Understanding and measuring nurses' professionalism: Development and validation of the Nurses' Professionalism Inventory

Incorporating equity, diversity and inclusion (EDI) into the education and assessment of professionalism for healthcare professionals and trainees: a scoping review

BACKGROUND

Current definitions of professionalism for healthcare trainees often lack equity, diversity and inclusion (EDI) in the expectations and assessment of professionalism. While professionalism teaching is incorporated in healthcare training, equity-deserving groups still experience discrimination. This scoping review investigates the literature to understand how EDI and associated domains of cultural humility, and advocacy can be incorporated in healthcare trainees' education and assessment of professionalism.

METHODS

The Arksey and O'Malley framework was applied to this scoping review. MEDLINE, Embase & PsychINFO were searched up to March 2023, with terms surrounding health professionals, professionalism, EDI, cultural humility, and advocacy. Titles and abstracts (n = 3870) and full-texts (n = 140) were independently screened by two reviewers. Articles were included if they focused on EDI, cultural humility, or advocacy among healthcare students/trainees, and had outcomes related to professionalism. Articles lacking discussion of professionalism as an outcome were excluded. Themes were generated by mutual discussion. Risk of bias was assessed using the Cote et al. and Medical Education Research Study Quality Instrument (MERSQI) tools.

RESULTS

48 articles underwent thematic analysis. Studies investigated the disciplines of medicine, nursing, social work, physiotherapy, and dentistry. Most studies were qualitative in methodology (n = 23). Three themes emerged: (1) EDI-related interventions are associated with improved professionalism of healthcare trainees/workers (n = 21). Interventions employed were either an EDI-associated educational course (n = 8) or an exchange program to promote EDI competencies among trainees (n = 13). (2) Trainee definitions and perceptions of professionalism include themes related to EDI and cultural humility (n = 12). (3) Current standards of professionalism are perceived as non-inclusive towards historically-marginalized populations (n = 15). Literature investigating advocacy as it relates to professionalism is limited.

CONCLUSION

This review identified that core EDI principles and its associated domains of cultural humility and advocacy are often viewed as integral to professionalism. These findings create a strong impetus to incorporate EDI principles within professionalism frameworks in healthcare education. Future research should employ standardized tools for professionalism assessment to provide more conclusive evidence. Incorporating patient perspectives of professionalism can inform actionable recommendations for fostering inclusive healthcare environments.

Self-report of Nurse Professionalism and Factors Affecting It: A Cross-sectional Study

OBJECTIVE

To evaluate the perception of professionalism by nurses and identify factors that affect the evaluation of professionalism.

BACKGROUND

Professionalism is conceptualized as the set of beliefs related to the autonomy of the profession. Lack of professional respect, a disruptive work environment, and suppression of progressivism in the profession are identified as factors that lead to leaving the profession.

METHODS

The study was carried out according to the CHEERIES (Checklist for Reporting Results of Internet E-Surveys) checklist and included 250 RNs. The Nurses' Professionalism Inventory (NPI) was used.

RESULTS

The mean composite score of the NPI indicates a positive reflection of the professionalism of the nurse. Nurse education and job position were the most significant factors that affected perception of professionalism (P < 0.05).

CONCLUSIONS

The results show the need to examine the issue of professionalism in nursing to a greater extent and implement the findings of research on innovations at all levels of nursing education.

Study of Nightingale's nursing professionalism: a survey of nurses and nursing students in China

Background

Nursing professionalism is highly significant to the development of nursing. Florence Nightingale was the founder and leader of modern nursing, and Nightingale’s nursing professionalism has a significant impact on nursing in China and all over the world. In the new era, a new understanding of Nightingale’s nursing professionalism should be developed, and its positive role in nursing reshaped.

Methods

A total of 1,557 nurses and nursing students from 27 provincial administrative regions of China were surveyed using a customized questionnaire. Their recognitions of Nightingale’s nursing professionalism were evaluated based on scores, and statistical differences between and within the groups were analyzed using an Analysis of Variance (ANOVA). The elements of Nightingale’s nursing professionalism were extracted by the exploratory factor method and a principal component analysis.

