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Stelwagen M, Westmaas A, Van Kempen A, Scheele F. Rebalancing of professional identity roles in an integrated maternity and neonatal care setting designed to increase parent autonomy: a qualitative study among health professionals. J Interprof Care 2024:1-9. [PMID: 38655873 DOI: 10.1080/13561820.2024.2343843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
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.
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Affiliation(s)
- Mireille Stelwagen
- Department of Teaching and Pediatrics, OLVG Hospital, Amsterdam, The Netherlands
| | - Alvin Westmaas
- Department of Social Psychology, Faculty of Health, University of Applied Sciences Leiden, Leiden, Netherlands
| | - Anne Van Kempen
- Department of Pediatrics, OLVG Hospital, Amsterdam, The Netherlands
| | - Fedde Scheele
- Department of Gynecology and Teaching, OLVG Hospital, Amsterdam, The Netherlands
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Onetto J, Sobczak M, Skapetis T, Kahler B, Tishkina O, Van Gorp G, O'Connell AC. Appraisal of the IADT fellowship - A member survey. Dent Traumatol 2024. [PMID: 38651791 DOI: 10.1111/edt.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/07/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND/AIM The International Association of Dental Traumatology (IADT) is considered the foremost authority in Dental Traumatology. Fellowship status was introduced in 2015 and is considered an international standard of excellence. The Fellowship Committee of the IADT believed it was essential to survey members seeking information on the benefits of the IADT Fellowship and potential considerations for future development. This survey aimed to explore the perceptions of members of IADT surrounding the fellowship process in terms of interest, accessibility, equality, perceived prestige, and value to the membership. MATERIAL AND METHODS The survey was sent to 546 IADT members, of whom 89 were fellows (as of 31 July 2022) from 74 countries via an email invitation. Answers were analysed using the Chi2 and Fisher's exact test (p < .05). RESULTS The response rate to the survey was 20.69% (n = 113), including 28 fellows (24.78%). Forty-six respondents (40.71%) were female, and 67 (59.30%) were male. Dentists identified as specialists were significantly more likely to be involved in teaching dental trauma (p = .000008). A majority of respondents (87.76%; 86/98) expressed interest in obtaining fellowship, with increased interest from more recent graduates. Learning opportunities, obtaining expertise, networking and a sense of community and prestige, were key factors in considering fellowship. There was interest in alternate pathways other than examination alone, with 60.2% of 98 respondents suggesting a combination of publications /service to IADT/ reviewer for Dental Traumatology, 57.14% suggesting the submission of case reports, and 42.86% suggesting Honorary Fellowship. Respondents (73%) were willing to participate in online discussion forums and other professional development opportunities. This preference was more notable among non-fellows (75.29%) than fellows (67.85%). CONCLUSIONS The survey indicates the diverse motivations and perceptions regarding the IADT Fellowship, despite the low participation of IADT members. Achieving fellowship status is desired by 87.7% of non-fellows. The majority of respondents were aware of the process, but main concerns were identified as eligibility criteria and examination difficulty. Options for alternate pathways and other initiatives promoting engagement were identified. Further exploration of these issues is required to be representative of the entire IADT membership. Addressing these obstacles could significantly enhance fellowship participation and overall member satisfaction within the IADT community.
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Affiliation(s)
- Juan Onetto
- Pediatric Dentistry, Faculty of Dentistry, Research Center in Dental and Medical Sciuences (CICOM), Universidad de Valparaíso, Valparaiso, Chile
| | | | - Tony Skapetis
- Western Sydney Local Health District, NSW Health, Westmead, New South Wales, Australia
| | - Bill Kahler
- Faculty of Medicine and Health, Sydney Dental School, The University of Sydney, Surry Hills, New South Wales, Australia
| | - Olga Tishkina
- Private Practice, Dental Trauma Center Iceberg, Moscow, Russia
| | - Geertje Van Gorp
- Department of Oral Health Sciences-Population Studies in Oral Health, KU Leuven, Leuven, Belgium
- Pediatric Dentistry and Special Care, University Hospitals Leuven, Leuven, Belgium
| | - Anne C O'Connell
- School of Dental Science, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
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Ahluwalia S, Spicer J. Professional identity and GP trainers as educational leaders. Educ Prim Care 2024:1-5. [PMID: 38651611 DOI: 10.1080/14739879.2024.2329891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/09/2024] [Indexed: 04/25/2024]
Abstract
GP training in the UK has a long history of success, however that is measured. That success is in part due to the formality and credentialling that underlies preparation to take on that role of a GP teacher, which is somewhat under current threat due to workforce pressures. We identify three important factors associated with the GP trainer function [leadership, professional identity and clinical care improvement] that are not often analysed but are at some risk if preparation for the GP trainer role is reduced or devalued. Of particular note are the differing ways that GPs conceptualise their professional roles as teachers and clinicians, despite the transferable skills between them, the demonstrably improved patient care that occurs in practices that teach, and the necessary connections between educational theory and practice. We suggest that these areas define a research agenda ripe for exploration.
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Affiliation(s)
- Sanjiv Ahluwalia
- Primary Care and Medical Education, Head of School of Medicine, Anglia Ruskin University, Chelmsford, UK
| | - John Spicer
- Institute of Medical and Biomedical Education, St George's University of London, London, UK
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Wu J, Ghayas S, Aziz A, Adil A, Niazi S. Relationship between teachers' professional identity and career satisfaction among college teachers: role of career calling. Front Psychol 2024; 15:1348217. [PMID: 38659685 PMCID: PMC11039962 DOI: 10.3389/fpsyg.2024.1348217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/14/2024] [Indexed: 04/26/2024] Open
Abstract
Objectives Professional identity has been found an important determinant of career satisfaction of employees working in various fields. Teachers' professional identity is a relatively less explored domain. Considering the importance of teacher's career satisfaction, the current study was designed to test the role of career calling in the relationship between teachers' professional identity and career satisfaction. Methods A sample of teachers (N = 300) with (n = 115) men and (n = 185) women was recruited from the colleges of Sargodha City, Pakistan with an age range from 24 to 45 (M = 31.3, SD = 6.4). A purposive sampling technique was employed for data collection. Variables of the present study were operationalized through the Professional Identity Scale, Brief Calling Scale, and Career Satisfaction Scale. Results Path analysis revealed that normative identity did not have any direct or indirect effects on career satisfaction and career calling. Whereas affective and efficacy identity demonstrated significant positive direct effects on career calling whereas career calling had significant positive direct effect on career satisfaction. Efficacy identity also had a significant positive direct effect on career satisfaction. Finally, both affective and efficacy identity had significant positive indirect effects on career satisfaction via career calling. Conclusion The findings of the current study may help in devising plans to improve the career satisfaction of teachers working in the higher education sector.
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Affiliation(s)
- Jinshun Wu
- College of Economics and Management, East China Jiaotong University, Nanchang, Jiangxi Province, China
| | - Saba Ghayas
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Aiman Aziz
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Adnan Adil
- Department of Psychology, GC Women University Sialkot, Sialkot, Pakistan
| | - Sadia Niazi
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
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Knop M, Mueller M, Kaiser S, Rester C. The impact of digital technology use on nurses' professional identity and relations of power: a literature review. J Adv Nurs 2024. [PMID: 38558440 DOI: 10.1111/jan.16178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/20/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024]
Abstract
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.
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Affiliation(s)
- Michael Knop
- Faculty for Applied Healthcare Sciences, Deggendorf Institute of Technology, Deggendorf, Germany
| | | | | | - Christian Rester
- Faculty for Applied Healthcare Sciences, Deggendorf Institute of Technology, Deggendorf, Germany
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Hu X, Chen X, Ouyang Q, Li G, Wade GH, Chen Y. The potential influences of professional identity for undergraduate nursing students during the COVID-19 pandemic: A cross-sectional study. Jpn J Nurs Sci 2024; 21:e12567. [PMID: 37797954 DOI: 10.1111/jjns.12567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/11/2023] [Accepted: 09/13/2023] [Indexed: 10/07/2023]
Abstract
AIM We aimed to investigate the level of undergraduate nursing students' professional identity (PI) during the COVID-19 pandemic and its potential influences. METHODS This cross-sectional study included 742 undergraduate nursing students from Chengdu Medical College. Basic demographics, personal characteristics and PI score were collected. Chi-squared test, one-way analysis of variance, and multivariable logistic regression analysis were used to analyze the data. RESULTS In the classes of 2019, 2020, and 2021, the PI score was 96.85 ± 18.26, 105.37 ± 17.46, 106.67 ± 22.08 (P < .001). PI score was the independent predictive factor for both "want to be a nurse" and "willingness to serve during COVID-19 or other pandemics". CONCLUSIONS PI contributes greatly to nursing students' willingness to be a nurse and overcome pandemics. The challenge of culturing PI during COVID-19 pandemic revealed the necessity of developing individual management strategies for nursing education.
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Affiliation(s)
- Xiao Hu
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Xiaoju Chen
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Qian Ouyang
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Gang Li
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Gail Holland Wade
- School of Nursing, College of Health Sciences University of Delaware, Newark, New Jersey, USA
| | - Yidi Chen
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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Fukuya Y, Asaka Y. Work engagement influencing factors of Japanese midwives working in prenatal medical centers. Eur J Midwifery 2024; 8:EJM-8-10. [PMID: 38469115 PMCID: PMC10926299 DOI: 10.18332/ejm/183805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/07/2024] [Accepted: 02/20/2024] [Indexed: 03/13/2024] Open
Abstract
INTRODUCTION There have been significant changes in the work environment of midwives, such as the establishment of prenatal medical centers and shared wards for obstetrics and other departments. These changes in the work environment pose a psychological burden on midwives. Under these circumstances, the concept of work engagement is essential for overcoming the ensuing difficulties. However, no studies have yet investigated midwives working in prenatal medical centers in Japan. This study examined the factors affecting work engagement among midwives working in prenatal medical centers in Japan. METHODS A cross-sectional survey of 498 midwives working at prenatal medical centers nationwide was conducted. Data were analyzed using the Mann-Whitney U test or Kruskal-Wallis test, correlation analysis using Spearman's rank correlation coefficient, and multiple regression analysis as linear regression. RESULTS The median of work engagement score was 3.00 (IQR: 2.40-3.60). The multiple linear regression analysis showed that professional identity (β=0.494, p<0.001), resilience (β=0.243, p<0.001), presence of in-hospital midwifery in the facility (β=0.138, p<0.011), and age (β=0.085, p=0.021) were significant. The adjusted R2 value was 0.490 (p<0.001). CONCLUSIONS These results offer management insights into improving work engagement among midwives working in prenatal medical centers in Japan. The proposed measures include hospital/ward administrators establishing the professional identity of midwives and providing them with opportunities to demonstrate their expertise, for instance, within in-hospital midwifery systems at perinatal medical centers.
