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Al-Noumani H, Al Zaabi O, Arulappan J, George HR. Professional identity and preparedness for hospital practice among undergraduate nursing students: A cross-sectional study. NURSE EDUCATION TODAY 2024; 133:106044. [PMID: 38011753 DOI: 10.1016/j.nedt.2023.106044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/29/2023] [Accepted: 11/12/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Professional identity is a crucial characteristic that undergraduate nursing students must possess to ensure effective and safe clinical practice. It has been identified as a factor influencing nursing student retention and their intention to remain in the nursing profession. However, the influential factors that impact the development of professional identity among nursing students currently are not well known. OBJECTIVES To identify factors determining professional identity among undergraduate nursing students and to confirm the relationship between nursing students' professional identity and their preparedness for hospital practice. DESIGN A cross-sectional study. SETTINGS The largest public nursing college in Oman. PARTICIPANTS 180 full-time undergraduate nursing students in their third and fourth years who had completed at least one clinical course. METHODS Students completed validated, self-administered paper questionnaires through convenience sampling, including professional identity and preparedness for hospital practice scales. RESULTS The mean total score for professional identity was 63.3 (SD = 10.5), indicating a moderate level of professional identity. The findings showed a low level of preparedness for hospital practice among nursing students, with, a mean total score of 165.8 out of 246 (SD = 30.4). We found a significant positive association between professional identity and preparedness for hospital practice (r = 0.43, p < 0.001), the number of clinical courses taken (r = 0.15, p = 0.041), enrolment in fourth-year clinical courses (H (4) = 19.9, p = 0.001), grade (H (3) = 7.8, p = 0.049) and the selection of nursing profession as the first choice (H (3) = 28.0, p = 0.05). CONCLUSIONS The study has implications for identifying students with lower readiness for hospital practice and providing them with the necessary training. Nursing educators should prioritize reinforcing professional identity among students who have chosen nursing as a secondary option or have a lower grade. This can be achieved by promoting a positive nursing image and fostering a supportive clinical learning environment.
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Affiliation(s)
- Huda Al-Noumani
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, 66, Al Khoud, Muscat, Oman.
| | - Omar Al Zaabi
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, 66, Al Khoud, Muscat, Oman.
| | - Judie Arulappan
- Department of Maternal and Child Health, College of Nursing, Sultan Qaboos University, 66, Al Khoud, 123 Muscat, Oman.
| | - Hema Roslin George
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, 66, Al Khoud, Muscat, Oman.
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Barradell S. Reimagining Preparedness of Health Professional Graduates Through Stewardship. TEACHING AND LEARNING IN MEDICINE 2023; 35:486-495. [PMID: 36520110 DOI: 10.1080/10401334.2022.2148108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 11/01/2022] [Indexed: 06/17/2023]
Abstract
Issue: Preparing health professional students for practice matters and is an important objective of health professional education. But although health professional courses grow in number and continue to graduate entry-level practitioners annually, there are signs that health professional education is not quite hitting the "purpose" mark. Preparedness is a term encountered often in health professional education, but it is besieged with challenges. Those challenges relate to whether graduates are prepared for their future careers and how preparedness for practice is understood; understandings of preparedness influence what curriculum, teaching, and learning prepares graduates about and for. Evidence: There is a wealth of the literature that suggests that graduates are not prepared for practice or believe they are not. This literature tends to grow rather than diminish, with arguments about preparedness materializing time and again. Preparedness means different things to students, academics, and practitioners and this creates misunderstanding as well as lessening the construct's value to research, education, and practice. What it means to be prepared is in fact not a static construct but changes in response to the needs of individuals and communities and broader societal context. When preparedness is defined as competence in skills or knowledge, graduates will be ill equipped to operate in the chaotic, ambiguous times we now face as competencies tend to oversimplify and reduce the demands of practice. Implications: Preparedness is only one purpose that could be attached to the educational formation of university graduates. It is time we expand our thinking about what is valuable and necessary to learn in order to become health professionals equipped to address the health and social care problems now and to come. Furthermore, continuing to address the challenges of preparedness for practice in the same ways as we have done for decades will not result in change; new and different educational approaches are required to meaningfully reimagine health professional education. We need to value education as a scholarly field in its own right, as much as we do evidence-based healthcare. A concept that prompts us to think and act in these reinvigorated ways is stewardship, which I offer as an expansive way to think about the purposes and desired outcomes of health professional education. Stewardship is an idea that sustains and cares for the professions, and therefore is highly relevant to the preparation of healthcare practitioners.
