating the pandemic impact on resilience, medical competence, communication skills, and research competence of medical graduates.

METHODS

The study employed data from the "Bavarian Graduate Study of Medicine" (MediBAS), a cross-sectional evaluation survey conducted in cooperation with Bavarian universities and the Bavarian Institute for higher education research and planning. It targeted medical, dental, and veterinary graduates. The data were collected in two waves (2018/19 and 2022/23), with 1.114 human medicine graduates participating. The questionnaire assessed among others resilience, medical expertise, communication skills, and research competence. Statistical analysis involved descriptive statistics, correlation analysis, and Mann-Whitney-U tests due to non-normal data distribution.

RESULTS

The study analyzed self-assessed resilience, medical expertise, communication, and research skills of medical graduates from two waves. The findings demonstrated through descriptive statistics a decline in all competencies except research skills, which exhibited an increase. Correlation analysis revealed significant relationships between variables. Mann-Whitney-U tests revealed no significant differences between the waves in resilience (p =.079, r =.06), medical expertise (p =.117, r =.05), communication skills (p =.053, r =.07), or research competence (p =.106, r =.05).

CONCLUSION

The study examined the impact of COVID-19 on medical graduates' resilience, medical expertise, communication skills, and research competence. While there was a slight decline in resilience, medical expertise, and communication skills between the waves, there was an improvement in research competence. None of these changes were statistically significant. The findings suggest that the pandemic may have contributed to these trends by limiting practical experiences. No major negative impacts were found, suggesting no "lost generation" of doctors. The long-term effects of the changes remain uncertain due to the cross-sectional design and require further research.

Exploring nurses' leadership and resilience in a complex daily work environment: a qualitative study

BACKGROUND

The contemporary healthcare system is inherently complex, necessitating organizational and ward-level changes to address challenges. Continuous adaptations in daily practices are essential to meet unexpected patient needs. These dynamic changes require resilience from healthcare staff, including nurses. This paper explores how nurses show leadership in response to changes within a complex work environment that demands resilience in their daily practices.

METHODS

An empirical qualitative study was employed. Non-participatory observations were conducted in February and March 2022 (n = 60 h), providing thick descriptions of nurses working across various shifts. Subsequently, two semi-structured group interviews were held: the first with nurses only and the second with multidisciplinary healthcare professionals. The interview transcripts and thick descriptions were analyzed using thematic analysis. Descriptive statistics were used to summarize participant characteristics.

RESULTS

Responding to a changing work environment requires resilience from nurses who exhibit leadership showing four distinct behaviors: proactive, patient-centered care; investigative problem-solving; reflective learning; and profession-based approaches.

CONCLUSION

Collaboration is a key factor in resilient nurse leadership, both among nurses, and in interaction with patients, other healthcare professionals, and management. This research highlights how nurses' considerations, beliefs, and interactions, make their leadership behavior visible in a context that demands situated, structural, and social resilience.

The impact of empathy on professional identity among Chinese junior male nurses: a moderated mediation model

Background

Nursing care is essential, but the role of junior male nurses in medical and health services is underestimated; thus, many junior male nurses leave the profession due to a lack of professional identity.

Objective

This study examined how the mediating effect of emotional intelligence and the moderating role of locomotion mode influence the relationship between empathy and professional identity among Chinese junior male nurses.

Methods

This cross-sectional descriptive study was conducted among junior male nurses in China from December 2021 to May 2022. We asked participants from ten hospitals to complete a questionnaire regarding empathy, emotional intelligence, locomotion mode, and professional identity. Bootstrap and simple slope methods were used to test the moderated mediation model.

Results

Emotional intelligence partly mediated the effects of perspective-taking on professional identity (β = 0.253, p < 0.05). Furthermore, locomotion mode moderated the relationships between perspective-taking and emotional intelligence, perspective-taking and professional identity, and emotional intelligence and professional identity (β = 0.136, p < 0.01; β = 0.107, p < 0.05; β = -0.155, p < 0.01).

Conclusion

The findings revealed that,the mediating effect of emotional intelligence on the relation between perspective-taking and professional adaptability was moderated by locomotion mode. Whereas. These findings are meaningful for early intervention and the improvement of professional identity among junior male nurses.

A longitudinal study on the professional identity formation of health promotion practitioners: evidence from undergraduate students in Switzerland

Introduction

Professional identity (PI) is crucial for workforce capacity building, as it leads to the adoption of the professional role and commitment. And yet, there is little literature on the PI of health promotion practitioners as part of the public health workforce. Education plays a significant role in PI formation. Therefore, the aim of this study is to investigate PI formation in undergraduate health promotion students. To conceptualize PI, we draw on social psychological theories and consider potential determinants across cognitive, social, motivational, and behavioral dimensions.

Methods

To gain insights into the PI formation of health promotion students, an observational longitudinal study was conducted using an online survey at three times of measurement. Undergraduate physiotherapy students served as the comparison group. The outcome variable of PI was calculated as a composite score with three subscales. In addition to sociodemographic data, potential determinants in cognitive, social, motivational, and behavioral dimensions were measured. Mixed effect models were used to analyze these determinants of PI formation.

Results

The study included 276 participants. On average, PI in health promotion students was moderate and declined over the course of the undergraduate program. In contrast, PI in physiotherapy students was high from the beginning and remained stable throughout their studies. Factors such as gender, self-esteem, insecurity about the study program, the perceived social status of the profession, and planned behavior during and after the program were found to influence health promotion students' PI formation.

Discussion

Undergraduate health promotion students lack a strong PI, especially compared to physiotherapy students. Given the importance of a strong PI, the following interventions are suggested to strengthen health promotion students' PI: (1) incorporating PI formation as a learning objective within curricula, and (2) enhancing the visibility and clarity of health promotion's professional profile within undergraduate studies and in society. By recognizing the factors that shape PI and implementing targeted interventions, stakeholders can empower the next generation of health promotion practitioners to navigate their professional journeys with confidence and purpose, thereby strengthening workforce capacity building in health promotion.

Building nursing students' professional identity through the 'Design process' methodology: A qualitative study

AIM

To explore the elements of nursing identity recognized by nursing students in models developed through the 'Design process' methodology.

BACKGROUND

The construction of nursing professional identity is a complex process involving identification, group belonging, partial assessments and social representations. Nursing identity is one of the most stereotyped and its formation during the nursing degree has a significant impact on professional development. Design can transform society and communicate a positive nursing identity. The 'Design process' connects conceptual content with real-world contexts, particularly with students' future professional roles.

DESIGN

A qualitative hermeneutic-interpretative phenomenological study was performed.

METHODS

135 first-year nursing students developed 22 informative content documents, which design students used to create 22 models. Nursing students then analyzed the models and responded to an ad hoc questionnaire with open-ended questions.

RESULTS

Two categories 'nurse' and 'nursing' were identified. Students identified the core competencies of the profession in the models and showed that nurses' professional behavior encompasses other traits besides the stereotyped ones. Students perceived 'Design process' methodology was a valuable tool to raise awareness among the population about the nurses' work.

CONCLUSIONS

Nurse training is crucial for building professional identity and improving social perceptions. Greater visibility and curricular programs that support identity development are needed. Collaborative work with disciplines like design enhances identity construction and disseminates nursing's true image. The 'Design Process' fosters creativity, problem-solving and innovation in nursing education.