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Affiliation(s)
- Yuki Fukuya
- Department of Maternal and Child Nursing/Midwifery, Course of Nursing, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Yoko Asaka
- Department of Maternal and Child Nursing/Midwifery, Course of Nursing, Graduate School of Medicine, Mie University, Tsu, Japan
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Rozario SY, Sarkar M, Farlie MK, Lazarus MD. Responding to the healthcare workforce shortage: A scoping review exploring anatomical pathologists' professional identities over time. Anat Sci Educ 2024; 17:351-365. [PMID: 36748328 DOI: 10.1002/ase.2260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 01/16/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
Anatomical pathology (AP) is an anatomy-centric medical specialty devoted to tissue-based diagnosis of disease. The field faces a current and predicted workforce shortage, likely increasing diagnostic wait times and delaying patient access to urgent treatment. A lack of AP exposure is proposed to preclude recruitment to the field, as medical students are afforded only a limited understanding of who a pathologist is and what they do (their professional identity/PI and role). Anatomical sciences educators may be well placed to increase student understanding of anatomical pathologists' PI features, but until features of anatomical pathologists' PI are understood, recommendations for anatomy educators are premature. Thus, this scoping review asked: "What are the professional identity features of anatomical pathologists reported in the literature, and how have these changed over time?" A six-stage scoping review was performed. Medline and PubMed, Global Health, and Embase were used to identify relevant studies (n = 74). Team-based framework analysis identified that features of anatomical pathologists' professional identity encompass five overarching themes: professional practice, views about the role, training and education, personal implications, and technology. Technology was identified as an important theme of anatomical pathologists' PI, as it intersected with many other PI feature themes, including diagnosis and collaboration. This review found that pathologists may sometimes perceive professional competition with technology, such as artificial intelligence. These findings suggest unique opportunities for integrating AP-specific PI features into anatomy teaching, which may foster student interest in AP, and potentially increase recruitment into the field.
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Affiliation(s)
- Shemona Y Rozario
- Centre for Human Anatomy Education (CHAE), Department of Anatomy and Developmental Biology, Biomedical Discovery Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Mahbub Sarkar
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Melanie K Farlie
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Department of Physiotherapy, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michelle D Lazarus
- Centre for Human Anatomy Education (CHAE), Department of Anatomy and Developmental Biology, Biomedical Discovery Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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Hawes M, Werners A. The future of pharmacology education: The Veterinary Educators in Pharmacology Special Interest Group (VEPSIG). Expert Rev Clin Pharmacol 2024; 17:303-304. [PMID: 38314564 DOI: 10.1080/17512433.2024.2315309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/02/2024] [Indexed: 02/06/2024]
Affiliation(s)
- Martin Hawes
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, UK
| | - Arno Werners
- School of Veterinary Medicine, Department of Anatomy, Physiology and Pharmacology, True Blue Campus, St. George's University, St. George's, Grenada
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Kiran F, Ayub R, Rauf A, Zahoor A. Transforming professional identity of medical teachers in Pakistan by a certificate program in health professions education: a thematic analysis of reflective essays. Front Med (Lausanne) 2024; 10:1323075. [PMID: 38450394 PMCID: PMC10916688 DOI: 10.3389/fmed.2023.1323075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/27/2023] [Indexed: 03/08/2024] Open
Abstract
Introduction A teacher's professional identity development is a dynamic and continuous process that requires rigorous, longitudinal, faculty development initiatives which are designed to work on individual professional growth. Impact of such programs must be evaluated by qualitative means to identify the process of change; The purpose of our study was to investigate whether and how our thoughtfully designed 6-month certificate program has transformed the professional identity of medical teachers. Methods The study was conducted in National University of Medical Sciences, Pakistan using thematic analysis, wherein a weekly task of guided reflective writing, on Moodle, was given. Data was analyzed in six phases to achieve credibility and transferability. Results By analyzing 202 reflective writings, seven subthemes were identified which manifest transformation in certain aspects of identity of participants and grouped under three major themes. The seven subthemes represent transformative journey of participants and include recognizing millennial learners' dilemma, identifying learning gaps and overcoming barriers, discovering a newer version of self, alternative frame of thinking, transforming traditional classroom, conducive learning environment and Community of Practice. Three major themes identified were Awareness, Modeling and Socialization which represent three processes bringing transformation in participants. Conclusion Our faculty development program has transformed certain aspects of professional identities of medical teachers by incorporating informal teaching strategies of experiential learning, professional socialization, reflections, and role modeling. Participants' beliefs and practices on teaching were challenged by giving a disorienting dilemma of millennial learners and learning theories. They underwent critical discourse with professional peers and mentors in community of practice, reflected on their traditional teaching practices, acquired new insight, underwent self-discovery, and introduced digitalization and interactive learning strategies within their classrooms.
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Affiliation(s)
- Faiza Kiran
- Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Rukhsana Ayub
- NUMS Department of Health Professions Education, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Ayesha Rauf
- NUMS Department of Health Professions Education, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Asiya Zahoor
- NUMS Department of Health Professions Education, National University of Medical Sciences, Rawalpindi, Pakistan
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Zhang W, Zhu Q, Yu R, He T, Huang J. Regulatory focus as a mediator in the relationship between nurses' organizational silence and professional identity. J Adv Nurs 2024. [PMID: 38380591 DOI: 10.1111/jan.16113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/09/2024] [Accepted: 02/09/2024] [Indexed: 02/22/2024]
Abstract
AIMS This work aims to analyse the current state of the professional identity of Chinese nurses; examine the relationship amongst regulatory focus, organizational silence and professional identity and determine how regulatory focus affects the relationship between professional identity and organizational silence. DESIGN This study conducted a cross-sectional survey. METHODS From June to August 2023, 420 nurses from six hospitals in Hunan Province, China, were selected through convenience sampling and surveyed by using a general information questionnaire, the regulatory focus scale, the organizational silence scale and the professional identity scale. The relationship amongst the regulatory focus, organizational silence and professional identity of nurses was examined by utilizing SPSS 25.0 and the mediating role of regulatory focus between organizational silence and nurses' professional identity was examined by applying AMOS 24.0. RESULTS Nurses had a moderate level of professional identity. Professional identity was positively correlated with regulatory focus and negatively correlated with organizational silence. Regulatory focus was negatively correlated with organizational silence. Mediation effect studies revealed that organizational silence and professional identity were partially mediated by regulatory focus. CONCLUSION In accordance with research showing that nurses' organizational silence can indirectly affect professional identity via regulatory focus, clinical nursing managers should concentrate on the interaction amongst these three variables to strengthen professional identity. IMPACT The results of this study serve as a reminder to nurses to select a preventive or promotive focus based on their career objectives and to effectively express their views to enhance their professional identity. This also reminds nursing managers assess nurse-led regulatory focus, identify their underlying qualities and understand their professional aspirations and career orientation, create a good atmosphere for advice and encourage nurses to express their views, so as to improve nurses 'professional identity. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Wenxia Zhang
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Quanli Zhu
- Hunan Academy of Traditional Chinese Medicine Affiliated Hospital, Changsha, China
| | - Renhe Yu
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Taotao He
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Jing Huang
- Hunan Academy of Traditional Chinese Medicine, Changsha, China
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Acharya A, Black RC, Smithies A, Darzi A. Evaluating the Impact of the National Health Service Digital Academy on Participants' Perceptions of Their Identity as Leaders of Digital Health Change: Mixed Methods Study. JMIR Med Educ 2024; 10:e46740. [PMID: 38381477 PMCID: PMC10918534 DOI: 10.2196/46740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 10/14/2023] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND The key to the digital leveling-up strategy of the National Health Service is the development of a digitally proficient leadership. The National Health Service Digital Academy (NHSDA) Digital Health Leadership program was designed to support emerging digital leaders to acquire the necessary skills to facilitate transformation. This study examined the influence of the program on professional identity formation as a means of creating a more proficient digital health leadership. OBJECTIVE This study aims to examine the impact of the NHSDA program on participants' perceptions of themselves as digital health leaders. METHODS We recruited 41 participants from 2 cohorts of the 2-year NHSDA program in this mixed methods study, all of whom had completed it >6 months before the study. The participants were initially invited to complete a web-based scoping questionnaire. This involved both quantitative and qualitative responses to prompts. Frequencies of responses were aggregated, while free-text comments from the questionnaire were analyzed inductively. The content of the 30 highest-scoring dissertations was also reviewed by 2 independent authors. A total of 14 semistructured interviews were then conducted with a subset of the cohort. These focused on individuals' perceptions of digital leadership and the influence of the course on the attainment of skills. In total, 3 in-depth focus groups were then conducted with participants to examine shared perceptions of professional identity as digital health leaders. The transcripts from the interviews and focus groups were aligned with a previously published examination of leadership as a framework. RESULTS Of the 41 participants, 42% (17/41) were in clinical roles, 34% (14/41) were in program delivery or management roles, 20% (8/41) were in data science roles, and 5% (2/41) were in "other" roles. Interviews and focus groups highlighted that the course influenced 8 domains of professional identity: commitment to the profession, critical thinking, goal orientation, mentoring, perception of the profession, socialization, reflection, and self-efficacy. The dissertation of the practice model, in which candidates undertake digital projects within their organizations supported by faculty, largely impacted metacognitive skill acquisition and goal orientation. However, the program also affected participants' values and direction within the wider digital health community. According to the questionnaire, after graduation, 59% (24/41) of the participants changed roles in search of more prominence within digital leadership, with 46% (11/24) reporting that the course was a strong determinant of this change. CONCLUSIONS A digital leadership course aimed at providing attendees with the necessary attributes to guide transformation can have a significant impact on professional identity formation. This can create a sense of belonging to a wider health leadership structure and facilitate the attainment of organizational and national digital targets. This effect is diminished by a lack of locoregional support for professional development.
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Affiliation(s)
- Amish Acharya
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Ruth Claire Black
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Alisdair Smithies
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Ara Darzi
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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Li YR, Liu JY, Fang Y, Shen X, Li SW. Novice nurses' transition shock and professional identity: The chain mediating roles of self-efficacy and resilience. J Clin Nurs 2024. [PMID: 38379345 DOI: 10.1111/jocn.17002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/11/2023] [Accepted: 01/07/2024] [Indexed: 02/22/2024]
Abstract
AIMS AND OBJECTIVES The aim of this study was to explore the association between transition shocks and professional identity and the mediating roles of self-efficacy and resilience among Chinese novice nurses. BACKGROUND Novice nurses experience transition shock when they start their careers, which might lead to decreased professional identity and ultimately turnover. By contrast, self-efficacy and resilience are excellent psychological resources that may be associated with higher professional identity. It is unclear how transition shock affects professional identity by influencing these two internal resources. DESIGN A cross-sectional survey. METHODS The STROBE guidelines were followed to report this study. Convenience sampling was used to recruit participants, and 252 novice nurses completed the Transition Shock of Novice Nurses Scale, the Professional Identity Assessment Scale, the General Self-Efficacy Scale and the Connor-Davidson Resilience Scale between April 2022 and May 2022. Influencing factors were primarily identified using independent-sample t-tests and a one-way ANOVA. Structural equation modelling was used to detect the mediating effects of self-efficacy and resilience. RESULTS Differences in novice nurses' levels of professional identity were found across age groups, hospitals and departments. Transition shock was negatively related to professional identity. Self-efficacy and resilience mediated the complete chain relationship between transition shock and professional identity. CONCLUSION To our knowledge, this study is the first to explore the mediating effect of self-efficacy and resilience on transition shock and professional identity. Higher transition shock may lead to lower professional identity by reducing self-efficacy and resilience. RELEVANCE TO CLINICAL PRACTICE Nursing managers ought to emphasise the significant role of psychological resources in the work adaptation process of novice nurses. It may be more effective to improve professional identity and maintain the stability of the health care system. PATIENT OR PUBLIC CONTRIBUTION Nursing administrators working at seven preselected hospitals actively assisted us in the process of collecting self-report questionnaires from novice nurses, such as by booking appointments and providing access for questionnaire administration. In addition, the participants were actively involved in the data collection process.
