Professional socialization: an analytical definition

Nursing Professional Values Scale (NPVS-3) in an Austrian context: validation of a scale and reliability assessment

BACKGROUND

The Nurses Professional Values Scale-3 (NPVS-3) is a psychometric instrument derived from a set of values initially established by the American Nurses Association (ANA) Code of Ethics. The present study evaluates the reliability of the NPVS-3 scale for nursing students and nurses in Austria.

METHODS

A cross-sectional methodological study was conducted on 209 research participants, comprising 139 nursing students and 70 nurses, with the objective of determining the reliability of the Austrian version of the scale. A multilevel approach was employed in the study, encompassing cultural and linguistic validation, content validity, face validity, and construct validity. The scale translation was performed per the established translation stages of back-translation and was subsequently reviewed by an expert committee. The translated instrument was applied to the participants who completed an online survey between April and July 2023. Internal consistency was evaluated using Cronbach's alpha, while construct validity was assessed using confirmatory factor analysis (CFA).

RESULTS

The Cronbach's alpha values obtained were deemed appropriate, with the following results: Caring (0.852), Activism (0.832), and Professionalism (0.676). Through factorial analysis, three factors were identified as original NPVS-3 and construct validity was verified.

CONCLUSION

The Austrian version of the NPVS-3 demonstrated satisfactory validity, efficiently evaluating the professional values of nurses and nursing students in Austria.

Mentoring as a complex adaptive system - a systematic scoping review of prevailing mentoring theories in medical education

BACKGROUND

Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring's personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS).

METHODS

A systematic scoping review using Krishna's Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion.

RESULTS

Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring's CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes.

CONCLUSION

Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.

A scoping review and theory-informed conceptual model of professional identity formation in medical education

INTRODUCTION

Professional identity formation (PIF) is a central tenet of effective medical education. However, efforts to support, assess and study PIF are hindered by unclear definitions and conceptualisations of what it means to 'think, act, and feel like a physician'. Gaps in understanding PIF, and by extension, its support mechanisms, can predispose individuals towards disengaged or unprofessional conduct and institutions towards short-sighted or reactionary responses to systemic issues.

METHODS

A Systematic Evidence-Based Approach-guided systematic scoping review of PIF theories was conducted related to medical students, trainees and practising doctors, published between 1 January 2000 and 31 December 2021 in PubMed, Embase, ERIC and Scopus databases.

RESULTS

A total of 2441 abstracts were reviewed, 607 full-text articles evaluated and 204 articles included. The domains identified were understanding PIF through the lens of pivotal theories and characterising PIF by delineating the underlying factors that influence it and processes that define it.

CONCLUSIONS

Based on regnant theories and frameworks related to self-concepts of identity and personhood, the relationships between key PIF influences, processes and outcomes were examined. A theory-backed integrated conceptual model was proposed to delineate the interconnected relationships among these, aiming to untangle some of the complexities inherent to PIF, to shed light on existing practices and to identify shortcomings in our understanding so as to develop mechanisms in support of its multifaceted, interlinked components.

Identification of Factors Influencing Professional Identity Development in Medical Students at Basic Sciences Stage

Introduction

Medical education is beyond gaining a certain level of knowledge and mastering a specific set of skill. Medical students should try to improve the self and system, which necessitates personal growth and professional identity development. In this study, we aimed to investigate the factors which contribute to the formation of professional identity of medical students in basic sciences stage and finding out the significance of each factor.

Methods

In this cross-sectional practical survey, semi-structured interviews were done with 10 medical students. The interview results yielded several items, which were used to make a 14-item questionnaire, the validity and reliability of which were verified. The contribution of the items to the factors was verified through factor analysis, the prerequisites of which were KMO and Bartlett test, which were done and approved. The significance of the factors obtained was evaluated and ranked through one sample t-test and Friedman test, respectively.

Results

The result showed that professional identity development in the stage of basic sciences was influenced by several factors, including educational, socioeconomic, personal, and familial ones. Also, the personal factor ranked first, followed by socioeconomic, educational, and familial factors, respectively.

Conclusion

In this study, it was concluded that the participants were more influenced by their own personal attitudes as compared to their familial, socioeconomic, or educational factors. Moreover, the factors which contributed to the professional identity of medical students were not at the same level of significance. To train physicians with high professional identity, medical education authorities are recommended to consider the above-mentioned factors.

Evaluation of the feasibility of an Education-Career pathway in Healthcare for Older People (ECHO) for early career nurses

BACKGROUND

Rapid population ageing is driving demand for qualified gerontological nurses. Yet, early career nurse attrition and limited focus on retention in the speciality limits supply.

OBJECTIVES

To test the feasibility and acceptability of an Education-Career pathway in Healthcare for Older People (ECHO) intervention for early career nurses to improve retention and capability in gerontological nursing. ECHO is a multicomponent intervention with integrated education, career planning and coaching components, tested over two 6-month cycles.