Exploring Nurses' Personal and Professional Values and Care Quality: A Convergent Mixed-Methods Analysis

BACKGROUND

Professional standards and the Codes of Ethics from the International Council of Nurses and American Nurses Association are frameworks driving professional practice and are linked to positive patient and nursing outcomes.

OBJECTIVE

To describe qualitative themes extracted from narrative responses on how nurses' personal values influence nursing care and converge with quantitative results assessing personal values, professional values, and the practice environment, a key component of nurse satisfaction and subsequent care quality.

METHODS

A convenience sample of nurses across 19 sites within a large nonprofit healthcare system was surveyed. Quantitative measures included the Short Schwartz's Value Survey for personal values, the Nurses Professional Values Scale-3 for professional values, and the Practice Environment Scale of the Nursing Work Index, assessing practice settings. Concurrently, nurses were asked, "How do your values influence the care you provide?" Responses were examined using a descriptive qualitative method for thematic analysis.

RESULTS

The sample included qualitative (n = 408) and quantitative (n = 671) responses. Six qualitative themes emerged: patient-centered care, professionalism/integrity of practice, advocacy, dissonance, golden rule/ethics of reciprocity (religiosity), and perseverance. Themes converged with the mean personal values of achievement, self-direction, universalism, benevolence, tradition, and conformity, and diverged with hedonism, security, and stimulation. All professional values factor means and work environment subscale means converged.

CONCLUSIONS

Findings highlight convergence and divergence between qualitative and quantitative responses from nurses, offering new insights into the themes of dissonance, perseverance, and religiosity. The findings present valuable opportunities to enhance recruitment and retention strategies.

Genetic counselors' professional identity in North America: A scoping review

Professional identity (PI) comprises attributes, beliefs, values, motives, and experiences by which people define themselves in a professional role and evolves through socialization with others in the workplace. While there have been several studies exploring the expanding roles of genetic counselors, few have specifically addressed PI. This scoping review aimed to describe the contexts in which PI has been discussed or examined in the genetic counseling literature. Articles were searched using PubMed, Scopus, and CINAHL with a priori terms including and related to PI. Articles based in the United States or Canada and of all study designs, commentaries, and speeches were included. Date of publication was not restricted. Using social identity theory (SIT) to formulate a definition of PI, multiple reviewers applied inclusion and exclusion criteria to all titles, abstracts, and full-text articles with conflicts addressed through consensus among all reviewers. A total of 5523 titles and/or abstracts were screened, and 467 full-text articles were evaluated and categorized as (1) focusing on PI specifically, (2) containing elements of PI although focused on another topic, or (3) not related to PI. Eighty-seven (87) articles were reviewed during the extraction phase. Ultimately, 41 articles were deemed to meet the agreed upon characteristics of PI. While empirical studies of PI among genetic counselors were limited, PI is being addressed in research focused on related areas, including professional development and diversity, equity, and inclusion, as well as in personal accounts, addresses, and commentaries. Sentiments regarding PI voiced by genetic counselors align with those reported among other health professionals. Given the lack of diversity in the field and rapidly expanding opportunities for genetic counselors, there is risk of some members of the profession feeling excluded, which in turn could negatively impact the collective identity of the profession and translate into impacts on patient care. Additional research regarding the PI of genetic counselors is needed.

[Strong Professional identity construction as a change lever]

Professional identity is the way in which professionals define themselves in relation to their professional role, encompassing both their sense of identity and the expected behaviors associated with that role. The formation of this identity is a complex process that begins at the undergraduate level and continues throughout a pharmacist's professional career. Several different professional identities have been identified in the world of pharmacy, which may indicate a degree of ambiguity in the role expected of this professional and a lack of clear direction and characterization of what makes the pharmacist "unique", although it may also suggest a flexible and broad view of the pharmacist's role. For the clinical role promoted by the various professional organizations at the international level to become a reality, and for the profession to be re-professionalized, students need to build a solid identity, and this work must begin at the undergraduate level. With the publication of the recent Delegated Directive (EU) 2024/782, a window of opportunity has opened for both the university and the profession to discuss where the profession should go and, more specifically, what the professional role of the pharmacist should be.

Turkish adaptation study of the Professional Identity Scale

BACKGROUND

Professional identity encompasses the understanding of professional practices and the development of values and skills within a specific profession.

OBJECTIVE

This study aimed to assess the suitability of the 9-item Macleod Clark Professional Identity Scale, originally developed by Adams et al. (2006), for Turkish culture and examine its psychometric properties in a sample of postgraduate nurses.

METHODS

The study was conducted using a methodological approach. The sample consisted of 100 postgraduate nurses. Various analyses were conducted, including descriptive statistics of the scale, Cronbach's alpha coefficient, item-total score correlation, and scale response bias for reliability assessments. Validity analyses included assessments of language, content, construct validity, concurrent validity, and known group validity.

RESULTS

The Cronbach's alpha coefficient for the 9-item Macleod Clark Professional Identity Scale was found to be 0.85, indicating good internal consistency. Item-total score correlations ranged from 0.34 to 0.88. The confirmatory factor analysis goodness of fit indices, except for the AGFI index, had acceptable values after two modifications. The single-factor structure of the scale was confirmed by confirmatory factor analysis. For concurrent validity, the scale demonstrated a positive and robust correlation with scores from the Nursing Professional Commitment Scale, supporting its validity. In terms of predictive validity, a regression model was established to assess the relationship between independent variables and core professional identity, and the model was found to be at acceptable levels.

CONCLUSIONS

This study showed that the Turkish adaptation of the 9-item unidimensional "Macleod Clark Professional Identity Scale" demonstrates acceptable levels of validity and reliability when administered to postgraduate nurses in Turkey.

Professional Identity in Nursing: A Narrative Review of the ISPIN Definition and Domains Usage

Introduction

Established in 2020, the International Society for Professional Identity in Nursing (ISPIN) developed a definition of professional identity in nursing (PIN). This definition encompasses four domains: values and ethics, knowledge, nurse as leader, and professional comportment.

Objective

This narrative review aimed to summarize and synthesize identified published evidence, the extent of discussion of PIN domains, and literature gaps for the ISPIN definition of PIN.

Methods

Sources included peer-reviewed literature published between 2018 to 2025 from CINAHL and PubMed. Gray literature through Google Scholar and ISPIN archived publications were also searched. These were identified by two researchers and a PRISMA flow diagram was developed. No registered protocol was utilized. Search and MeSH terms included "professional identity," "nurs*," and "ISPIN."

Findings

Thirty-seven articles met inclusion criteria and were extracted from 16,295 initially identified articles, with the majority with authors from the United States. There were very few research papers and a noticeable dearth using quantitative methodologies. Twenty-eight of the retrieved articles were considered expert accounts, conceptual discussion or opinions, common for a relatively new concept.

Discussion

Nurse as leader was discussed in 34 of 37 articles. Professional comportment was discussed in 31 articles. Both knowledge and value and ethics were discussed in 28 articles.