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Affiliation(s)
- Yan Ran Li
- School of Nursing, An Hui medical University, Hefei, China
| | - Jing Ya Liu
- School of Nursing, An Hui medical University, Hefei, China
| | - Yuan Fang
- School of Nursing, An Hui medical University, Hefei, China
- Department of Geriatrics, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Xin Shen
- School of Nursing, An Hui medical University, Hefei, China
| | - Shu Wen Li
- School of Nursing, An Hui medical University, Hefei, China
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Lombi L, Rossero E. How artificial intelligence is reshaping the autonomy and boundary work of radiologists. A qualitative study. Sociol Health Illn 2024; 46:200-218. [PMID: 37573551 DOI: 10.1111/1467-9566.13702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/19/2023] [Indexed: 08/15/2023]
Abstract
The application of artificial intelligence (AI) in medical practice is spreading, especially in technologically dense fields such as radiology, which could consequently undergo profound transformations in the near future. This article aims to qualitatively explore the potential influence of AI technologies on the professional identity of radiologists. Drawing on 12 in-depth interviews with a subgroup of radiologists who participated in a larger study, this article investigated (1) whether radiologists perceived AI as a threat to their decision-making autonomy; and (2) how radiologists perceived the future of their profession compared to other health-care professions. The findings revealed that while AI did not generally affect radiologists' decision-making autonomy, it threatened their professional and epistemic authority. Two discursive strategies were identified to explain these findings. The first strategy emphasised radiologists' specific expertise and knowledge that extends beyond interpreting images, a task performed with high accuracy by AI machines. The second strategy underscored the fostering of radiologists' professional prestige through developing expertise in using AI technologies, a skill that would distinguish them from other clinicians who did not pose this knowledge. This study identifies AI machines as status objects and useful tools in performing boundary work in and around the radiological profession.
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Affiliation(s)
- Linda Lombi
- Department of Sociology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Eleonora Rossero
- Fundamental Rights Laboratory, Collegio Carlo Alberto, Turin, Italy
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15
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Salaten EFMM, Zakaria AM, Ibrahim IA. The role of professional identity and job satisfaction in paediatric nurses' intention to remain employed amidst the COVID-19 pandemic. Int J Ment Health Nurs 2024; 33:114-124. [PMID: 37732543 DOI: 10.1111/inm.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
The COVID-19 pandemic has significantly affected nursing, as nurses are crucial in providing healthcare services. Understanding the factors influencing nurse retention is essential for maintaining a strong and long-lasting workforce because nurse retention is becoming increasingly complex. This study aimed to investigate the influence of professional identity and job satisfaction on the intention to remain employed while also evaluating the levels of professional identity, job satisfaction, and intention to stay among paediatric nurses amidst the COVID-19 pandemic. This correlational and descriptive study included a stratified sample of 257 paediatric nurses and was guided by the STROBE checklist. Data were collected through valid and reliable questionnaires, which included a nurses' professional identity scale, job satisfaction survey, intention to stay scale, and a demographic questionnaire. Data collection was conducted from January to April 2022. The study was approved by the ethical research committee at the Nursing Faculty - Mansoura University, ensuring adherence to the Helsinki Declaration. The paediatric nurses reported elevated professional identity, moderate job satisfaction, and moderate intention to stay employed with mean scores of 80.35 ± 13.22, 113.70 ± 19.58, and 8.40 ± 3.55, respectively. Multiple regression explained 13.0% of the variation in paediatric nurses' intention to remain employed (F = 18.50, p < 0.001). Professional identity positively correlated with the intention to stay (β = 2.69, p = 0.008). Job satisfaction also had a positive relationship with the intention to stay (β = 3.49, p < 0.001). Healthcare managers should focus on professional identity strategies such as supportive work environments, growth opportunities, and valuing paediatric nurses' contributions. Implementing interventions such as fair compensation, support, and rewards can enhance paediatric nurses' retention and quality of patient care.
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Affiliation(s)
| | - Abeer Mohammed Zakaria
- Nursing Administration Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Ibrahim Abdullatif Ibrahim
- Nursing Administration Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Shaqra City, Saudi Arabia
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16
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Fogarty S, Hay P, Calleri F, Fiddes L, Barnett R, Baskwill A. Explaining the Impact of the COVID-19 Pandemic on Massage Therapists in Australia and Canada: A Mixed Methods Study. J Integr Complement Med 2024; 30:157-164. [PMID: 37585621 DOI: 10.1089/jicm.2023.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Background: The COVID-19 pandemic was a time of rapid change and uncertainty, with individual jurisdictions within countries implementing a variety of preventative measures. At the onset of the pandemic, as little was known about how COVID-19 was transmitted, restrictions, such as lockdowns, were implemented to prevent further spread of this virus. In many jurisdictions, massage therapists were deemed as nonessential for a period. This disruption to their livelihood, as a professional group and without autonomy to decide, was unprecedented. This prompted the question as to whether this experience had impacted massage therapists' professional identity. Methods: A sequential explanatory mixed methods design was used and massage therapists in Australia and Canada were recruited to participate. Results from a quantitative questionnaire completed by 649 respondents and from 31 semistructured interviews from a subset of the questionnaire participants were used in the mixed analysis. Results: Massage therapists, impacted by the pandemic, experienced a discord between what it means to be a massage therapist, providing patient-centered care and the public health initiatives implemented during the pandemic. This discord occurred in multiple situations and the type of discord was influenced by a number of factors, including how therapists identified themselves within the workforce (i.e., as a health care provider or a service provider). Conclusion: This study sought to understand how the COVID-19 pandemic impacted massage therapists' professional identity. Massage therapists reported that the pandemic impacted their professional identity through a lack of congruence and discord between their identity-constituting beliefs and what it means to be a massage therapist. The sequela to this discord was therapists experiencing different types of moral distress and or moral injury. Future research is needed to determine the longer-term impacts of COVID-19 on massage therapists.
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Affiliation(s)
- Sarah Fogarty
- School of Medicine, Western Sydney University, Penrith, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South DC, Australia
- Camden and Campbelltown Hospitals, South Western Sydney Local Health District, Campbelltown, Australia
| | - Felicia Calleri
- Faculty of Health Sciences and Wellness, Humber College, Toronto, Canada
| | | | | | - Amanda Baskwill
- Faculty of Health Sciences and Wellness, Humber College, Toronto, Canada
- School of Health, Human and Justice Studies, Loyalist College, Belleville, Canada
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17
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van Heteren F, Raaphorst NJ, Bussemaker JM. Health promotion roles shaped by professional identity: an ethnographic study in the Netherlands. Health Promot Int 2024; 39:daad195. [PMID: 38217454 PMCID: PMC10787352 DOI: 10.1093/heapro/daad195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024] Open
Abstract
How frontline care professionals interpret and fulfill their health promotion roles is of great importance for the health of the vulnerable clients they work with. While the literature on health promotion is limited to describing the roles of healthcare professionals, this study examines the health promotion roles held by various frontline professionals when working with clients with combined psychosocial problems and how this is associated with professional identity. Based on ethnographic data from Dutch frontline professionals in social welfare, general healthcare and mental healthcare, this article shows how various frontline professionals promote health by reframing and customizing health problems and that this is associated with how they identify as pragmatic or holistic professionals.
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Affiliation(s)
- F van Heteren
- Department of Public Health and Primary Care/Health Campus, Leiden University Medical Centre, Turfmarkt 99, 2511 DP The Hague, The Netherlands
- Faculty of Governance and Global Affairs, Institute of Public Administration, Leiden University, 2511 DP The Hague, The Netherlands
| | - N J Raaphorst
- Faculty of Governance and Global Affairs, Institute of Public Administration, Leiden University, 2511 DP The Hague, The Netherlands
| | - J M Bussemaker
- Department of Public Health and Primary Care/Health Campus, Leiden University Medical Centre, Turfmarkt 99, 2511 DP The Hague, The Netherlands
- Faculty of Governance and Global Affairs, Institute of Public Administration, Leiden University, 2511 DP The Hague, The Netherlands
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18
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Anurat K, Thamyongkit S, Pakakasama S, Sumrithe S. Assessing the role of mentors in mitigating burnout and enhancing professional development in medical education. Int J Med Educ 2024; 15:1-7. [PMID: 38284420 DOI: 10.5116/ijme.659b.d08c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 01/08/2024] [Indexed: 01/30/2024]
Abstract
Objectives To assess the correlation between mentor behaviours and medical student burnout and their professional development within medical education. Methods A cross-sectional study using convenience sampling was conducted among third-, fifth-, and sixth-year medical students (N=307). Participants voluntarily completed anonymous online questionnaires measuring the Mentor Behavior Scale, the Maslach Burnout Inventory-Student Survey, and the Professional Self-Identity Questionnaire. Multivariate regression analysis was performed to analyse relationships between student burnout, mentor behaviours and their impact on professional development. Results Among participants, 26% (N=80) experienced burnout, which was significantly associated with lower competency support (OR = 2.0, 95% CI: 1.1-3.5, p = 0.016), medication use (OR = 2.1, 95% CI: 1.1-4.0, p = 0.029), and a lower Grade Point Average (OR = 3.3, 95% CI: 1.6-6.9, p = 0.001) compared to non-burnout students. In the development of professional identity, a high level of mentor relationship structure had statistically significant associations with higher scores in key domains of the Professional Self-Identity Questionnaire, including teamwork (OR = 3.9, 95% CI: 1.5-9.9, p < 0.01), communication (OR = 3.4, 95% CI: 1.5-7.7, p < 0.01), ethical awareness (OR = 3.3, 95% CI: 1.4-8.0, p < 0.01), and record use (OR = 2.8, 95% CI: 1.2-6.5, p < 0.05). Conclusions The impact of mentor behaviours on medical students is evident. Enhancing mentorship by addressing specific mentor behaviours can improve programme quality. Future research should explore the long-term effects and strategies for effectively implementing targeted enhancements in mentor behaviours.
