University of Kansas School of Nursing ngodfrey@kumc.edu 4. Shift - - PowerPoint PPT Presentation

Nelda Godfrey University 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 Work Veterinary Medicine

Occupational Therapy

Dietitians Genetic Counselors Family Systems Educators Undergraduate Students Alumni Nursing Paramedics Advanced Practice Nurses Physician Assistants Psychologists 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