Conclusion

This narrative review highlights the nature and prevalence of the ISPIN definitions and its four domains in current literature and can be visualized through diagramming. Minimal quantitative studies and a higher volume of discussion articles present limitations to its strength and applicability. Results suggests the need for further research in all domains, particularly in knowledge and values and ethics, and its implications in strengthening nursing practice and education.

Professional Identity Formation in Allied Health: A Systematic Review with Narrative Synthesis

Phenomenon: Professional identity formation is a key component of health professional education. Changing expectations of healthcare requires more than competencies, but also an ingrained responsibility to patients, with our values and behaviors aligned with community expectations of patient-centered health professionals. Research into professional identity formation has focused on nursing and medical training, and, although allied health professionals make up one third of the workforce, research is uneven across these disciplines. Health professions educators from these under-researched disciplines have less guidance for how to support students' professional identity, meaning students may graduate with less mature professional identities. This systematic literature review synthesizes the research on professional identity formation across nine similar allied health disciplines. The purpose is to guide health professions educators in the formation of professional identity in allied health students. Approach: We carried out a systematic literature review, registered on Prospero, following the PRIMSA framework, to find, appraise, and synthesize research on professional identity for nine allied health professions. We synthesized extracted data using a narrative synthesis with convergent qualitative meta-integration of qualitative and quantitative data. Results: Our database searches combined with ancestry and forward searching resulted in 70 studies that met inclusion criteria. Studies came from 17 countries, from seven of the included disciplines (art therapy, dietetics, occupational therapy, physiotherapy, podiatry, psychology, and speech pathology) and from undergraduate, postgraduate, and new graduate perspectives. We found professional identity was influenced by the places of learning (curriculum and clinical experiences or placements), interactions with people (relationships with academics, peers, supervisors, patients,and role models), and educational practices engaged (dialogue, reflection, processing challenges), each acting on the individual person (student or new graduate) who also brought unique characteristics and experiences. Insights: This model of influences can inform health professions education to enable students to develop and graduate with a stronger professional identity formation.

Evaluation of the relationship between adversity quotient, professional identity, and perceived humanistic care of head nurses in Master's Degrees in nursings

Background

High-level nursing talents play an important role in solving nursing scientific problems and leading nursing innovation, so the construction of high-level nursing talents has become a necessary guarantee for the health strategy in the new era. Managers have high expectations for master's degree in nursing, hoping that they will develop in all aspects of research, teaching, and professionalism, etc. However, the high expectations of managers have led to unclear job orientation, high clinical and scientific research pressure, and low recognition of nurses' sense of professional value from the outside world, which have led to the lowering of master's degree of professional identity and the tendency to leave the profession, which is not conducive to the stabilization of the nursing workforce.

Purpose

To explore the influence of adversity quotient, perceived humanistic care of nurse leaders on professional identity of nursing masters, and to clarify the relationship model between the three.

Methods

A convenience sampling method was used to conduct an online questionnaire survey on 160 master's degree nursing students in Ningbo and Shanghai from July to September 2022 using the general information questionnaire, adversity quotient, career identity and perceived humanistic care of nurse leaders scale.

Results

Adversity quotient, occupational identity and perceived humanistic care of nurse leaders were all at a moderate level. Adversity quotient (r = 0.430, P < 0.01), perceived humanistic care of nurse leaders (r = 0.443, P < 0.01) and occupational identity were positively correlated, and perceived humanistic care of nurse leaders could affect occupational identity through the mediating effect of adversity quotient, with the mediating effect accounting for 31.8%.

Conclusion

Nursing managers should create a good organizational atmosphere, build a training system for adversity quotient courses, conduct regular assessment and humanistic care to improve the ability of nursing masters to face adversity and enhance the awareness of their own professional values.

Development of nursing students' professional identity in different mentoring approaches during clinical training: A quasi-experimental study

BACKGROUND

The professional identity (PI) of nursing students' is essential for high quality performance and safe healthcare. Clinical training plays a key role in the development of professional identity during nursing studies.

AIM

The aim of this study was to investigate the impact of individual and group mentoring approaches on the development of PI during clinical training, as well as the influence of the order in which these approaches are applied, and the effect of time on the development of PI.

DESIGN

This study used a quasi-experimental design.

SETTINGS

The study was conducted at the Department of Health Studies in Croatia.

PARTICIPANTS

The 119 first, second, and third year ungraduate nursing students.

METHODS

Students were divided into two groups. Each group performed clinical training in group and individual mentoring approaches, but in different order. The Professional Identity Five Factor Scale (PIFFS) was used to measure PI levels at four different time points: immediately before and after the first and second rounds of clinical exercises.

RESULTS

Both groups of students, achieved approximately average results in all three dimensions of the PI. There was no statistically significant main effect of the group/individual mentoring approach on the dimensions of knowledge (P = 0.471), experience (P = 0.865) or perception of role model and professional future (P = 0.565). The levels of the dimensions knowledge (P = 0.001), experience (P = 0.001) or perception of the role model and professional future (P = 0.002) differed in four measurement points, which indicates a general increase in all three PI dimensions.

CONCLUSIONS

During the performance of the clinical training, the level of PI increased. The group mentoring approach has an immediate effect on increasing knowledge, but this effect diminishes over time. In terms of experience, both mentoring approaches have similar reinforcing effects. However, the individual approach seems to be more suitable for improving the perception of role models and the professional future.

The relationship between challenge-hindrance stress, professional identity, and emotional labor of Chinese preschool teachers

BACKGROUND

Teaching will bring work stress and affect emotions, as well as require a high level of professional identity. However, few have examined trilateral relationships between work stress (in terms of challenge-hindrance stress), professional identity, and emotional labor among Chinese preschool teachers during COVID-19.

OBJECTIVE

Based on the conservation of resource theory, this study aimed to examine the relationship between challenge-hindrance stress, emotional labor, and professional identity, as well as explore the mediating effects of professional identity between job stress and emotional labor among Chinese preschool teachers.

METHODS

A cross-sectional study was conducted, with 753 preschool teachers completing a self-report questionnaire. Statistical analyses were conducted using SPSS 26.0 and included descriptive statistics, Pearson correlation analysis, regression analysis, and mediation effect testing.

RESULTS

Research indicated that 1) challenge-hindrance stress was positively correlated with surface acting (r = 0.21, p < 0.01, and r = 0.28, p < 0.01) but negatively correlated with the expression of naturally felt emotions (r = -0.08, p < 0.05, and r = -0.12, p < 0.01); 2) Challenge-hindrance stress was negatively correlated with professional identity (r = -0.08, p < 0.05, and r = -0.20, p < 0.01); 3) Professional identity exhibited positive correlations with the three dimensions of emotional labor (r = 0.12, p < 0.01; r = 0.64, p < 0.01; and r = 0.56, p < 0.01) and partially mediated the relationship between challenge-hindrance stress and emotional labor.

CONCLUSION

The study underscored that challenge-hindrance stress affected emotional labor directly and indirectly through the mediating role of professional identity. Interventions focusing on alleviating work stress and promoting professional identity through comprehensive training could effectively mitigate emotional labor among preschool teachers.