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Affiliation(s)
- Kingthong Anurat
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Sorawut Thamyongkit
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Samart Pakakasama
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Sutida Sumrithe
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
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19
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Damien C, Marion DH, Deborah S, Margot M. Professional identity and representations of advanced practice nurses specialising in psychiatry and mental health: A national study. Int J Ment Health Nurs 2024. [PMID: 38240063 DOI: 10.1111/inm.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 03/06/2024]
Abstract
Advanced practice nurses constitute a new professional group within the French health care system. Advanced practice nurses specialise in one of five disciplines including Psychiatry/Mental-Health. This specific discipline is strongly marked by stigmatising representations by healthcare users and other health professionals (including other advanced practice nurses), whose consequences have a deleterious effect. The aim was to highlight all advanced practice nurses representation of Psychiatry/Mental-Health advanced practice nurses. An observational descriptive survey, based on an anonymous online questionnaire was conducted in April 2022 among qualified and student advanced practice nurses from the five specialist disciplines. Overall, 356 advanced practice nurses completed the survey questionnaire. No significant difference in stigmatising representations of Psychiatry/Mental-Health advanced practice nurses versus other advanced practice nurses was observed. Only 3.3% of other advanced practice nurses thought that Psychiatry/Mental-Health advanced practice nurses are often 'strange'. Psychiatry/Mental-Health advanced practice nurses and other advanced practice nurses appeared to have similar representations of the professional roles of advanced practice nurses in general and of advanced practice nurses APN specifically. Unlike other professionals in the psychiatric field (e.g. medical interns, nurses), very little stigmatisation of Psychiatry/Mental-Health advanced practice nurses by their colleagues (i.e. other advanced practice nurses) was observed. This could be partly due to the fact that advanced practice nurses professional identity appeared to be built collectively around the concept of advanced practice. Advanced practice nurses constitute a professional group that is fully involved in contemporary transformations in care and organisational innovation. The very low level of stigmatisation of Psychiatry/Mental-Health advanced practice nurses by other advanced practice nurses in our study suggests that these new healthcare actors could play a crucial role in the improvement of professional health practices, particularly in terms of improved coordination between psychiatric-care and physical-care.
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Affiliation(s)
- Croguennec Damien
- Pôle 94g16, Hôpitaux de St. Maurice, St. Maurice, France
- Université Paris Cité, Paris, France
| | - Darras-Hostens Marion
- WHO Collaborating Centre for Research and Training in Mental Health, EPSM Lille-Métropole, Hellemmes-Lille, France
| | - Sebbane Deborah
- WHO Collaborating Centre for Research and Training in Mental Health, EPSM Lille-Métropole, Hellemmes-Lille, France
- ECEVE, UMR 1123, Inserm, Université Paris Cité, Paris, France
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20
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Zhong Y, Ma H, Zhang CC, Jiang QY, Li J, Liao CJ, Liang YF, Shu L. Professional identity, job satisfaction, and turnover intention among Chinese novice nurses: A cross-sectional study. Medicine (Baltimore) 2024; 103:e36903. [PMID: 38241583 PMCID: PMC10798701 DOI: 10.1097/md.0000000000036903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024] Open
Abstract
The world is faced with challenges due to a growing aging population and the increasing burden of chronic disease. The acute shortage of nurses and high turnover rates, particularly among novice nurses, are of great concern in many countries. Several studies have shown that turnover intention among nurses is influenced by professional identity and job satisfaction. However, to the best of our knowledge, no studies have examined this issue in the context of novice nurses. Thus, the present study aimed to explore the relationship between professional identity, job satisfaction, and turnover intention among novice nurses in China. From March 18 to April 23, 2022, a cross-sectional survey was carried out involving 532 novice nurses recruited from four public hospitals in Sichuan Province, China. Among the sample, 526 questionnaires were retrieved, with an effective response rate of 98.87%. The mean scores for turnover intention, professional identity, and job satisfaction were 13.02 ± 3.94, 36.17 ± 7.98, and 111.02 ± 21.46, respectively. High turnover intention was observed among novice nurses, of whom 54.37% (286/526) had high or very high turnover intention. Professional identity and job satisfaction among novice nurses were moderate. In terms of demographic characteristics, "Whether living with relatives" and "Monthly income" had a statistically significant impact on the turnover intention of novice nurses (P < .05). Both professional identity (r = -0.459) and job satisfaction (r = -0.517) were significantly and moderately negatively correlated with turnover intention (P < .01). The results of the multivariate linear regression analysis revealed that variables including "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" jointly accounted for 29.9% of the variance related to turnover intention among novice nurses. "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" were highly predictive of turnover intention levels among novice nurses. Hence, potential predictors of turnover intention should be considered, and intervention research should be conducted to reduce the level of turnover intention among novice nurses.
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Affiliation(s)
- Ying Zhong
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Huan Ma
- School of Nursing, Sichuan Vocational College of Health and Rehabilitation, Sichuan, China
| | - Cui-Cui Zhang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Qin-Ying Jiang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Jun Li
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Chang-Ju Liao
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Yu-Fen Liang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Li Shu
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
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21
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Lipscomb M. Can professional nursing value claims be refused? Might nursing values be accepted provisionally and tentatively? Nurs Inq 2024:e12621. [PMID: 38206299 DOI: 10.1111/nin.12621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/05/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024]
Abstract
Value-act relationships are less secure than is commonly supposed and this insecurity is leveraged to address two questions. First, can nurses refuse professional value claims (e.g., claims regarding care and compassion)? Second, even when value claims are accepted, might values be held provisionally and tentatively? These questions may seem absurd. Nurses deliver care and nursing is, we are told, a profession the members of which hold and share values. However, focusing attention on the problematic nature of professional value claims qua claims permits a more conciliatory and realistic stance to be taken towards nurses holding alternative values and value interpretations. This could prove beneficial.
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Affiliation(s)
- Martin Lipscomb
- Three Counties School of Nursing and Midwifery, College of Health, Life and Environmental Science, St John's Campus, University of Worcester, Worcester, UK
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22
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Dahri K, Luo C, Kent B, Lai M, Driver A, Haag H. Exploring the Professional Identity of Hospital Pharmacists in British Columbia. Can J Hosp Pharm 2024; 77:e3419. [PMID: 38204498 PMCID: PMC10754406 DOI: 10.4212/cjhp.3419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/11/2023] [Indexed: 01/12/2024]
Abstract
Background Pharmacists lack a cohesive professional identity, with only limited previous research on the formation of a professional identity for pharmacy. In particular, there is sparse information on the professional identity of pharmacists who practise in hospital settings. Objectives To determine hospital pharmacists' professional identity and the characteristics of an ideal pharmacist and ideal practice setting. Methods This qualitative study used key informant interviews with semistructured questions. A maximum variation sampling strategy was used to recruit a cross-section of pharmacists from different geographic areas of British Columbia who were practising in a variety of roles. The interviews were transcribed and then analyzed thematically. Results Nineteen pharmacists participated in the study. Seven themes pertaining to hospital pharmacists' professional identity were generated, specifically medication expert, therapy optimizer, collaborator, educator, researcher, patient advocate, and unknown professional. Similarities were found with personas previously identified in a population of primarily community pharmacists. The ideal pharmacist was described as being a medication expert, a collaborator, and a leader. The ideal practice setting was characterized as being adequately funded and allowing pharmacists to practise to their full scope. Conclusions Hospital pharmacists' professional identity is based on being a medication expert who is seen as an essential member of a collaborative team.
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Affiliation(s)
- Karen Dahri
- , BSc, BScPharm, PharmD, ACPR, FCSHP, is with the Faculty of Pharmaceutical Sciences, The University of British Columbia, and Vancouver General Hospital, Lower Mainland Pharmacy Services, Vancouver, British Columbia
| | - Cindy Luo
- , BScPharm, PharmD, ACPR, is with Vancouver General Hospital, Lower Mainland Pharmacy Services, Vancouver, British Columbia
| | - Brandy Kent
- , PharmD, is with the Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia
| | - Madison Lai
- , BSc, PharmD, is with the Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia
| | - Amanda Driver
- , BScPharm, ACPR, is with Vancouver General Hospital, Lower Mainland Pharmacy Services, Vancouver, British Columbia
| | - Hans Haag
- , BSc, BScPharm, ACPR, is with Vancouver General Hospital, Lower Mainland Pharmacy Services, Vancouver, British Columbia
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Tuscano SC, Haxton J, Ciardo A, Ciullo L, Zegarra-Parodi R. The Revisions of the First Autobiography of AT Still, the Founder of Osteopathy, as a Step towards Integration in the American Healthcare System: A Comparative and Historiographic Review. Healthcare (Basel) 2024; 12:130. [PMID: 38255019 PMCID: PMC10815194 DOI: 10.3390/healthcare12020130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION Osteopathy was originally introduced in rural America in 1874 as a comprehensive therapeutic approach aimed at promoting health. This approach was distinct and often conflicting with conventional/allopathic therapeutic methods available at that time to fight disease. We argue that, in struggling to achieve recognition within the American healthcare system and within the educational academic field that was about to be structured, the American osteopathic profession tried to protect itself from the charges of sectarism by starting to embrace principles of the biomedical paradigm. METHODS A comparative and historiographic review of the second version of the autobiography of AT Still (1908), the founder of osteopathy, against the first (1897) was chosen as an example of the adaptation of the American osteopathic profession to its evolving academic environment. RESULTS Although there were only a few substantial variations, we argue that they aimed to dampen the non-biological components of osteopathy, namely, its philosophical, spiritual, religious, emotional, and Native American roots, in an effort to gain respect and recognition within the emerging gold standard of the Western medical system. The shift towards a distinct, fully integrated profession within regulated Western healthcare systems was perceived by many professionals as a threat to AT Still's original ideas, and the trend started when he was alive. CONCLUSION Our findings suggest that a crucial conversation regarding the future of the professional identity must take place within the osteopathic community.