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Affiliation(s)
- Sarah Barradell
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Moroni M, Díaz Crescitelli ME, Capuccini J, Pedroni C, Bianco M, Montanari L, Ghirotto L. 'Now I can train myself to be with death': a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy. BMJ Open 2023; 13:e065458. [PMID: 37041055 PMCID: PMC10105916 DOI: 10.1136/bmjopen-2022-065458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVE During the second wave of the COVID-19 pandemic, one of the organisational strategies established by the Italian National Health System was the special units for continuity of care (SUCCs). In the province of Ravenna, those units enrolled novice doctors to care for elderly patients with COVID-19 in care homes (CHs). The local palliative care (PC) unit decided to offer consultations and support to them. This study aimed to comprehend the experience of young doctors who asked for consultations when facing, during their first early years of practice, complex situations. DESIGN We conducted a qualitative study employing a phenomenological approach and in-depth interviews. PARTICIPANTS We involved 10 young doctors who worked in Italian SUCC during the pandemic and used a PC consultation support service. RESULTS What describes our participants' experience is related to four main themes: (1) reducing distances, (2) perceiving medical futility and improvising, (3) being supported to learn how to be with death and (4) narrowed timing to humanise care. The pandemic was, for our participants, a moment of reflection and critique on the skills acquired during the university course. It was a strong experience of human and professional growth that helped them reshape and deepen their role and skills, incorporating the approach of PC into their professional identity. CONCLUSIONS Integration between specialists and young doctors with an early entry into the workforce during the pandemic in CHs set out a 'shift' to a proactive and creative approach through a new awareness of professional and personal roles in doctor-patient relations. The continuity of care models should be rethought by integrating CHs and PC. Adequate PC training for young doctors (at pregraduate and postgraduate levels) can change doctors' vision and daily practice in assisting patients at the end of life.
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Affiliation(s)
- Matteo Moroni
- S.S.D. Cure Palliative, AUSL della Romagna, Ravenna, Italy
| | | | | | | | - Mattia Bianco
- Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Luca Ghirotto
- Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Edmiston N, Hu W, Tobin S, Bailey J, Joyce C, Reed K, Mogensen L. "You're actually part of the team": a qualitative study of a novel transitional role from medical student to doctor. BMC MEDICAL EDUCATION 2023; 23:112. [PMID: 36793053 PMCID: PMC9930018 DOI: 10.1186/s12909-023-04084-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Optimizing transitions from final year of medical school and into first post graduate year has important implications for students, patients and the health care system. Student experiences during novel transitional roles can provide insights into potential opportunities for final year curricula. We explored the experiences of medical students in a novel transitional role and their ability to continue learning whilst working as part of a medical team. METHODS Novel transitional role for final year medical students were created in partnership by medical schools and state health departments in 2020 in response to the COVID-19 pandemic and the need for a medical surge workforce. Final year medical students from an undergraduate entry medical school were employed as Assistants in Medicine (AiMs) in urban and regional hospitals. A qualitative study with semi-structured interviews at two time points was used to obtain experiences of the role from 26 AiMs. Transcripts were analyzed using deductive thematic analysis with Activity theory as a conceptual lens. RESULTS This unique role was defined by the objective of supporting the hospital team. Experiential learning opportunities in patient management were optimized when AiMs had opportunities to contribute meaningfully. Team structure and access to the key instrument, the electronic medical record, enabled participants to contribute meaningfully, whilst contractual arrangements and payments formalized the obligations to contribute. CONCLUSIONS The experiential nature of the role was facilitated by organizational factors. Structuring teams to involve a dedicated medical assistant position with specific duties and access to the electronic medical record sufficient to complete duties are key to successful transitional roles. Both should be considered when designing transitional roles as placements for final year medical students.
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Affiliation(s)
- Natalie Edmiston
- School of Medicine, Western Sydney University, Sydney, Australia.
- University Centre for Rural Health, Lismore, Australia.
| | - Wendy Hu
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Stephen Tobin
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Jannine Bailey
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Caroline Joyce
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Krista Reed
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Lise Mogensen
- School of Medicine, Western Sydney University, Sydney, Australia
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Squirrell K, Deivanayagam S, Niles K, Wang J, Kopar PC. A Gap in Mission: The Disparate Missions of Medical Schools and Teaching Hospitals. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231211081. [PMID: 37928890 PMCID: PMC10621289 DOI: 10.1177/23821205231211081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023]
Abstract
Objective The social contract mandates that in return for the government-funded labor of residents and fellows, the medical profession trains, to the best of its ability, the physicians of our future. This contract obligates graduate medical education (GME) to utilize all available information to create an optimal learning environment for its trainees. Business research has determined that a clearly defined mission statement is associated with improved employee engagement, retention, and wellness. Given that GME trainees are situated at the intersection of at least two institutions, each with its own separate mission, trainees could potentially be hindered by incongruent missions in the learning environment. The literature on mission statements has analyzed medical schools and hospitals separately; however, investigations comparing the statements of these affiliated institutions have not been conducted. Therefore, we plan to compare the content and assess the consistency of mission statements from affiliated medical schools and hospitals to determine if incongruencies exist. Methods In 2023, the mission statements from the Association of American Medical Colleges (AAMC) medical schools and affiliated teaching hospitals (n = 163) were aggregated from their public websites. The content of each mission statement was thematically analyzed to assess variation. Results According to content analysis of the mission statements from 163 AAMC medical school members and affiliated teaching hospitals, less than half of their top priorities are shared by their affiliated hospitals (45%). Additionally, themes of diversity, religion, and global care were found to be contrasting priorities between affiliated institutions. Conclusion Given the precedence within the business and the observed discrepancies in mission, further research is needed to determine whether collaborating medical schools and hospitals could provide a more favorable graduate training environment by uniting their priorities and identifying shared goals.