Gender diverse people's psychological wellbeing and identity in the context of gender affirming speech pathology practice: A qualitative study protocol

BACKGROUND

Gender diverse people may experience discomfort with the sound of their voice. Additionally, their psychological wellbeing, closely connected to a person's identity, or perspective of themselves, is often reduced. A primary goal of gender affirming healthcare is to support clients' psychological wellbeing. Speech pathology practices assist clients to alter their voice to develop authentic self-presentation. These practices have been shown to have positive outcomes related to clients' voices but have not yet been shown to improve overall client psychological wellbeing. Assisting gender diverse people to transform a negative identity perspective into a positive one could have a beneficial impact on their psychological wellbeing. Therefore, to support clients' psychological wellbeing, gender affirming speech pathology care could benefit from focusing on gender diverse clients' identity more broadly, i.e., beyond gender. For this type of care, speech pathologists would need to see themselves as responsible for supporting client psychological wellbeing and identity. However, some clinicians may be hesitant to incorporate more holistic approaches to provide such care. This study aims to explore gender diverse speech pathology clients' views on psychological wellbeing and identity and speech pathologists' perspectives and actions in supporting clients in that regard.

METHODS

This qualitative study approaches the research topic through insights from gender diverse people's and speech pathologists' subjective perspectives and experiences on psychological wellbeing and identity. Gender diverse people will participate in one-on-one episodic interviews, whereas speech pathologists providing gender affirming care will participate in focus group discussions. Data will be analysed with reflexive thematic analysis. The study is supported by collaborators from the gender diverse community. Study findings will be disseminated in an accessible manner to healthcare professionals providing gender affirming care, mainly speech pathologists, and to the gender diverse community.

IMPLICATIONS

Study findings are anticipated to contribute to further understanding gender diverse people's psychological wellbeing and identity in a gender affirming speech pathology context to tailor practices to the unique needs of gender diverse clients.

Professional identity development of Flemish occupational therapists: A narrative study

BACKGROUND

A less developed professional identity negatively influences a person's mental well-being and is suggested to potentially affect quality of care and thus clients' well-being. Literature indicates that a strong developed professional identity is to strive for. In Flanders, Belgium, cultural and legislative challenges negatively impact the professional development of occupational therapists.

AIM/OBJECTIVES

To explore the professional identity development of Flemish occupational therapists, with a focus on significant events shaped by aspects of self-efficacy.

METHOD

Five Flemish occupational therapists were interviewed twice. The semi-structured and open follow-up interviews were all conducted online. Data was analysed by using a narrative- and narrative slopes analysis.

RESULTS

Similar and unique experiences emerged: occupational therapy appeared as an unexpected career choice, clinical placements were important, getting and staying in the work field has its challenges, and continuously improving themselves. Self-efficacy fluctuated during their whole journey.

CONCLUSION

Five unique narratives, raise awareness of potentially vulnerable events in becoming an occupational therapist.

SIGNIFICANCE

This study highlights the importance of actively reflecting on how to support students, novice, and senior therapists in developing and nurturing their professional identity (e.g. continued professional development, strong supervisor relationship, interprofessional education).

Why is it so hard to improve physicians' health? A qualitative interview study with senior physicians on mechanisms inherent in professional identity

Objectives

Current research increasingly describes physicians' health as endangered. Interventions to improve physicians' health show inconsistent results. In order to investigate possible causes for weak long-term effects, we examined senior physicians' perceptions about the relevance of their own health and analyzed whether and how these might affect the difficulty to improve physicians' health.

Method

The authors conducted 19 semi-structured interviews with senior physicians from different medical disciplines, analyzed the data and developed theory using the grounded theory method.

Results

Based on the interviews, we developed a conceptual model which identifies reinforcing factors for physicians' hesitancy in self-care as well as barriers to change. Participants regarded their own health needs as low and equated health with performance. These perceptions were described as being part of their professional identity and mirrored by the hospital culture they work in. Mechanisms as part of the collective professional identity (CPI) of physicians help to stabilize the status quo through early socialization and pride in exceptional performance. In addition, the tabooing of weakness and illness among colleagues, and dissociation from patients as well as sick doctors were identified as stabilizing mechanisms.

Conclusion

Findings support the assumption that one cause of physicians' health problems might lie in a CPI that includes tendencies to rate one's health as secondary or irrelevant. Identified mechanisms against change are, according to Social Identity Theory, typical group strategies which ensure the stability of CPI and make existing attitudes and beliefs difficult to change. However, barriers against change could possibly be overcome by addressing these underlying mechanisms and by a change process that is supported by experienced and competent members of the in-group for the benefit of both physicians and patients.

Belonging in dual roles: exploring professional identity formation among disabled healthcare students and clinicians

The development of a robust professional identity is a pivotal aspect of every healthcare professional's educational journey. Critical social perspectives are increasingly influencing the examination of professional identity formation within healthcare professions. While understanding how disabled students and practitioners integrate a disability identity into their professional identity is crucial, we have limited knowledge about the actual formation of their professional identity. This study aims to investigate how disabled students and clinicians in healthcare professions actively shape their professional identity during their educational and professional journeys. We conducted in-depth semi-structured interviews with 27 students and 29 clinicians, conducting up to three interviews per participant over a year, resulting in 124 interviews. Participants represented five healthcare professions: medicine, nursing, occupational therapy, physical therapy, and social work. Employing a constructivist grounded theory approach, our data analysis revealed two prominent dimensions: (a) The contextualization of identity formation processes and (b) The identity navigation dimension in which the professional identity and disability identity are explored. This emerging model sheds light on the dynamic processes involved in identity formation, emphasizing the significance of a supportive environment for disabled students and practitioners. Such an environment fosters the negotiation of both professional and disability identities. Moreover, this study recognizes the importance of a re-examination of the concepts of professionalism and professional identity in healthcare professions. In conclusion, this research underscores the importance of understanding and supporting the multifaceted identity formation processes among disabled individuals within healthcare professions.

The impact of digital technology use on nurses' professional identity and relations of power: a literature review

AIM

This study seeks to review how the use of digital technologies in clinical nursing affects nurses' professional identity and the relations of power within clinical environments.

DESIGN

Literature review.

DATA SOURCES

PubMed and CINAHL databases were searched in April 2023.

METHODS

We screened 874 studies in English and German, of which 15 were included in our final synthesis reflecting the scientific discourse from 1992 until 2023.

RESULTS

Our review revealed relevant effects of digital technologies on nurses' professional identity and power relations. Few studies cover outcomes relating to identity, such as moral agency or nurses' autonomy. Most studies describe negative impacts of technology on professional identity, for example, creating a barrier between nurses and patients leading to decreased empathetic interaction. Regarding power relations, technologically skilled nurses can yield power over colleagues and patients, while depending on technology. The investigation of these effects is underrepresented.

CONCLUSION

Our review presents insights into the relation between technology and nurses' professional identity and prevalent power relations. For future studies, dedicated and critical investigations of digital technologies' impact on the formation of professional identity in nursing are required.

IMPLICATIONS FOR THE PROFESSION

Nurses' professional identity may be altered by digital technologies used in clinical care. Nurses, who are aware of the potential effects of digitized work environments, can reflect on the relationship of technology and the nursing profession.

IMPACT

The use of digital technology might lead to a decrease in nurses' moral agency and competence to shape patient-centred care. Digital technologies seem to become an essential measure for nurses to wield power over patients and colleagues, whilst being a control mechanism. Our work encourages nurses to actively shape digital care.