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Affiliation(s)
- Silvia Clara Tuscano
- Istituto Europeo per la Medicina Osteopatica (IEMO), 16122 Genova, Italy; (S.C.T.); (L.C.)
| | - Jason Haxton
- Museum of the Osteopathic Medicine, Kirksville, MO 63501, USA;
| | - Antonio Ciardo
- Grupo Thuban-Fundación Europea de Medicina Tradicional Complementaria e Integrativa (FEMTCI), 28028 Madrid, Spain;
- Facultad de Ciencias de la Salud, Universidad Europea del Atlántico, 39011 Santander, Spain
| | - Luigi Ciullo
- Istituto Europeo per la Medicina Osteopatica (IEMO), 16122 Genova, Italy; (S.C.T.); (L.C.)
| | - Rafael Zegarra-Parodi
- BMS Formation, 75116 Paris, France
- A.T. Still Research Institute, Kirksville, MO 63501, USA
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Maxwell S, Fuchs-Young R, Wells GB, Kapler G, Green S, Pepper C, Gastel B, Huston DP. Short-Term Training with Basic Science Research Literature Advances Medical Students' Skills for Adaptive Expertise. J Med Educ Curric Dev 2024; 11:23821205241227328. [PMID: 38304279 PMCID: PMC10832445 DOI: 10.1177/23821205241227328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 11/28/2023] [Indexed: 02/03/2024]
Abstract
Physicians must adapt their learning and expertise to the rapid evolution of healthcare. To train for the innovation-efficient demands of adaptive expertise, medical students need to acquire the skill of adaptive self-regulated learning, which includes accessing, interpreting, and synthesizing emerging basic and translational research to support patient care. In response, we developed the course Medical Student Grand Rounds (MSGR). It engages all pre-clerkship students at our institution with self-regulated learning from translational basic research literature. In this report, we describe MSGR's methodology and important outcomes. Students found, interpreted, critically assessed, and presented basic research literature about self-selected clinically relevant topics. In less than one semester and mentored by basic science researchers, they completed eight milestones: (a) search research literature databases; (b) choose a clinical topic using searching skills; (c) outline the topic's background; (d) outline a presentation based on the topic's mechanistic research literature; (e) attend translational research-oriented grand rounds by faculty; (f) learn to prepare oral presentations; (g) write an abstract; and (h) present at Grand Rounds Day, emphasizing their topic's research literature. Graded milestones and end-of-course self-assessments indicated students became proficient in interpreting research articles, preparing and delivering presentations, understanding links among basic and translational research and clinical applications, and pursuing self-regulated learning. Qualitative analysis of self-assessment surveys found most students thought they progressed toward the learning objectives: find scientific information about a research topic (56% positive responses), interpret and critically assess scientific information (64%), and prepare and deliver a scientific presentation (50%). Milestones improve time management and provide a scaffolded method for presenting focused research topics. MSGR equips students with critical thinking skills for lifelong, adaptive, self-regulated learning-a foundation for adaptive expertise. The master adaptive learner cycle of planning, learning, assessing, and adjusting is a conceptual framework for understanding students' MSGR learning experiences.
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Affiliation(s)
- Steve Maxwell
- Department of Cell Biology and Genetics, Texas A&M University, Bryan, Texas, USA
| | - Robin Fuchs-Young
- Department of Cell Biology and Genetics, Texas A&M University, Bryan, Texas, USA
| | - Gregg B. Wells
- Department of Cell Biology and Genetics, Texas A&M University, Bryan, Texas, USA
| | - Geoffrey Kapler
- Department of Cell Biology and Genetics, Texas A&M University, Bryan, Texas, USA
| | - Sheila Green
- Medical Sciences Library, Texas A&M University, Bryan, Texas, USA
| | - Catherine Pepper
- Medical Sciences Library, Texas A&M University, Bryan, Texas, USA
| | - Barbara Gastel
- Department of Veterinary Integrative Biosciences, Texas A&M University, Bryan, Texas, USA
- Department of Humanities in Medicine, Texas A&M University, Bryan, Texas, USA
| | - David P. Huston
- Department of Microbial Pathogenesis and Immunology, Texas A&M University, Bryan, Texas, USA
- Clinical Science and Translational Research Program, Texas A&M University School of Medicine, Bryan, Texas, USA
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Guilding C, Kelly-Laubscher R, White P. The future of pharmacology education: a global outlook. Expert Rev Clin Pharmacol 2024; 17:115-118. [PMID: 38192241 DOI: 10.1080/17512433.2024.2302602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Affiliation(s)
- Clare Guilding
- School of Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - Roisin Kelly-Laubscher
- Department of Pharmacology & Therapeutics, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Paul White
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
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Ramdawar A, Bozinoff N, Lazare K. "Not doing it justice": Perspectives of Recent Family Medicine Graduates on Mental Health and Addictions Training in Residency. J Med Educ Curric Dev 2024; 11:23821205241238642. [PMID: 38601795 PMCID: PMC11005487 DOI: 10.1177/23821205241238642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/25/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Family physicians report feeling inadequately prepared to meet the evolving mental health care needs of the population. Little scholarship exists evaluating the effectiveness of curricula designed to teach mental health and addiction (MH&A) care to family medicine (FM) residents. As such, the purpose of this study was to explore the experiences of recent FM residency graduates in providing mental health care, and their perceptions of mental health training gaps during their residencies. METHODS A qualitative descriptive study design was conducted by 8 recent graduates of the University of Toronto's FM residency program, who participated in semi-structured video interviews. A thematic analysis approach was used to collect and analyze the data. RESULTS Through thematic analysis, 3 overarching themes were developed: (1) barriers in providing mental health and addiction care, (2) curriculum renewal, and (3) the role of FPs and professional identity. Consistent with the literature, the majority of recent FM graduates expressed discomfort when managing patients with mental health and addiction concerns. Additionally, participants perceived residency program time constraints, rotational site differences, and limited exposure to marginalized populations all impacted learning and mastery of skills. CONCLUSION The findings of this study underscore current gaps within the FM residency curriculum and highlight the need to address current curricular deficits.
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Affiliation(s)
- Abigail Ramdawar
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Nikki Bozinoff
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Kimberly Lazare
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- North York General Hospital, Toronto, ON, Canada
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Jantzen D, Newton L, Dompierre KA, Sturgill S. Promoting moral imagination in nursing education: Imagining and performing. Nurs Philos 2024; 25:e12427. [PMID: 36846907 DOI: 10.1111/nup.12427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/03/2022] [Accepted: 02/13/2023] [Indexed: 03/01/2023]
Abstract
Moral imagination is a central component of moral agency and person-centred care. Becoming moral agents who can sustain attention on patients and their families through their illness and suffering involves imagining the other, what moral possibilities are available, what choices to make, and how one wants to be. This relationship between moral agency, moral imagination, and personhood can be effaced by a focus on task-driven technical rationality within the multifaceted challenges of contemporary healthcare. Similarly, facilitating students' moral agency can also be obscured by the task-driven technical rationality of teaching. The development of moral agency requires deliberate attention across the trajectory of nursing education. To prepare nursing students for one practice challenge, workplace violence, we developed a multimodal education intervention which included a simulated learning experience (SLE). To enhance the realism and consistency of the educational experience, 11 nursing students were trained as simulated participants (SP). As part of a larger study to examine knowledge acquisition and practice confidence of learners who completed the SLE, we explored the experience of being the SP through interviews and a focus group with the SP students. The SP described how their multiple performances contributed to imagining the situation 'on both sides' prompting empathy, a reconsideration of their moral agency, and the potential to prevent violence in the workplace beyond technical rational techniques, such as verbal de-escalation scripts. The empirical findings from the SP prompted a philosophical exploration into moral imagination. We summarise the multimodal educational intervention and relevant findings, and then, using Johnson's conception of moral imagination and relevant nursing literature, we discuss the significance of the SP embodied experiences and their professional formation. We suggest that SLEs offer a unique avenue to create pedagogical spaces which promote moral imagination, thereby teaching for moral agency and person-centred care.
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Affiliation(s)
| | - Lorelei Newton
- University of Victoria, Victoria, British Columbia, Canada
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Chen Q, Zhang Q, Yu F, Hou B. Investigating Structural Relationships between Professional Identity, Learning Engagement, Academic Self-Efficacy, and University Support: Evidence from Tourism Students in China. Behav Sci (Basel) 2023; 14:26. [PMID: 38247678 PMCID: PMC10813133 DOI: 10.3390/bs14010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
In order to foster students' development and enhance the training quality within tourism programs at universities, this study aims to investigate the relationships among tourism students' professional identity, academic self-efficacy, learning engagement, and university support. Professional identity refers to learners' recognition and understanding of their study programs and is viewed as a dynamic, progressive process consisting of professional cognition, professional emotion, and professional appraisal. Data were collected from 333 tourism students studying at Chinese universities. They were analyzed through SPSS and SmartPLS. The results revealed that there is no significant correlation between students' professional cognition and learning engagement. However, students' professional emotions and professional appraisals positively influence learning engagement. Moreover, all three dimensions of professional identity exhibit positive effects on students' academic self-efficacy. Additionally, students' academic self-efficacy demonstrates a positive impact on learning engagement, and university support is associated with increased learning engagement and academic self-efficacy. This study contributes to a comprehensive understanding of the learning experience of tourism students and aims to facilitate the advancement of tourism education through cultivating students' professional identity towards tourism and developing students' career commitment in the tourism industry. Theoretical and practical implications are discussed.
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Affiliation(s)
| | | | | | - Bing Hou
- School of Tourism and Cuisine, Yangzhou University, Yangzhou 225127, China; (Q.C.); (Q.Z.); (F.Y.)
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Abstract
BACKGROUND The paramedic profession within the United Kingdom has been evolving at pace over the last 20 years. While they are most associated with their work in ambulance services, paramedics are now found throughout a range of clinical and academic settings. SOURCES OF DATA Literature Review. AREAS OF AGREEMENT Despite emergence of the paramedic across the healthcare workforce, the understanding and awareness of the professional role and capabilities is poor. This could be due to a lack of representation within senior leadership roles and within health and social care policy. AREAS OF CONTROVERSY Understanding of the paramedic professional identity, from a philosophical and sociological perspective, remains incomplete. GROWING POINTS A challenge for the future is to explore how the paramedic role can continue to develop across a range of clinical settings, while retaining its sui generis professional identity. AREAS TIMELY FOR DEVELOPING RESEARCH Research to establish perspectives of and about the paramedic profession may assist in developing an understanding of identity and its place within the wider healthcare workforce.
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Affiliation(s)
- Georgette Eaton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
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Peart J, Michels NR, Hanley K, Dolan C, Luyckx J, Tanghe V, Peeters E, Burneikaite M, Varvuolyte S, Homar V, Galič L, Klobučar Kragelj K, McCoombe G, Scherpbier N. What influences on their professional development do general practice trainees report from their hospital placements? A qualitative study. Eur J Gen Pract 2023; 29:2191947. [PMID: 37132423 PMCID: PMC10158549 DOI: 10.1080/13814788.2023.2191947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND The clinical learning environment is important in GP specialty training and impacts professional development. Uniquely for GP trainees, about half of their training periods occur in a hospital environment, which is not their final workplace. There is still little understanding of how hospital-based training influences GP's professional development. OBJECTIVES To seek the views of GP trainees on how their hospital experience contributes to their professional development as a GP. METHODS This international and qualitative study seeks the views of GP trainees from Belgium, Ireland, Lithuania, and Slovenia. Semi-structured interviews were performed in the original languages. A joint thematic analysis in the English language resulted in key categories and themes. RESULTS From the four themes identified, GP trainees were found to experience additional challenges on top of the service provision/education tensions, which are common to all hospital trainees. Despite these, the hospital rotation component of GP training is valued by trainees. A strong finding of our study is the need to ensure that learning from the hospital placements is placed firmly in the context of general practice, e.g. GP placements prior or parallel with the hospital placements, educational activities resourced by GPs during their hospital experience, encouraging hospital teachers to have greater awareness of the educational needs of GPs, including an awareness of their training curriculum. CONCLUSION This novel study highlights how hospital placements for GP trainees could be enhanced. Further study could be broadened to recently qualified GPs, which may uncover new areas of interest.