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Affiliation(s)
- Kyler Squirrell
- The Center for Humanism and Ethics in Surgical Specialties, Washington University, Saint Louis, MO, USA
| | - Shanthi Deivanayagam
- The Center for Humanism and Ethics in Surgical Specialties, Washington University, Saint Louis, MO, USA
| | - Katharine Niles
- The Center for Humanism and Ethics in Surgical Specialties, Washington University, Saint Louis, MO, USA
| | - John Wang
- The Center for Humanism and Ethics in Surgical Specialties, Washington University, Saint Louis, MO, USA
| | - Piroska Cornell Kopar
- The Center for Humanism and Ethics in Surgical Specialties, Washington University, Saint Louis, MO, USA
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Routh J, Paramasivam SJ, Cockcroft P, Nadarajah VD, Jeevaratnam K. Stakeholder perspectives on veterinary student preparedness for workplace clinical training – a qualitative study. BMC Vet Res 2022; 18:340. [PMID: 36085152 PMCID: PMC9461096 DOI: 10.1186/s12917-022-03439-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The success of workplace clinical training (WCT) is important given that veterinary students are licensed to work independently upon graduation. Considering this, it is perhaps surprising that there is limited published work describing what it means to be prepared for this educational experience, particularly given that the transition to WCT can be stressful for students. This paper reports the results of a qualitative study aiming to generate a rich understanding of veterinary student preparedness for WCT using emic, or insider, perspectives of key stakeholders.
Methods
From a constructivist standpoint, homogenous online group interviews were held with final year veterinary students, recent student alumni, clinical supervisors, faculty, and academic educationalists to discuss what it means to be prepared for WCT. The data was analysed using a template analysis approach.
Results
A three-tier taxonomy to describe preparedness for WCT was constructed from the data. At the topmost level, there were seven themes to illuminate different aspects of preparedness: students should be prepared 1) for the transition to learning and working in a clinical and professional environment, 2) for self-directed and experiential learning whilst working, 3) with a growth mindset, 4) with intrinsic motivation and enthusiasm for learning and working, 5) for communication, consultation and clinical reasoning, 6) with the knowledge for work, and 7) with the practical competence and confidence for work.
Conclusions
This study provides a deeper understanding of the tools we can provide, and the attributes we can nurture in, senior veterinary students to facilitate their learning and working during WCT. This improved understanding is a necessary precursor to refining pedagogical support and curriculum design within veterinary schools.
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Exploring Midwifery Students’ Experiences of Professional Identity Development During Clinical Placement: A Qualitative Study. Nurse Educ Pract 2022; 63:103377. [DOI: 10.1016/j.nepr.2022.103377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/08/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
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Routh J, Paramasivam SJ, Cockcroft P, Nadarajah VD, Jeevaratnam K. Using Learning Theories to Develop a Veterinary Student Preparedness Toolkit for Workplace Clinical Training. Front Vet Sci 2022; 9:833034. [PMID: 35464375 PMCID: PMC9021599 DOI: 10.3389/fvets.2022.833034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
Learning theories are abstract descriptions which help us make sense of educational practice. Multiple theories can inform our understanding of a single concept, in this case: veterinary workplace clinical training (WCT), which occurs just prior to students' graduation as competent veterinary surgeons. The competency movement has strongly influenced reforms in veterinary education and is considered important. In reflection of this, the term “preparedness” is operationalised here as a measure of the likelihood that the veterinary student is going to be a competent learner and participant during WCT. Preparedness itself is therefore important because it directly impacts performance. Workplace clinical training is explored through the lenses of cognitivist, social constructivist and socio-culturalist learning theories and used to inform student preparedness characteristics (“tools”) in terms of their behaviours, personal attributes, knowledge and skills, and awarenesses to optimise learning and participation. These form a new conceptual framework—the “Preparedness Toolkit.”
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Affiliation(s)
- Jennifer Routh
- School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
- *Correspondence: Jennifer Routh
| | | | - Peter Cockcroft
- School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | - Vishna Devi Nadarajah
- Division of Human Biology, School of Medicine and IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
| | - Kamalan Jeevaratnam
- School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
- Kamalan Jeevaratnam
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