METHODS

A feasibility study with a pre-post design using a multi-methods evaluation. Twenty-nine early career nurse participants were recruited from eight NHS acute and community care Trusts in England. ECHO participants completed online questionnaires at baseline (Time 1), 6-month (T2, end of intervention) and follow-up at 18 months from baseline (T3). Outcome measures were career intention, self-reported knowledge, career planning confidence, and burnout using the Maslach Burnout Inventory. Qualitative interviews were undertaken with participants (n = 23) and organizational stakeholders (n = 16) who facilitated ECHO. Data analysis used descriptive statistics and non-parametric tests for paired data and thematic analysis for qualitative data.

RESULTS

Overall, 19 of 29 participants (65%) completed all aspects of the intervention. The evaluation was completed by 23 participants. ECHO was well received by participants and stakeholders. At T3, the 23 participants were working in the speciality, though two had changed organizations. There was a significant improvement in self-reported gerontological knowledge, pre 87 (IQR 81-102), post 107 (IQR 98-112) p = 0.006, but no significant changes in other outcomes. In qualitative data, participants and organizational stakeholders held similar views, presented under four main themes: intended outcomes (personal and professional development, raise gerontological profile, expand horizons); nurse retention-a double-edged sword, ECHO logistics, and sustainability.

CONCLUSION

Education-Career pathway in Healthcare for Older People was feasible and may positively impact early career nurse retention, capability and socialization into gerontological nursing. ECHO requires further refinement and piloting, but learning can contribute to retention strategies.

IMPLICATIONS FOR PRACTICE

Attracting and retaining early-career nurses to the gerontological speciality requires greater innovation, organizational and senior nurse leadership.

Validating an Instrument for Measuring Newly Graduated Nurses' Adaptation

A long-established approach, Confirmatory Factor Analysis (CFA) is used to validate measurement models of latent constructs. Employing CFA can be useful for assessing the validity and reliability of such models. The study adapted previous instruments and modified them to suit the current setting. The new measurement model is termed NENA-q. Exploratory factor analysis (EFA) revealed the instruments of the NENA-q model formed a construct of the second order with four dimensions, namely organizational contribution (OC), academic institution contribution (AIC), personality traits (PT), and newly employed nurses' adaptation (NENA). Researchers administered the questionnaires to a sample of 496 newly employed nurses working in hospitals under the Ministry of Health (MOH) for the confirmation of the extracted dimensions. The study performed a two-step CFA procedure to validate NENA-q since the model involves higher-order constructs. The first step was individual CFA, while the second step was pooled CFA. The validation procedure through confirmatory factor analysis (CFA) found the model achieved the threshold of construct validity through fitness index assessment. The model also achieved convergent validity when all average variance extracted (AVE) exceeded the threshold value of greater than 0.5. The assessment of the composite reliability (CR) value indicates all CR values exceeded the threshold value of 0.6, which indicates the construct achieved composite reliability. Overall, the NENA-q model consisting of the OC construct, AIC construct, PT construct, and NENA construct for CFA has met the fitness indexes and passed the measurements of the AVE, CR, and normality test. Once the measurement models have been validated through CFA procedure, the researcher can assemble these constructs into structural model and estimate the required parameter through structural equation modelling (SEM) procedure.

Professional socialization of hospital nurses: A scale development and validation study

BACKGROUND

Tools currently available to measure professional socialization are outdated or could not reflect various properties of professional socialization of nurses. Thus, the objective of this study was to develop and validate a professional socialization measurement instrument for hospital nurses.

METHODS

Fifty-two items were initially extracted from literature reviews and in-depth interviews with 32 nurses. After content validity testing, 48 items remained. They were used to survey 881 hospital nurses in Korea in the testing phase for construct validity and reliability.

RESULTS

Four factors (21 items) were extracted: ethical practice and reflection, perception of respect and recognition, clinical competency based on leadership, and desires and motivation for professional development. These factors demonstrated good construct validity and reliability. Correlation coefficients of professional socialization with professional value, compassion satisfaction, secondary traumatic stress, and burden were 0.58 (p < 0.001), 0.70 (p < 0.001), - 0.08 (p = 0.014), and - 0.56 (p < 0.001), respectively. Reliability had a Cronbach's alpha of 0.95. Test-retest reliability intraclass correlation coefficient was 0.90.

CONCLUSIONS

The four professional socialization scale factors in this study reflected attributes of knowledge, skills, values, and professional roles. Professional socialization of nurses can be continuously developed by emphasizing elements of the professional socialization scale in nursing education programs. Nursing managers should help nurses go through the professional socialization process. The professional socialization scale will serve as a tool for developing careers of hospital nurses.