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Affiliation(s)
- Joanna Peart
- Irish College of General Practice, Dublin, Ireland
| | - Nele R Michels
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | | | - Cian Dolan
- Irish College of General Practice, Dublin, Ireland
| | - Julie Luyckx
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Valerie Tanghe
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Emma Peeters
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Milda Burneikaite
- Faculty of Medicine, Clinic of Internal Diseases, Family medicine and Oncology, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Sonata Varvuolyte
- Faculty of Medicine, Clinic of Internal Diseases, Family medicine and Oncology, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Vesna Homar
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Lucija Galič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Kamala Klobučar Kragelj
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Geoff McCoombe
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Nynke Scherpbier
- Department of General Practice and Elderly Care, Groningen University, Groningen, The Netherlands
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Liao HC, Wang YH. Narrative medicine and humanities for health professions education: an experimental study. Med Educ Online 2023; 28:2235749. [PMID: 37434389 DOI: 10.1080/10872981.2023.2235749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
BACKGROUND Narrative medicine can serve as a tool to empathize with human beings' predicament and suffering. The research intended to examine whether the use of narrative medicine to form an empathetic connection could bring any positive impacts on health professions students. METHODS A two-group quasi-experimental design was adopted to examine whether the intervention of narrative medicine to form an empathetic connection could demonstrate differences between the experimental group (35 students) and the control group (32 students) with regard to professional identity, self-reflection, emotional catharsis, and reflective writing competency. These 67 participants were health professions students in a medical university (mean age = 20.02; SD = 0.23), with varied majors in health disciplines. The 16-week intervention was the use of narrative medicine to form an empathetic connection with those suffering, via the three stages of narrative medicine: attention → representation → affiliation. The quantitative instruments included a professional identity scale (PIS-HSP), a reflective thinking scale (RTS-HSP), and an emotional catharsis scale (ECS-IN), as well as an analytic reflective writing scoring rubric (ARWSR-HSP). To triangulate the quantitative results, the study also used the student interviews. The SPSS software was used to analyze the data. RESULTS The quantitative results demonstrated that the narrative medicine-based intervention could bring positive effects on the health professions students. After going through the intervention, the students in the experimental group had stronger professional identity, a higher reflective thinking level, more emotional catharsis, and greater improvement in reflective writing competency than those not receiving the intervention, though some subscales not reaching statistical significance. CONCLUSION This research results proved that the use of narrative medicine to form an empathetic connection could bring positive impacts on health professions students regarding professional identity, self-reflection, emotional catharsis, and self-reflective writing competency.
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Affiliation(s)
- Hung-Chang Liao
- Department of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Management, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ya-Huei Wang
- Department of Applied Foreign Languages, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Education, Chung Shan Medical University Hospital, Taichung, Taiwan
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Wurth S, Maisonneuve H, Moussa MA, Campion B, Caire Fon N, Peltier C, Audétat MC. Development of complex pedagogical competencies and reflexivity in clinical teachers via distance learning: a mixed methods study. Med Educ Online 2023; 28:2265163. [PMID: 37818594 PMCID: PMC10569352 DOI: 10.1080/10872981.2023.2265163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/26/2023] [Indexed: 10/12/2023]
Abstract
Clinical reasoning is the cornerstone to healthcare practice and teaching it appropriately is of utmost importance. Yet there is little formal training for clinical supervisors in supervising this reasoning process. Distance education provides interesting opportunities for continuous professional development of healthcare professionals. This mixed methods study aimed at gaining in-depth understanding about whether and how clinical teachers can develop complex pedagogical competencies through participation in a Massive Open Online Course on the supervision of clinical reasoning (MOOC SCR). Participants self-assed their clinical supervision skills before and after partaking in the MOOC SCR through the Maastricht Clinical Teachers Questionnaire. Item scores and the distribution of response proportions before and after participation were compared using paired t-tests and McNemar's tests respectively. In parallel, the evolution of a subset of MOOC participants' pedagogical practice and posture was explored via semi-structured interviews throughout and beyond their MOOC participation using simulated and personal situational recalls. The verbatim were analysed with standard thematic analysis. Quantitative and qualitative findings converged and their integration demonstrated that partaking in the MOOC SCR promoted the development of complex pedagogical competencies and reflexivity with the participants. This was quantitatively evidenced by significantly higher self-assessed supervision skills and corresponding attitudes after completing the MOOC. The qualitative data provided rich descriptions of how this progression in pedagogical practice and posture occurred in the field and how it was shaped by participants' interaction with the MOOC's content and their motivations to progress. Our findings provide evidence for the development of pedagogical skills and corresponding attitudes for the supervision of clinical reasoning through participation in the MOOC SCR and contribute to the literature body on the opportunities that distance learning provides for the development of pedagogical competencies. The extent to which the pedagogical underpinnings of the MOOC contributed to these developments remains to be determined.
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Affiliation(s)
- Sophie Wurth
- Unit for Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Hubert Maisonneuve
- University Institute for Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Mohamed Amir Moussa
- University Institute for Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Baptiste Campion
- Institute of Higher Studies in Social Communications, Brussels School of Journalism and Communication, Brussels, Belgium
| | - Nathalie Caire Fon
- Family Medicine and Emergency Medicine Department, Medicine, Université de Montréal, Montréal, Canada
| | - Claire Peltier
- Unit for Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Faculty of Educational Sciences, Université Laval, Quebec City, Canada
| | - Marie-Claude Audétat
- Unit for Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Institute for Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Zaccagnini M, Bussières A, Kim S, Nugus P, West A, Thomas A. What scholarly practice means to respiratory therapists: An interpretive description study. J Eval Clin Pract 2023; 29:1314-1325. [PMID: 37622229 DOI: 10.1111/jep.13917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/24/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023]
Abstract
RATIONALE Engagement in scholarly practice has been associated with professional empowerment, role satisfaction and improvements in care delivery and patient outcomes across many healthcare professions. However, in evolving professions like respiratory therapy, scholarly practice is excluded from competency frameworks, resulting in a gap in education and subsequent application of this competency in practice. An exploration of scholarly practice in respiratory therapy may provide insights into evolving professions that face tensions between meeting competency requirements as outlined in frameworks and providing quality healthcare to the populations they serve. AIMS AND OBJECTIVES The aim of the study was to explore what scholarly practice means, and how it manifests in practice from respiratory therapists' (RTs) perspectives. METHODS We used interpretive description methodology. We purposively sampled participants to obtain varied perspectives of scholarly practice in respiratory therapy. We conducted 26 semistructured interviews with RTs in different roles (clinicians, educators, researchers, leaders and managers) across Canada and analysed the data using inductive analysis. Data collection and analysis proceeded concurrently. RESULTS We developed five main themes: (i) the identity of a scholarly practitioner in RTs; (ii) factors influencing scholarly practice; (iii) one's impression of their professional self-image; (iv) scholarly practice as a vehicle for changing practice and (v) the complex interconnections between knowledges and practices. CONCLUSION Scholarly practice appears to be a multifaceted phenomenon encompassing a wide range of activities and skills including conducting research, reflective practice, application of research to practice, and contributing to the advancement of the profession and healthcare. Scholarly practice is influenced by organisational context and culture, available resources, intrinsic motivation and external political context. We identified similarities between professional identity and the description of the scholarly practitioner, suggesting that these two phenomena may be interconnected. Furthermore, participants believed that scholarly practice could enhance the image, credibility, legitimacy and professionalisation of the profession.
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Affiliation(s)
- Marco Zaccagnini
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
| | - André Bussières
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Sungha Kim
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
| | - Peter Nugus
- Institute of Health Sciences Education, McGill University, Montréal, Québec, Canada
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Andrew West
- The Canadian Society of Respiratory Therapists, St John, New Brunswick, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
- Institute of Health Sciences Education, McGill University, Montréal, Québec, Canada
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Hill L, Eaton G. The paramedics' pledge: a short commentary on its inception and development. Br Paramed J 2023; 8:52-54. [PMID: 38046789 PMCID: PMC10690485 DOI: 10.29045/14784726.2023.12.8.3.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
This article discusses the creation and evolution of a unifying pledge designed to encapsulate the identity of paramedics and convey the essence of belonging to this professional group.
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Affiliation(s)
- Lawrence Hill
- University of East Anglia ORCID iD https://orcid.org/0000-0002-9147-0934
| | - Georgette Eaton
- University of Oxford; London Ambulance Service NHS Trust ORCID iD: http://orcid.org/0000-0001-9421-2845
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McLean M, Khaira A, Alexander C. Symbols and rituals are alive and well in clinical practice in Australia: Perspectives from a longitudinal qualitative professional identity study. Med Teach 2023; 45:1425-1430. [PMID: 37339497 DOI: 10.1080/0142159x.2023.2225722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
PURPOSE Many factors impact an individual's professional identity on their journey to becoming a doctor, including their experiences, the learning environment, role models, and symbols and rituals. Rituals and symbols associated with the medical profession have historically included wearing a white coat (now rare) and the stethoscope. This study explored two medical students' perspectives of symbolic identifiers in a six-year longitudinal study in Australia (2012-2017). METHODOLOGY A 2012 qualitative cross-sectional qualitative professional identity study in an Australian five-year undergraduate medical programme was extended to a longitudinal study with annual interviews. A conversation about the symbolism of the stethoscope and other identifiers began in Year 1 and concluded when the students were junior doctors. FINDINGS Symbols and rituals remain part of the 'becoming' and 'being' a doctor. In the context of Australian hospitals, the stethoscope appears to no longer be exclusively associated with the medical profession, with 'professional attire' distinguishing medical students and doctors from other team members (uniform). The study identified lanyard colour and design as a symbol and language as a ritual. CONCLUSIONS Although symbols and rituals may change over time and across cultural contexts, some forms of treasured material possessions and rituals will persist in medical practice.[Box: see text].
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Affiliation(s)
- Michelle McLean
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Arjun Khaira
- Mental Health, Mayo Private Hospital, Taree, New South Wales, Australia
| | - Charlotte Alexander
- Emergency Department, Gold Coast University Hospital, Gold Coast, Queensland, Australia
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Hill L, Eaton G. Exploring paramedic professional identity. Br Paramed J 2023; 8:42-51. [PMID: 38046791 PMCID: PMC10690486 DOI: 10.29045/14784726.2023.12.8.3.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
The notion of a paramedic (as a title protected in law) has recently entered its third decade, but the history of the paramedic is considerably older than that. Who are we as a profession? What does it mean to be a paramedic? What makes us who we are? These intriguing and yet seldom asked philosophical questions are at the heart of this article, which is intended to provoke discussion and serve as a foundation for further inquiry into questions of identity and philosophy in paramedicine. Literature pertaining to paramedic professional identity was explored and contextualised within current paramedic practice. Although the overall picture is complex, four key areas for discussion emerged: the history of the paramedic profession; role diversity; the influence of ambulance work; and the education and training of paramedics. The influence of ambulance work permeates all areas, suggesting that it is central to the development of paramedic professional identity. This discussion article is an exploration of the unique contexts and experiences that are associated with the process of being and becoming for paramedics.