REPORTING METHOD

We adhere to the JBI Manual for Evidence Synthesis where applicable. EQUATOR reporting guidelines were not applicable for this type of review.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Cognitive Flexibility and Professional Identity in Nursing Students: The Modeling Role

BACKGROUND

Students' professional identity is essential to build nursing competence. Cognitive flexibility plays a crucial role in developing professional identity, as well as clinical supervisors and academic teachers through role modeling. This study analyzed the role of internship and theoretical modeling in the link between cognitive flexibility and professional identity.

METHOD

Participants were first-, second-, and third-year nursing students (n = 284) at a university in northern Italy. Participants completed an online survey, and multigroup analysis was performed.

RESULTS

Internship modeling was positively associated with professional identity but not for second-year students. Theoretical modeling was not significantly associated with professional identity and cognitive flexibility. Theoretical modeling did not mediate the relationship between cognitive flexibility and professional identity. Clinical internship modeling mediated the relationship between cognitive flexibility and professional identity but not for second-year students.

CONCLUSION

Internship modeling helps students give sense and coherence to learning, which contributes to their professional identity. [J Nurs Educ. 2024;63(11):764-772.].

Nursing Professional Identity: A Critical Review of the Concept Amidst COVID-19

Heroism is an immutable and quintessential part of what gives rise to the phenomenon that is nurse. This altruistic discourse comes with profound consequences for the nursing profession, particularly in relation to nursing's professional identity. This critical review explores nursing's professional identity against the backdrop of gendered and heroic discourses. Two concept analyses of nursing's professional identity are critically reviewed and juxtaposed with literature on the topic amidst COVID-19. Using poststructural feminism and critical discourse analysis, the review provides valuable insights into the evolutionary significance of the concept and raises key questions around knowledge-power structures and discursive constructions of nurse.

Exploring influencing factors to clinical leadership development: a qualitative study with healthcare professionals in Flemish nursing homes

BACKGROUND

Nursing homes face a critical need for competent healthcare professionals to deliver high-quality care. Focusing on clinical leadership is crucial for equipping healthcare professionals with the skills necessary to manage complex care needs, collaborate effectively within multidisciplinary teams, and improve care quality in nursing homes. Developing clinical leadership fosters professional growth and enhances healthcare professionals' ability to tackle the challenges unique to the nursing home environment. However, the concept of clinical leadership in nursing homes remains poorly defined and investigated. This study aimed to explore and define influencing factors for the development of clinical leadership within healthcare professionals in nursing homes.

METHODS

A qualitative study was conducted in Flanders, Belgium, using semi-structured focus group interviews (n = 5) with healthcare professionals (n = 41), including nurse assistants, licensed practical nurses, registered nurses, occupational therapists, recreational therapists, psychologists, and gerontologists. Interviews were audio-taped, transcribed, analysed and interpretated by using a thematic analysis based on descriptive phenomenology.

RESULTS

Clinical leadership development within healthcare professionals' hinges on four pivotal themes: (1) Cultivating an empowering working environment that fosters open feedback, encourages peer learning, and champions a stimulating learning climate. (2) Nurturing a supportive leadership style in formal leaders that exemplifies role modeling, accessibility, and a coaching approach. (3) Elevating well-developed professional identity through targeted training, experience, and a talent-oriented work approach. (4) Fostering team dynamics marked by commitment, collaboration, support, and trust.

CONCLUSIONS

The study's findings on the influencing factors for clinical leadership development should be actively applied in nursing homes and guide the creation of targeted training programs and leadership development initiatives. Awareness of these factors are crucial to optimise and to support the development and implementation of clinical leadership in nursing homes in an attempt to reduce the workforce shortages.

Exploring Determinants of Nurse Retention: The Influence of Personal and Professional Values, and Work Environment in Predicting Intent to Leave

Nurse retention remains a pivotal issue, necessitating urgent strategies aimed at the recruitment and retention of highly qualified nurses. However, there is limited knowledge regarding the influence of nurses' personal and professional values, along with work environment, on predicting intent to leave an organization. Utilizing a secondary analysis approach, this study employed logistic regression to predict intent to leave among registered nurses (n = 671) using results from the Short Schwartz's Value Survey, the Nurses Professional Values Scale-3, and the Practice Environment Scale of the Nursing Work Index. Regression analysis indicates that the work environment including "Participation in Hospital Affairs" (B = -.665, odds ratio = .514), "Nurse Manager Ability, Leadership, and Support" (B = -.448, odds ratio = .639), and "Staffing and Resource Adequacy" (B = -.589, odds ratio = .555) are significant predictors of nurses' intentions to leave. Establishing and maintaining supportive work environments is essential for retention, highlighting the importance of effective leadership.

Nurses under fire: Insights from testimonies of community nurses and midwives in nonhospital settings in the southern Israel conflict zone

Nurses-with or without prehospital care training-may find themselves delivering immediate care to injured individuals outside a healthcare facility, sometimes even in situations where their own life is at risk. This study explores the experiences of community nurses and midwives who provided immediate care during the Hamas militant movement's attack in southern Israel. The researchers collected and analyzed eight nurse and midwife survivors' testimonies published in digital media to gain a deeper understanding of their perspectives. Through qualitative content analysis, common themes, patterns, and insights were identified. The study aimed to contribute valuable knowledge in this field and followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist for methodological rigor. Two themes emerged from the testimonies, focusing on the nurses' swift realization of necessary action under fire and resilience and ingenuity in practice. Despite lacking training and resources, the nurses professionally assessed the situation and improvised creative solutions to care for the wounded. Although they had no prehospital emergency care background, community nurses and midwives were able to respond effectively, providing lifesaving care. The findings highlight the nurses' resilience, adaptability, and dedication in unprecedented situations. However, the study also emphasizes the importance of providing all nurses with baseline prehospital care training and structured planning of this care to empower them to deliver optimal patient care in uncertain and dangerous conditions, especially in and around conflict and disaster zones.

Introducing professionalism and medical ethics in undergraduate integrative medical curriculum through a four-dimensional model

BACKGROUND

To develop a method for designing the ethics and professionalism compatible with the integrative medical curriculum. So that the insertion of ethics and professionalism should start from the initial stages of the integrative program in an indirect manner through student-centered activities, passing through introducing some ethical topics that are appropriate for each module, developing a condensed module at the beginning of the clinical stage, and ended by developing a practical course in the internship period. In this way, a four-dimensional model to present ethics and professionalism has been introduced.

MATERIALS AND METHODS

A questionnaire was conducted for students (230 students) and faculty (65 faculty members) to find out the current situation of ethics and professionalism and the extent of their aspiration and passion for developing it.

RESULT

The result revealed low student and faculty satisfaction with the ethics presentation in the current situation. Educational objectives and outcomes have been developed, and the appropriate teaching model was selected, selecting the main topics, and mapped through a four-dimensional model and assigning the appropriate assessment tools and evaluation mechanisms.

CONCLUSION

This model ensures that the student learns ethics and professionalism and breathes its rules from the beginning of his academic studies. In this way, the student will be able to practice those rules in an automatic and spontaneous manner without having any difficulty in practicing them. In addition, this model helps in breaking down the barriers between faculty members, the basic and clinical sciences, and medical departments which are one of the most important goals of integrative medical education.

