Nelda GodfreyUniversity of Kansas

School of Nursing

ngodfrey@kumc.edu

4. Shift from an emphasis on

socialization and role taking to an

emphasis on formation.

Novice Competent Proficient Expert Mastery

Non situated

recollection

Situated

recollection

Situated

recollection

Situated

recollection

Situated

recollection

Decomposed

recognition

Decomposed

recognition

Wholistic

recognition

Wholistic

recognition

Wholistic

recognition

Analytic

decision-

making

Analytic

decision-

making

Analytic

decision-

making

Intuitive

decision-

making

Intuitive

decision-

making

Monitoring

awareness

Monitoring

awareness

Monitoring

awareness

Monitoring

awareness

Absorbed

awareness

Dreyfus Model of Skill Acquisition

https://www.youtube.com/watch?v=3tSWWaFnsF8

Professional Identity

Professional Identity Development

Professional Identity Formation

1900s to 1950s

• Virtue based approaches

1960s to 2000

• Behaviorist (competency)approaches dominated

2000 --present

• Virtue + Behaviorist (competency) + emerging identities

ACGME (US)

Patient care

Medical knowledge

Practice based learning

and improvement

Interpersonal and

communication skills

Professionalism

Systems-based practice

Cruess, R. & Cruess, S. (2009). Professionalism. CanMEDS Train the Trainer Program.

1870s to 1950s

• Virtue based approaches

1960s to present

day

• Behaviorist (competency)approaches dominate

Next??

• Virtue + Behaviorist (competency) + identity formation?

Professional Identity

Professional Identity Development

Professional Identity Formation

Pharmacy

Medicine

Physical Therapy

Social WorkVeterinary Medicine

Occupational Therapy

Dietitians

Genetic Counselors

Family Systems Educators

Undergraduate Students

Alumni

NursingParamedicsAdvanced Practice Nurses

Physician AssistantsPsychologists

Mental Health Professionals

BIG PICTURE:

Topic is poorly addressed in higher education literature (Trede & Macklin, 2012)

Review of professional identity in registered nurses did not yield enough articles for review (Rasmussen, et al., 2018)

Very few theoretically based studies to guide researchers and educators (Roberts & Kumar, 2015)

Professional identity of the nurse concept analysis completed (Ohlen & Segesten, 1998)

Key components for optimizing professional identity/professional identity formation:• Experiential learning (9)

• Longitudinal curriculum (10)

• Pedagogical innovations (8)

• Mindfulness and reflection (4)

• Make values explicit (3)

• Move past negative implications of hidden curriculum (3)

Key components for optimizing professional identity/professional identity formation:• Organization in teaching counts (3)

• Good role models make all the difference (2)

• Quality clinical experiences (3)

• Clarity of professional identity (2)

• Develop a personal commitment (1)

• A focus on self care (1)

• Create a sense of belonging (1)

Key Findings:• Professional identity is a developmental

phenomenon (Jebril 2008)

• Burnout decreases with a professional identity

development program (Sabancıogullari &

Dogan, 2015)

• Tensions can destabilize professional identity in

difficult patient care areas (Dadich, et al., 2014))

• Professional identity and self-concept appear to

be linked (Tinkler, et al., 2018)

Key Findings:• 11 research articles reported professional

identity formation as a positive outcome of the

research

• No instruments yet exist that measure

professional identity with confidence (Cowin, et

al., 2013)

• A focus on professional identity increased

empathy scores (Schweller, et al., 2017)

Many professions are identifying issues and approaches to forming and fostering professional identity

Specific strategies are present in the literature—though less for practice than education

Generally patient care benefits from a strong professional identity

Other disciplines are developing language and strategies to form and foster professional identity.

2010 Carnegie report recommendations affirm the need for nursing to do the same.

It is time to develop the language and start setting the course in nursing, informed by practice, education and regulation

Beal and Riley, 2015

Margaret Wheatley

Beal, J. & Riley, JM (2015). The Development of a Clinical Nurse Scholar in Baccalaureate Education. Journal of Professional Nursing, 31 (5), 379-387.

Cowin, L., Johnson, M., Wilson, I & Borgese, K. (2013). The psychometric properties of five Professional Identity measures in a sample of nursing students. Nurse Education Today, 33 (6), 608-613.

Dadich, A., Jarrett, C., Robards, F., & Bennett, D. (2015). How professional identity shapes youth healthcare. J Health Organ Manag, 29(3), 317-342. doi:10.1108/jhom-06-2012-0096

Schweller M, Ribeiro DL, Celeri EV, de Carvalho-Filho MA. (2017). Nurturing virtues of the medical profession: does it enhance medical students' empathy? Int J Med Educ. 2017 Jul 11;8:262-267. doi: 10.5116/ijme.5951.6044.

Tinkler, L., Smith, V., Yiannakou, Y., & Robinson, L. (2018). Professional identity and the Clinical Research Nurse: A qualitative study exploring issues having an impact on participant recruitment in research. Journal of Advanced Nursing, 74(2), 318-328. doi:10.1111/jan.13409

Sabancıogullari, S., & Dogan, S. (2015). Effects of the professional identity development programme on the professional identity, job satisfaction and burnout levels of nurses: A pilot study. International Journal of Nursing Practice, 21(6), 847-857. doi:10.1111/ijn.12330