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Affiliation(s)
- Lawrence Hill
- University of East Anglia ORCID iD https://orcid.org/0000-0002-9147-0934
| | - Georgette Eaton
- University of Oxford; London Ambulance Service NHS Trust ORCID iD: http://orcid.org/0000-0001-9421-2845
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Guraya SS, Guraya SY, Doubell FR, Mathew B, Clarke E, Ryan Á, Fredericks S, Smyth M, Hand S, Al-Qallaf A, Kelly H, Harkin DW. Understanding medical professionalism using express team-based learning; a qualitative case-based study. Med Educ Online 2023; 28:2235793. [PMID: 37463323 PMCID: PMC10355686 DOI: 10.1080/10872981.2023.2235793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/02/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023]
Abstract
Medical Professionalism (MP) defined as values, behaviours and attitudes that promote professional relationships, public trust and patient safety is a vital competency in health profession education. MP has a distinctive uniqueness due to cultural, contextual, conceptual, and generational variations. There is no standard instructional strategy to probe the understanding of MP in a cohesive, structured, interactive manner. This study aimed to investigate undergraduate medical students' understanding of MP using express team-based learning (e-TBL) at both campuses of Royal College of Surgeons Ireland (RCSI). Using the key principles of a sociocultural theoretical lens in adult learning theory, we designed e-TBL as a context-learning-based educational strategy. We conducted three e-TBL sessions on cross-cultural communication and health disparities, a reflective report on clinical encounters, and professionalism in practice. We collected, collated, and analyzed the student experiences qualitatively using data gathered from team-based case discussions during e-TBL sessions. A dedicated working group developed very short-answer questions for the individual readiness assurance test (IRAT) and MP-based case scenarios for team discussions. In this adapted 4-step e-TBL session, pre-class material was administered, IRAT was undertaken, and team-based discussions were facilitated, followed by facilitator feedback. A qualitative inductive thematic analysis was performed, which generated subthemes and themes illustrated in excerpts. Our thematic analysis of data from 172 students (101 from Bahrain and 71 from Dublin) yielded four unique themes: incoming professional attitudes, transformative experiences, sociological understanding of professionalism, and new professional identity formation. This qualitative study provides a deeper understanding of medical students' perceptions of medical professionalism. The generated themes resonated with divergent and evolving elements of MP in an era of socioeconomic and cultural diversity, transformative experiences, and professional identity formation. The core elements of these themes can be integrated into the teaching of MP to prepare fit-to-practice future doctors.
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Affiliation(s)
- Shaista Salman Guraya
- School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain
| | - Salman Yousuf Guraya
- College of Medicine, Clinical Sciences Department, University of Sharjah, Sharjah, UAE
| | - Fiza-Rashid Doubell
- School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain
| | - Bincy Mathew
- School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain
| | - Eric Clarke
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
| | - Áine Ryan
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
| | - Salim Fredericks
- School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain
| | - Mary Smyth
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
| | - Sinead Hand
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
| | - Amal Al-Qallaf
- School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain
| | - Helen Kelly
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
| | - Denis W. Harkin
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
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Maguire T, Ryan J, Levett-Jones T, Olasoji M, Garvey L. Modifying the clinical reasoning cycle to enhance forensic mental health nursing utility. Int J Ment Health Nurs 2023. [PMID: 38012100 DOI: 10.1111/inm.13265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/11/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
Forensic mental health nursing is a specialty area of practice requiring specific knowledge and skills to work collaboratively with consumers. The Clinical Reasoning Cycle has been recognised as a potential framework to support nursing practice; however, it has been identified that adaptations are required to enhance utility in a forensic mental health services. The aim of this study was to explore and finalise a version of the cycle for forensic mental health nursing practice. Focus groups and interviews were used to explore adaptations with staff from a state-wide forensic service and forensic mental health nursing academics. Data were thematically analysed. Four main themes were interpreted: (1) allegiance to the Nursing Process, (2) moving the cycle from page to practice, (3) working as a team, or not, and (4) implementation will be a marathon and not a sprint. While nursing academics were more in favour of updating the Nursing Process to ensure contemporary practice is captured, staff from the service were supportive of the adapted cycle but emphasised the need to ensure collaboration with the consumer and their supporters. The adapted cycle was seen to articulate the contribution of forensic mental health nursing care, and support for a nursing-specific cycle was embraced by other disciplines, despite some hesitation from nurses. Prior to implementation there is a need to ensure the merits of the cycle are clearly articulated, along with a range of resources and specific contextual information to ensure the cycle can be successfully applied to enhance nursing practice and consumer care.
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Affiliation(s)
- Tessa Maguire
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Alphington, Victoria, Australia
- Forensicare (Victorian institute of Forensic Mental Health), Melbourne, Victoria, Australia
- Federation University, Melbourne, Victoria, Australia
| | - Jo Ryan
- Forensicare (Victorian institute of Forensic Mental Health), Melbourne, Victoria, Australia
| | | | | | - Loretta Garvey
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Alphington, Victoria, Australia
- Federation University, Melbourne, Victoria, Australia
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Dopheide JA, Onyema IE, Casey T, Goodwin H, Moore TD, Payne GH. The mental health workforce needs pharmacists. Am J Health Syst Pharm 2023; 80:1752-1758. [PMID: 37659002 DOI: 10.1093/ajhp/zxad213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Indexed: 09/05/2023] Open
Affiliation(s)
- Julie A Dopheide
- University of Southern California Mann School of Pharmacy and Pharmaceutical Sciences, Los Angeles, CA, USA
| | | | - Tyler Casey
- Kaiser Permanente - Northwest, Portland, OR, USA
| | | | - Tera D Moore
- Clinical Pharmacy Practice Office, Department of Veterans Affairs, Aurora, CO, USA
| | - Gregory H Payne
- American Association of Psychiatric Pharmacists, Lincoln, NE, USA
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Rehsi AS, McCarthy KE. Twelve tips for recognizing and supporting medical learners experiencing impostorism. Med Teach 2023:1-6. [PMID: 37934695 DOI: 10.1080/0142159x.2023.2276976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The resurgence of studies focused on the Impostor Phenomenon (IP) demonstrates a need for greater understanding of the construct as well as strategies to limit the negative conditions that arise from it. To help address this need, the following twelve tips offer perspectives and suggested approaches for educators to assist medical learners with IP during clinical training. A review of the medical literature and the authors' experiences supplies the following information, organized first by etiology and diagnosis followed by management and special considerations. These tips provide insight into the multifaceted aspects of IP and offer suggestions for support at the individual and institutional levels. With proper monitoring and personalized guidance, educators can assist learners in breaking the cycle of negative thoughts and behaviors to achieve confidence in their professional identity and competence in their clinical skills.
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Affiliation(s)
- Anandpall Singh Rehsi
- Morsani College of Medicine, USF Health, University of South Florida, Tampa, FL, USA
| | - Kelly E McCarthy
- Morsani College of Medicine, USF Health, University of South Florida, Tampa, FL, USA
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Nygren-Bonnier M, Högstedt K, Laurell A, Boström C. First and final year physiotherapy students' expectations of their future profession. Physiother Theory Pract 2023; 39:2366-2376. [PMID: 35583494 DOI: 10.1080/09593985.2022.2075295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/04/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIM Students' expectations of their future profession may have an impact on their professional development. This study aimed to describe first and final year physiotherapy students' expectations of their future profession. METHODS A total of 96 respondents participated; 45 students in their first semester 2006, and 51 students in their final semester 2014. Individual written reflections were analyzed separately for each semester, using qualitative manifest inductive content analysis. RESULTS The analysis resulted in six categories from each semester. The categories from the first semester were: 1) Professional and person-centered; 2) Promote health in a holistic way; 3) Competence makes the patient and therapist feel confident; 4) Focus on education and behavioral change; 5) Confirmed as a role model; and 6) The impact of previous experiences and an unknown situation. The categories from the final semester were: 1) Interaction and learning; 2) Confidence by competence; 3) Value the work environment and knowledge exchange; 4) Personal goals and strategies; 5) Specialist or generalist work; and 6) Work with public health in a global world. CONCLUSIONS In the first semester, students described different work approaches, while students in the last semester described how approaches were to be used. Furthermore, students in their first semester referred more to previous experiences, while students in their final semester developed strategies to achieve their professional goals. These findings might contribute to guide students' in their continuous professional development based on their experiences and expectations.
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Affiliation(s)
- Malin Nygren-Bonnier
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Högstedt
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden
| | - Anders Laurell
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden
| | - Carina Boström
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
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Lusk P, Ark T, Crowe R, Monson V, Altshuler L, Harnik V, Buckvar-Keltz L, Poag M, Belluomini P, Kalet A. Measuring the development of a medical professional identity through medical school. Med Teach 2023:1-7. [PMID: 37917985 DOI: 10.1080/0142159x.2023.2273218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Purpose: The Professional Identity Essay (PIE) is a theory and evidence-based Medical Professional Identity Formation (MPIF) measure. We describe trajectories of PIE-measured MPIF over a 4-year US medical school curriculum.Methods: Students write PIEs at medical school orientation, clinical clerkships orientation, and post-advanced (near graduation) clerkship. A trained evaluator assigns an overall stage score to narrative responses to nine PIE prompts (inter-rater ICC 0.83, 95% CI [0.57 - 0.96], intra-rater ICC 0.85). Distribution of PIE stage scores across time points were analyzed in the aggregate and individual students were classified as Increase, Stable (no score change) or Decrease based on the trajectories of PIE stage scores over time.Results 202 students completed 592 PIEs from 2018-2023. There was a significant change in the proportion of PIEs in stages over time (X2 84.40, p < 0.001), 47% (n = 95) students were categorized in the Increase trajectory, 45.5% (n = 92) as Stable and 7.4% (n = 15) as Decrease. Older age and time-predicted stage scores change within trajectories (p < 0.05).Conclusions Medical students' PIE stage scores increase over time with three distinctive trajectories. Further study is needed to explore the utility of this method for formative assessment, program evaluation, and MPIF research.