Moral distress and compassion fatigue among nursing interns: a cross-sectional study on the mediating roles of moral resilience and professional identity

BACKGROUND

Nursing interns often faced moral distress in clinical practice, similar to registered nurses, which can lead to compassion fatigue. The roles of moral resilience and professional identity in influencing the psychological well-being of nursing interns are recognized, but the interrelationships among moral distress, moral resilience, professional identity, and compassion fatigue in this group remain unclear.

OBJECTIVES

This study aimed to investigate the impact of moral distress on compassion fatigue among nursing interns and to explore the mediating role of moral resilience and professional identity.

METHODS

A quantitative cross-sectional study was conducted with 467 nursing interns. Data were collected using Compassion Fatigue Short Scale, Moral Distress Scale-revised, Rushton Moral Resilience Scale, and Professional Identity Scale. Data analyses were performed using SPSS 22.0 and Amos 21.0, adhering to the STROBE statement.

RESULTS

The mean scores for compassion fatigue, moral distress, moral resilience, and professional identity were 35.876, 44.887, 2.578, and 37.610, respectively. Moral distress was positively correlated with compassion fatigue. Structural equation modeling showed that moral resilience and professional identity partially mediated the relationship between moral distress and compassion fatigue (β = 0.448, P < 0.001).

CONCLUSION

The findings suggest that moral distress directly influences compassion fatigue among nursing interns and also exerts an indirect effect through moral resilience and professional identity. Interventions aimed at enhancing moral resilience and fostering a strong professional identity may help mitigate the adverse effects of moral distress on compassion fatigue among nursing interns.

Clinical supervision experience of nurses in or transitioning to advanced practice: A systematic review

AIMS

To systematically explore the clinical supervision (CS) experience for nurses transitioning to advanced practice.

DESIGN

A qualitative systematic review using Joanna Briggs Institute meta-aggregation following an a priori protocol published on PROSPERO (CRD42023426658).

DATA SOURCES

Qualitative studies obtained from Medline, CINAHL, PsycINFO, Scopus, Emcare and ERIC databases and ProQuest dissertations and theses for peer-reviewed, published and unpublished studies from inception to July 2023.

REVIEW METHODS

Two authors conducted data screening and abstraction. Quality was appraised using the Critical Appraisal Skills Programme tool and reporting followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist for systematic reviews.

RESULTS

Sixteen studies contributed to five synthesized findings: CS that is beneficial requires structure and commitment, trusting relationships are foundational for learning, lifting burdens and preventing burnout, learning through reflection, critical thinking and feedback and barriers to CS.

CONCLUSIONS

This review provides a meaningful exploration of CS to support nurses transitioning to advanced practice. Well-structured supervision offers a safe space to share work-related concerns and develop an advanced practitioner identity. Sharing experiences helps alleviate work-related burdens and reduce professional isolation and burnout.

IMPLICATIONS FOR THE PROFESSION

Peer-support networks are vital for successful transition to advanced practice.

IMPACT

This review highlighted the impact of effective supervisory relationships in forming professional identity and possible links with nursing retention.

PUBLIC CONTRIBUTION

No direct patient contributions are included as it forms part of a research degree.

Habituation for professional learning: a qualitative study of physiotherapy students' experiences working with anatomy cadavers

INTRODUCTION

Cadaveric dissection shapes the ways in which healthcare students understand the human body and the attitudes, identities and behaviors they exhibit as health professionals. There is however a paucity of related research with physiotherapy (PT) students.

PURPOSE

The purpose of this interpretivist study was to investigate PT students' conceptions of the human body in relation to experiences with human cadavers in anatomy education.

METHODS

Ten semi-structured interviews were conducted with PT students along with four optional written reflections completed. Data was thematically analyzed.

RESULTS

Students engaged in a continuous process of habituation involving oscillation between "humanization" and "dehumanization" of cadavers in the anatomy lab. We describe the contextual mediators that shaped the process, the multi-sensory and emotional experience of the students, and the "interruptions" that contributed to the variability in their conceptions over time and contexts. Students ultimately habituated toward dehumanization which had multiple effects on learning and professionalization.

CONCLUSION

Study findings highlight the complexity of PT students' experiences and learning within the cadaver lab outside of the formal goals of anatomy education. We discuss the implications for anatomy curricula, including the potential advantages of incorporating a biopsychosocial approach.

The die-hards, negotiators and migrants: Portraits of doctors' career pathways through specialisation

INTRODUCTION

Global workforce shortages in medical specialties strain healthcare systems, jeopardising patient outcomes. Enhancing recruitment strategies by supporting professional identity (PI) development may be one way to address this workforce gap-yet little research has explored this topic. The goal of the current study was to explore specialty-specific recruitment through considering PI. As proposed causes of workforce shortages in anatomical pathology (AP) bear similarities to many other specialties, this study uses the field of AP as a model for specialist PI development and asks: (1) why, how and when do doctors choose to pursue AP training and (2) what can be learned from this for recruitment to AP and other specialties?

METHODS

A qualitative research approach was undertaken using narrative inquiry. Interviews with junior doctors interested in AP, AP registrars and AP consultants from Australia and New Zealand were interpreted as stories via 're-storying'. Narrative synthesis of participants' collective stories identified chronological key events (i.e. 'turning points') in choosing AP.

RESULTS

Narrative synthesis resulted in identification of three portraits entering medical specialist training: (1) die-hards, deciding upon initial exposure; (2) negotiators, choosing after comparing specialties; and (3) migrants, seeking to move away from non-pathology specialties. The negotiators and migrants cemented their decision to pursue AP as a postgraduate doctor, whereas the die-hards made this decision during medical school.

CONCLUSIONS

Given the similarities in portrait traits between AP and other specialties across the literature, our results suggest ways to support specialty recruitment using PI development. We propose a medical specialist recruitment framework to support the PI development of doctors with die-hard, negotiator and migrant traits. Use of this framework could enhance current specialty-specific recruitment approaches, particularly in fields challenged by workforce shortages.

Professional identity and its associated psychosocial factors among physicians from standardized residency training programs in China: a national cross-sectional study

Introduction

Shortage and high turnover intention rate of physicians are concerning problems in China. Professional identity has been shown as an influential factor for physicians' turnover intention. Enhancing physicians' professional identity in their early phase of career, standardized residency training program (SRTP), may help reduce the turnover rate. This study aimed to investigate the current status of professional identity and explore its associated psychosocial factors among Chinese SRTP trainees, hoping to provide evidence in strengthening the available medical human resources in China.

Methods

The final sample was comprised of 2,267 Chinese SRTP trainees in this cross-sectional survey conducted from 9 March to 20 March in 2023. Descriptive statistics were calculated. Bivariate analyses and hierarchical multiple linear regression were used to analyze potential associated factors of Chinese SRTP trainees' professional identity.