Results

The Cronbach’s α of the questionnaire was 0.965, and the two groups did not differ significantly (p > 0.05). Based on the standard that the cumulative contribution rate of common factor should be > 85%, three common factors of Nightingale’s nursing professionalism, including professional emotion, professional ability and professional ethics, were extracted based on the Scree plot.

Conclusions

This study aimed to explore the connotation of Nightingale’s nursing professionalism. Our survey indicates that Nightingale’s nursing professionalism is highly recognized by nurses and nursing students in China. Its connotation includes professional emotion, ability and ethics. Nursing education and nursing management should fully utilize the leading role of Nightingale and guide the professional behaviors of nurses to be consistent with Nightingale’s nursing professionalism, thus, improving the degree of nurse professionalism.

Undergraduate nursing students' self-reported professional behaviour at the University of Namibia

Background

Development of professional behaviour in nursing students is an important part of a nurse’s overall competence. Self-evaluation is one way of measuring professional behaviour amongst nursing students. However, studies on self-reported professional behaviour of nursing students are limited in Namibia.

Aim

This study aimed to investigate nursing students’ self-reported professional behaviour at the University of Namibia.

Setting

The setting was a university campus offering a Bachelor of Nursing Science degree in Namibia.

Methods

A quantitative descriptive contextual design was used with 100 nursing students. Data were analysed descriptively using a non-parametric Kruskal–Wallis and ANOVA tests of variance and statistical significance.

Results

High mean scores were found in the areas of utilising evidence-based solutions (4.78 ± 0.58), promoting clinical teaching (4.46 ± 0.94), willingness to implement quality improvement initiatives (4.34 ± 0.518), and protecting health, safety and patient’s rights (4.28 ± 0.55). The lowest mean scores were recorded in projecting professional image (2.22 ± 1.27), rendering evidence-based care (4.08 ± 0.44). The study found statistical significance difference between self-reported professional competency (p = 0.01) and quality care improvements (p = 0.02).

Conclusion

In this study, nursing students’ self-reported professional behaviour was rated high (mean scores > 4.0 out of 5). Despite this high rating, it cannot be concluded that the students were professionally competent. We recommend that professional behaviour be measured from both students’ and nurse educators’ or patients’ perspectives.

Contribution

The findings from this study provide supplementary evidence on self-reported professional behaviour with implications on nursing education and practice.

Development and validation of scale for measuring attitudes towards e-professionalism among medical and dental students: SMePROF-S scale

BACKGROUND

Social media permeated everyday life and consequently it brought some changes to behaviour of health professionals. New form of professionalism emerged called e-professionalism depicting professional behaviour while using social media. There are a number of studies conducted in the past several years measuring behaviour of different populations of health professionals on social media and social media sites. Many studies have investigated aspects of e-professionalism of medical or dental students as future health professionals, but there are no validated instruments made for assessing attitude towards e-professionalism of those two populations. Objective of this paper is to validate a newly developed scale for measuring attitudes towards e-professionalism among medical and dental students.

METHODS

The original 32-item scale was developed and administered to 411 medical students (RR 69%), and 287 dental students (RR 49.7%). Exploratory factor analysis was used to investigate the existence of underlying factors. Principal component analysis was used as an extraction method with oblimin as selected oblique rotation method. Cronbach's alpha was used to assess reliability.

RESULTS

Total of 698 student answers entered analysis. The final scale had 24 items that formed seven factors named: ethical aspects, dangers of social media, excluding physicians, freedom of choice, importance of professionalism, physicians in the digital age, negative consequences. Cronbach's alpha indicating scale reliability was .72. Reliability conducted on each factor ranged from .570 to .877.

CONCLUSIONS

The scale measures seven factors of attitude towards e-professionalism and exhibits satisfactory reliability. Based on insights from validation, some possible improvements are suggested.