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Affiliation(s)
- P Lusk
- Graduate School of Education, University of Pennsylvania, Philadelphia, PA, USA
| | - T Ark
- The Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee,WI, USA
| | - R Crowe
- Office of Medical Education, New York University Long Island School of Medicine, New York, NY, USA
| | - V Monson
- The Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee,WI, USA
| | - L Altshuler
- New York University Grossman School of Medicine, New York, NY, USA
| | - V Harnik
- New York University Grossman School of Medicine, New York, NY, USA
| | - L Buckvar-Keltz
- New York University Grossman School of Medicine, New York, NY, USA
| | - M Poag
- New York University Grossman School of Medicine, New York, NY, USA
| | - P Belluomini
- New York University Grossman School of Medicine, New York, NY, USA
| | - A Kalet
- The Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee,WI, USA
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Kim DT, Shelton W, Applewhite MK. Clinician Moral Distress: Toward an Ethics of Agent-Regret. Hastings Cent Rep 2023; 53:40-53. [PMID: 38131494 DOI: 10.1002/hast.1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the same circumstances. This indicates a problematic ambiguity in the moral distress concept that obscures its distinctiveness, its relevant circumstances, and how individual clinicians and the medical community should practically respond to it. We argue that, in a range of situations that are said to be morally distressing, the characteristic emotion can be well-understood in terms of what Bernard Williams calls "agent-regret." We show what can thereby be gained in terms of a less ambiguous concept and a more adequate ethical response to this distinctive and complex clinician experience.
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Bono L, Gurenlian J, August J. A conceptual model using CliftonStrengths® to support dental hygiene students' professional development. Int J Dent Hyg 2023; 21:770-780. [PMID: 37864380 DOI: 10.1111/idh.12768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 10/22/2023]
Abstract
PURPOSE Professional development is instrumental in the ongoing success of healthcare professionals and students. The purpose of the second year of this 2-year study was to continue to apply the results from the CliftonStrengths® assessment to support entry-level dental hygiene students' professional development and to create a conceptual model for professional development in dental hygiene education. METHODS CliftonStrengths® was incorporated into didactic and community learning experiences throughout year two of the dental hygiene curriculum. At the end of year two, focus group interviews assessed student perceptions of professional strengths based on these learning experiences. Co-investigators used a qualitative analysis software program to identify codes and themes. Investigator triangulation and member checks were used to validate responses. RESULTS All second-year dental hygiene students (n = 32) participated in year two of the study. Two themes were identified: relevance of CliftonStrengths® and professional development. Within the theme of relevance, the subthemes of adaptability, making connections and teamwork emerged. The theme of professional development yielded three subthemes: appreciation, personal and professional identity and insight. CONCLUSION This study demonstrated CliftonStrengths® can be used to promote professional development among dental hygiene students. As a result, a conceptual model was developed for professional development in dental hygiene education. This model can be used as a framework for teaching and to improve student learning experiences.
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Affiliation(s)
- Leciel Bono
- Department of Dental Hygiene, Idaho State University, Pocatello, Idaho, USA
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45
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Nissim Y, Simon E. Divided Village, Divided Identity? Exploring the Professional Identity of Teachers Amid the Geopolitical Configuration in Al-Ghajar. Behav Sci (Basel) 2023; 13:878. [PMID: 37998625 PMCID: PMC10669424 DOI: 10.3390/bs13110878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/25/2023] Open
Abstract
This quantitative research is based on a validated research questionnaire. It presents a preliminary exploratory study examining perspectives of professional identity as reflected in self-reports of the teachers of Al-Ghajar, a village on Israel's northern border, given its unique geographical and geopolitical configuration. The current study is the first of its kind, clarifying the teachers' perception of their professional identity in the unique space in which they live and work via a questionnaire completed by 61 teachers of both genders from kindergarten through high school. The findings show that there are strong positive correlations: "love for the profession" and "self-fulfillment" have a very strong positive correlation (0.831). There is also a positive correlation (0.430) between the indicators of "professional skills" and "professional unity" suggesting that the teachers' perceptions of professional identity are holistic in all examined dimensions. These perceptions are motivated by a strong sense of mission that influences their profession and their sense of satisfaction. Al-Ghajar, as a unique enclave, has created a geopolitical configuration that contributes to the construction of the professional identity of teachers in the village. The research conclusion indicates that the ability to legitimize one's role has important implications for the quality of teaching, as it can help teachers form familiar, affiliated, and secure identities. These are key traits since a positive sense of professional self is a prerequisite for job satisfaction and resilience.
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Affiliation(s)
- Yonit Nissim
- Department of Education and Learning, Tel Hai College, Qiryat Shemona 1220800, Israel;
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Gasperini G, Renzi E, Massimi A, Mazzotta R, Stievano A, Cianciulli A, Villari P, De Maria M. Psychometric testing of the nurses professional values scale-revised on family and community health nurses. Nurs Ethics 2023:9697330231204986. [PMID: 37797312 DOI: 10.1177/09697330231204986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
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.
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Bono L, Gurenlian JR, August J. A Conceptual Model Using CliftonStrengths ® to Support Dental Hygiene Students' Professional Development. J Dent Hyg 2023; 97:91-102. [PMID: 37816625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 09/07/2023] [Indexed: 10/12/2023]
Abstract
Purpose Professional development is instrumental in the ongoing success of healthcare professionals and students. The purpose of the second year of this two-year study was to continue to apply the results from the CliftonStrengths® assessment to support entry-level dental hygiene students' professional development and to create a conceptual model for professional development in dental hygiene education.Methods CliftonStrengths® were incorporated in didactic and community learning experiences throughout year two of the dental hygiene curriculum. At the end of year two, focus group interviews assessed student perceptions of professional strengths based on these learning experiences. Co-investigators used a qualitative analysis software program to identify codes and themes. Investigator triangulation and member checks were used to validate responses.Results All second-year dental hygiene students (n=32) participated in year two of the study. Two themes were identified: relevance of CliftonStrengths® and professional development. Within the theme of relevance, the subthemes of adaptability, making connections, and teamwork emerged. The theme professional development yielded three subthemes: appreciation, personal and professional identity, and insight.Conclusion This study demonstrated CliftonStrengths® can be used to promote professional development among dental hygiene students. As a result, a conceptual model was developed for professional development in dental hygiene education. This model can be used as a framework for teaching and to improve student learning experiences.
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Affiliation(s)
- Leciel Bono
- Department of Dental Hygiene, Idaho State University, Pocatello, ID, USA
| | - JoAnn R Gurenlian
- Department of Dental Hygiene, Idaho State University, Education and Research Division, American Dental Hygienists' Association, Chicago, IL, USA
| | - Jessica August
- Dental Sciences, Portland Community College, Portland, OR, USA
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Hoerder R, Josephsson S, Kramer-Roy D. "Justice Becomes Our Agency." Occupational Therapists in Germany Reflect on Their Practice Processes in and with Communities. Occup Ther Health Care 2023:1-23. [PMID: 37747459 DOI: 10.1080/07380577.2023.2253911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/28/2023] [Indexed: 09/26/2023]
Abstract
Community development and population-oriented approaches are emphasized to advance the occupational therapy profession's scope of practice to meet the increasing demands created by socio-cultural-political and economic changes. This study explored the practice processes of occupational therapists in community settings outside existing health care structures in Germany. Data was gathered through five individual qualitative interviews and one focus group and analyzed using thematic analysis. Three main themes were identified: navigating parallel processes within the larger context or system; building community connections through occupation; growing professional identity. The utilization of occupational science concepts was essential to work successfully on a community level.
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Affiliation(s)
- Roswitha Hoerder
- ZHAW School of Health Sciences, Institute of Occupational Therapy, Zürich University of Applied Sciences, Winterthur, Switzerland
| | - Staffan Josephsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Debbie Kramer-Roy
- European Msc in Occupational Therapy, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
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Golan Cohen A, Tal Y, Hersh D, Vinker S, Merzon E, Green I, Isrel A, Tuval A. The professional agenda and its effect on the implementation of telemedicine among primary care physicians: A qualitative study. J Telemed Telecare 2023:1357633X231193787. [PMID: 37670678 DOI: 10.1177/1357633x231193787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
INTRODUCTION Studies show that physicians' attitudes are a major influential factor in the degree of implementation of telemedicine and that most of them identify much more opportunities in this type of visit than risks. These findings do not explain the observed decrease in the use of telemedicine in primary care with the decline of the COVID-19 pandemic. The aim of our study was to understand the gap between the attitudes that primary care physicians declare towards telemedicine and the extent to which they use it in practice. METHODS A qualitative research using a semi-structured phone interview with 33 primary care physicians experienced in telemedicine from Leumit Health Services, a health fund in Israel. A qualitative thematic analysis method was used to extract the main themes from all interviews, and descriptive statistical tests were used to analyze the demographic variables. RESULTS The attitude of the physicians depended on the perception of their professional identity and their sense of control over telemedicine implementation. The more established their professional identity and the stronger the support from the organization in the technology integration, the more positive the physician's attitude towards this type of visit. DISCUSSION Healthcare organizations that wish to improve the use of telemedicine in primary care should understand that this is more than just the implementation of new technology: they must find a way to properly support the profound change that doctors must undergo when defining their new role and professional status.
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Affiliation(s)
- Avivit Golan Cohen
- Leumit Health Services, Tel-Aviv, Israel
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yossi Tal
- Leumit Health Services, Tel-Aviv, Israel
| | - Daniel Hersh
- Leumit Health Services, Tel-Aviv, Israel
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomo Vinker
- Leumit Health Services, Tel-Aviv, Israel
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eugene Merzon
- Leumit Health Services, Tel-Aviv, Israel
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Green
- Leumit Health Services, Tel-Aviv, Israel
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Atalia Tuval
- Leumit Health Services, Tel-Aviv, Israel
- Department of Occupational Health, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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50
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Stout J, Stahl A, Fortenberry JD. Developing medical professionalism in care of gender nonconforming patients: Reflections of second-year medical students after a curricular experience with gender nonconforming people and allies. Med Teach 2023; 45:984-990. [PMID: 37068168 DOI: 10.1080/0142159x.2023.2197136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Negative healthcare experiences persist for gender nonconforming individuals. Clinician-related factors, including lack of comfort with gender nonconforming persons and unexamined personal biases, present barriers to equitable and affirming healthcare. We explored the effects of contact with gender nonconforming individuals in preclinical medical education through a structured curricular intervention designed to build medical and humanistic knowledge and stimulate the development of medical professionalism surrounding the care of gender nonconforming individuals. METHODS A curricular module (didactic prework, time-synchronous online panel discussion, and post-event written reflection) was implemented in a second-year preclinical course in a large multi-campus Midwestern medical school. The module was based on pedagogical foundations of contact theory and reflective writing. Post-event written reflections were investigated using thematic analysis. RESULTS Analysis of 355 written reflections revealed three major themes (moments of insight, topics of confusion, connections to professional identity formation) and eight sub-themes. The findings demonstrated emerging gender professionalism and the importance of contact in professional development. DISCUSSION Contact with gender nonconforming people and the use of written reflections can encourage self-examination and foster professional identity formation among preclinical medical students. Modeling gender-affirming approaches may help counteract negative cultural messages about gender nonconforming people, aiding development of inclusive future physicians.
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Affiliation(s)
- Julianne Stout
- Veterinary Administration Department, Purdue University, West Lafayette, IN, USA
| | - Aletha Stahl
- Center for Intercultural Learning, Mentorship, Assessment and Research Purdue University, West Lafayette, IN, USA
| | - J Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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