Results

The average score of respondents' professional identity was 47.68 (standard deviation, SD = 8.61). Results from hierarchical multiple linear regression analysis showed that being married (β = 0.066, p < 0.01), having work experience before SRTP (β = 0.036, p < 0.05), being satisfied with annual income (β = 0.062, p < 0.01), psychological distress (β = -0.144, p < 0.001), depersonalization (β = -0.053, p < 0.05), emotional exhaustion (β = -0.380, p < 0.001) and resilience (β = 0.169, p < 0.001) were associated with professional identity (F = 114.301, p < 0.001). All associated factors can explain 41.1% of the variance in professional identity, and individual psychological variables make up a substantial portion (28.6%) of this influence.

Discussion

Individual psychological variables are strongly associated with professional identity. Helping SRTP trainees reduce psychological distress, alleviate burnout and enhance resilience may be effective ways to promote the formation of their professional identity.

Health and social care workers' professional values: A cross-sectional study

BACKGROUND

Professional values create a basis for successful collaboration and person-centred care in integrated care and services. Little is known about how different health and social care workers assess their professional values.

RESEARCH AIM

To describe and compare professional value orientation among different health and social care workers in Finland.

RESEARCH DESIGN

A quantitative cross-sectional study.

PARTICIPANTS AND RESEARCH CONTEXT

We carried out an online survey of health and social care workers from 8 March to 31 May 2022, using the Finnish version of the Nurses' Professional Values Scale-3. The data were analysed using descriptive and advanced statistics.

ETHICAL CONSIDERATIONS

Permission was received from all participating organizations and those who completed the survey provided informed consent.

RESULTS

A total of 1823 health and social care workers, representing seven professional groups and students, took part. The overall level of professional values among the participants was relatively high. Commitment to providing patients and clients with equal care was more important than engaging with society and professional responsibilities in the work environment. Professional values were strongest among professionals with higher educational degrees and training in professional ethics. The same was true for workers who received organizational support for ethical practice, were satisfied with their work and had shorter work experience.

DISCUSSION

Our results showed shared professional values among different health and social care workers and students. These results are meaningful for integrated care and services. At the same time, a clear need for strengthening engagement with society and professional responsibilities for developing work environments were identified.

CONCLUSIONS

Health and social care workers and students need training in professional ethics and organizational support for ethical practice and work satisfaction to maintain their professional values at different stages of their career.

Explain the professional identity of nursing during COVID-19 pandemic

AIM

To explore the professional identity of nursing during the COVID-19 pandemic in Iran. Professional identity guides nurses' interaction with patients. In the COVID-19 pandemic, recent developments in society's view of the nursing profession are expected to change the perception of nurses' professional identities.

DESIGN

The qualitative study used a conventional content analysis approach.

METHODS

Data were collected using in-depth semi-structured interviews from June 2020 to January 2021. Data analysis was performed using Landman and Granheim's analysis and Lincoln and Guba's criteria to ensure the data's rigour.

RESULTS

After analysing the 20 interviews with 17 participants, including 11 nurses with an average age of 32.63 ± 6.71 years and six varius community members with an average age of 38.66 ± 5.85 years, three main categories were formed: (1) The dual role of the media in the two subcategories (the positive role and the negative role of the media), (2) Changes in public view of nursing during the COVID-19 pandemic (respect for avoidance and understanding the value of nursing practice) and (3) Change of professional identity by showing self-sacrifice (dealing with adversity and commitment to professional obligations).

CONCLUSION

The image in the public view of the nursing profession during the COVID-19 pandemic media differs from before and shows self-sacrifice, professional commitment and humanity in nursing. Nurses' experience of caring during the COVID-19 pandemic has positively affected their professional identity; however, they are concerned about the instability of improving the nursing image in society.

IMPACT

Nursing leaders and policymakers can utilize media platforms to portray the nursing profession in a positive light and emphasize the scientific capabilities of nurses. This approach goes beyond highlighting sacrifice and compassion, aiming to shift societal perceptions of nursing and bolster the professional identity of nurses.

REPORTING METHOD

We used the COREQ (COnsolidated criteria for REporting Qualitative research) checklist as a reporting method.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Psychometric testing of the nurses professional values scale-revised on family and community health nurses

BACKGROUND

Family and Community Health Nurses (FCHNs) are at a higher risk of experiencing emotional exhaustion and feelings of low personal accomplishment. Higher levels of professional identity may decrease these negative feelings. Its measurement could produce positive effects for FCHNs and the quality of care they offer.

AIM

This study aims to evaluate the psychometric properties (validity and reliability) of the Nurses Professional Values Scale-Revised (NPVS-R) on FCHNs in Italy.

RESEARCH DESIGN

A cross-sectional research design was used.

PARTICIPANTS AND RESEARCH CONTEXT

A convenience sample of FCHNs was recruited in an out-of-hospital setting from Italy. A total of 202 nurses were eligible (mean age of 41.11 ± 10.55 years; 78.2% female).

ETHICAL CONSIDERATIONS

The study was performed in accordance with the World Medical Association Declaration of Helsinki. Participants were asked for their consent and were guaranteed anonymity in the information collected. The study was approved by the internal review board of the university.

RESULTS

Confirmatory Factor Analysis (CFA) supported a unidimensional factorial structure of the NPVS-R with an adequate fit to the data. Internal consistency reliability was also supported. The construct validity was further reinforced by the concurrent validity results showing a positive and significant correlation of professional identity with job satisfaction.

CONCLUSION

The NPVS-R is a valid and reliable instrument to measure professional identity among FCHNs. It can be used in clinical practice to improve FCHNs' psychological-emotional feelings and quality of care provided, in research to allow comprehensive understanding of professional identity, and in educational settings to monitor the professional identity levels of Family and Community Health Nursing students.

Nursing Professional Values Scale (NPVS-3) in an Austrian context: validation of a scale and reliability assessment

BACKGROUND

The Nurses Professional Values Scale-3 (NPVS-3) is a psychometric instrument derived from a set of values initially established by the American Nurses Association (ANA) Code of Ethics. The present study evaluates the reliability of the NPVS-3 scale for nursing students and nurses in Austria.

METHODS

A cross-sectional methodological study was conducted on 209 research participants, comprising 139 nursing students and 70 nurses, with the objective of determining the reliability of the Austrian version of the scale. A multilevel approach was employed in the study, encompassing cultural and linguistic validation, content validity, face validity, and construct validity. The scale translation was performed per the established translation stages of back-translation and was subsequently reviewed by an expert committee. The translated instrument was applied to the participants who completed an online survey between April and July 2023. Internal consistency was evaluated using Cronbach's alpha, while construct validity was assessed using confirmatory factor analysis (CFA).

RESULTS

The Cronbach's alpha values obtained were deemed appropriate, with the following results: Caring (0.852), Activism (0.832), and Professionalism (0.676). Through factorial analysis, three factors were identified as original NPVS-3 and construct validity was verified.

CONCLUSION

The Austrian version of the NPVS-3 demonstrated satisfactory validity, efficiently evaluating the professional values of nurses and nursing students in Austria.

The influence factors of tour guides' professional identity and professional decision before and after the COVID-19 pandemic

The COVID-19 pandemic has significantly impacted the tourism sector, particularly tour guides (TGs), affecting their professional identity (TGPI) and intentions to return to work. As China strives to revive its tourism industry, it is crucial to understand the current state of TGPI, its evolution, influencing factors, and its impact on TGs' return intentions. This study employed a quantitative approach, using comparative analysis and binary logistic regression, to investigate these issues among frontline TGs in China, pre- and post-pandemic. Cross-sectional surveys were conducted with 422 participants in 2019 and 398 in 2022, yielding 370 and 342 valid responses, respectively. The questionnaire utilized a five-point Likert scale. Findings reveal that (1) The overall TGPI level in 2022 post-pandemic is medium (3.93), showing a significant decrease from the pre-pandemic level in 2019 (4.15). (2) Influencing factors of TGPI are predominantly material, reflected in social insurance and income changes pre- and post-pandemic. (3) This study presents a novel definition and scale of TGPI, encompassing tour guides' professional value identity (TGPVI), emotion identity (TGPEI), relationship identity (TGPRI), and behavior tendency (TGPBT). (4) The two dimensions of the TGPI, TGPVI and TGPRI, income and education level, significantly influence TGs' return intentions. The study provides valuable academic and practical insights into TGPI and offers significant implications for enhancing TGs' return intentions and policymaking for post-pandemic tourism industry development.

Effects of Arts-Based Pedagogy on Competence Development in Nursing: A Critical Systematic Review

The integration of arts-based methods into nursing education is a topic of growing interest in nursing practice. While there is an emerging body of research on this subject, evidence on competence development remains vague, largely due to methodological weaknesses. The purpose of this review is to evaluate the effectiveness of arts-based pedagogy in nursing, specifically in terms of students' changes in knowledge, skills, and attitudes. It explores which arts-based approaches to nursing education qualify as evidence-based practice in terms of nursing competence. A systematic critical review of research on arts-based pedagogy in nursing was conducted, identifying 43 relevant studies. These studies were assessed for methodological quality based on the CEC Standards for evidence-based practice, and 13 high-quality comparative studies representing a variety of arts-based approaches were selected. Creative drama was identified as the only evidence-based practice in the field, positively affecting empathy. The findings highlight a research gap in nursing education and emphasize the need for measurement and appraisal tools suitable for the peculiarities of arts-based pedagogy.

Rebalancing of professional identity roles in an integrated maternity and neonatal care setting designed to increase parent autonomy: a qualitative study among health professionals

This case-based qualitative study explored the professional identity as experienced by health professionals working in an integrated maternal-neonatal ward when their practice changed from a "paternalistic" model, in which physicians and nurses were in charge, to a shared or "consumerist" model, to increase parent autonomy. We analyzed transcripts of focus group discussions and interviews with 60 health professionals on their experiences with empowering parents and described factors associated with themes of professional identity. The changes most affecting professional identity were the constant proximity of parents to their newborns and the single-family room design. These changes influenced three themes of professional identity: (1) connectedness and relationships (2) communication, and (3) competencies. A fourth theme, values, beliefs, and ethics, affected how the health professionals coped with the changes in the first three themes. When empowering parents of newborns in a hospital setting, health professionals experience beneficial as well as threatening shifts in their professional identities. Values, beliefs, and ethics associated with family integrated care helped health professionals to embrace their new roles, but other values, beliefs and ethics could create barriers. Continuous professional identity development in a patient-inclusive team is a topic for future research.

Rebuilding Nursing Culture Through Application of Social Identity Theory and Inclusivity in Health Care Systems: An Exemplar

This article explores leader practices for rebuilding health system nursing culture by leveraging feedback from clinical nurses and applying Social Identity Theory (SIT) and inclusivity frameworks. An enriched nursing culture is the foundation of quality patient care, and as healthcare systems evolve, it becomes increasingly essential to foster a cohesive and inclusive environment in every aspect of employment practices. Social Identity Theory, which emphasizes how individuals define their self-concept through group affiliations, offers a lens to understand the interplay of identity, values, and behavior within nursing teams. Inclusivity practices are pivotal in creating a welcoming and diverse health care workplace. By employing these approaches, health care systems can rebuild and strengthen their nursing culture, improving retention, onboarding, job satisfaction, teamwork, and enhancing the quality of care provided to patients. This article delves into practical strategies and application of SIT and inclusivity practices to restructure and revitalize nursing culture, emphasizing the positive impact on health care outcomes. An exemplar demonstrating the impact of the voice of the clinician in program development highlights the application of SIT and inclusivity to create culture. It concludes with leader practices for rebuilding nursing culture to include contingent labor as part of the care team.

Nursing students' experiences from clinical education using the TPSN model

BACKGROUND

The TPSN model is an innovative model to create an integration and structured relationship between educational and healthcare provider institutions. This model is done to reduce the theoretical-practical gap in nursing. The present study aimed to explore the experiences of nursing students.

METHODS

In a conventional content analysis, 11 undergraduate nursing students, 7 graduate nursing students, and 4 doctoral students were selected. Data was collected through focus group discussions and individual interviews.

RESULTS

The findings from analyzing the students' experiences who had received education using this model resulted in four main categories: the feeling of being a nurse, an integrated and collaborative clinical education platform, the development of nursing clinical education, and educational challenges.

CONCLUSION

The TPSN model provides a suitable platform for nursing clinical education. This model helps students integrate theoretical knowledge with clinical practice and helps them act as professional nurses in the future.

"Safety Means Everything": An ethnographic methodology to explore the formation of professional identity in nursing students

AIM

The aim of this qualitative study is to explore how various conditions within educational contexts impact nursing students' experiences of becoming professional nurses and how these conditions affect their agency and the formation of their professional identities.

BACKGROUND

Nursing education is essential to becoming professional and competent in caring for patients. A strong professional identity in nursing contributes to better patient outcomes and improves the well-being, retention, and recruitment of practitioners in the health care system. At the same time, research indicates that development of a professional identity during education is challenging and needs further investigation.

DESIGN

The qualitative research design draws on the theoretical and methodological framework of critical psychology practice research. The practice research design and close collaboration with users ensure the continuous development and implementation of theory and practice.

METHODS

The data used in this study originated from ethnographic fieldwork, which involved following two nursing students through their final clinical placement training at the Geriatric Department of a university hospital in Denmark. Additionally, nursing students in two classes were observed as part of their nursing education practice at a university college from April to July 2022. The participant observational design, combined with in-situ interviewing, facilitated a comprehensive understanding of the students' engagement in social practices and interactions within the context of nursing education.

RESULTS

Our results show how the conditions of nursing students' everyday lives have a critical impact on their self-understanding and journey to becoming competent and professional nurses. Three main themes emerged from the analysis: (1) Perception of safety, (2) Motivation for learning in different communities of practice, and (3) The meaning of learning culture and role models.

CONCLUSION

The development of nursing students into professionals is profoundly influenced by factors affecting their ontological safety that are deeply embedded in socio-cultural and educational contexts. The results underscore the need to foster ontological safety in nursing education. Creating safe, participatory, and supportive learning environments is essential to the holistic development of students into caring, competent nurses. Educators and stakeholders must remember their crucial role in this context and focus on establishing these environments to facilitate students' sense of belonging in the nursing profession.

TWEETABLE ABSTRACT

The development of professional identity in nursing starts with safety. Ontological Safety in learning environments ensures competent and professional nurses. #NursingEducation#Safety#ProfessionalIdentity.