Collaborators as a key to survival: an ethnographic study on newly graduated doctors' collaboration with colleagues

BACKGROUND

Newly graduated doctors find their first months of practice challenging and overwhelming. As the newly graduated doctors need help to survive this period, collaborators such as peers, senior doctors, registered nurses and other junior doctors are crucial. However, little is known about what characterise these collaborations, and how much is at stake when newly graduated doctors are striving to establish and maintain them. This study aims to describe and explore the collaborations in depth from the newly graduated doctors' point of view.

METHODS

We conducted 135 h of participant observations among newly graduated doctors (n = 11), where the doctors were observed throughout their working hours at various times of the day and the week. Furthermore, six semi-structured interviews (four group interviews and two individual) were carried out. The data was analysed thematically.

RESULTS

Newly graduated doctors consulted different collaborators (peers, senior doctors, registered nurses, and other junior doctors) dependent on the challenge at hand, and they used different strategies to get help and secure good relationships with their collaborators: 1) displaying competence; 2) appearing humble; and 3) playing the game. Their use of different strategies shows how they are committed to engage in these collaborations, and how much is at stake.

CONCLUSIONS

Newly graduated doctors rely on building relationships with different collaborators in order to survive their first months of practice. We argue that the collaboration with peer NGDs and registered nurses has not received the attention it deserves when working with the transition from medical school. We highlight how it is important to focus on these and other collaborators and discuss different work-agendas, mutual expectations, and interdependence. This could be addressed in the introduction period and be one way to ensure a better learning environment and a respectful interprofessional culture.

Explanation of the professional development process of general surgery residents in the operating rooms: A situational analysis

INTRODUCTION

Numerous factors and elements are effective in the professional development of any field of study, including the educational structure, the individual characteristics of learners, and the educational atmosphere prevalent in the educational environment. Understanding each of these factors and elements and the relationships among them can guide educational system administrators in the direction of professional development. Surgical residents' professional development is no exception to this rule. As a consequence, the present research sought to explain and suggest a model for surgical assistant professional growth in Iranian operating rooms.

METHODS

The present research was a grounded theory study based on a post-positivist approach, in which data analysis was performed using Clark's situational analysis methodology by drawing three maps, situational map, social worlds/arenas map, and positional map.

RESULTS

In the presence of human and non-human factors, cultural, political, historical, and social components, the ordered situational map demonstrated the complexity of the operating room learning environment. The social worlds/arenas map confirmed the existence of several communities of practice wherein surgical residents were present with different power roles, and the positional map showed role of the educational level in the acquisition of the competence in the professional development pathway. Finally, the Triple Helix model of professional development was extracted, which has three components: psychological identity, social identity, and surgical competency.

CONCLUSION

The surgical residents' professional development in operating rooms occurs due to the acquisition of surgical competency along with the growth of individuals and socialization. As a result, all factors and components impacting the residents' competence development process in this learning environment must be identified and their linkages clarified.

Exploring the Impact of Pre-course High-Fidelity Simulation on Professional Socialization of Medical Students in Emergency Medicine Internship Rotation—A Qualitative Approach

Background

Medical students in block clerkships constantly adapt to new environments and learn to interact with new people as they rotate between specialties. This frequent change potentially limited interns' opportunities for participation in real clinical practice. The aims of this study were to explore interns' conceptualization of their learning opportunities and experiences in the workplace during an emergency medicine (EM) block internship. In addition, the study also explored how participating in the pre-rotation high-fidelity simulation (HFS) orientation influenced interns' perception of their transition, participation and learning experiences in the real EM setting.

Methods

We implemented a newly developed pre-EM rotation orientation curriculum for interns. This orientation took place on the first day of the 2-week EM internship rotation. Two focus group discussions were held after each simulation training, one immediately after simulation to understand the students' perception and the educational impact of this activity, the other at the end of EM rotation to explore and compare their roles and perception in both simulation activity and the real clinical practice. A total of 151 seventh-year medical students enrolled in the pre-course HFS and post-hoc focus group discussions between 2017 and 2019. We applied thematic analysis to systemically identify, examine, and construct themes.

Results

Four major themes were constructed from the data; 1. Challenges in finding authentic learning experiences within the context of emergency medicine; 2. Effectiveness of the pre-course HFS 3. Limitations of EM internship rotation curriculum and pre-course simulation. 4. Suggestions for EM block-internship curriculum reforms. Our study's key findings indicate that pre-rotation orientation HFS activity, which offered a psychologically safe space for students to explore facets of EM and gain a contextualized understanding of the emergency work culture and environment, was essential for enhancing students' ability to identify and maximize practice affordances in real workplace.

Conclusion

Simulation, facilitates interns' negotiation of legitimate peripheral participation opportunities as they transition into the EM community of practice during their block internship rotation; putting students at the center of the learning process.

Professional identity of medical students: Proposing a Meta Static Structural Model

INTRODUCTION

The realization of professionalism and its desirable consequences, as the most important goal of medical education, primarily depends on identifying the process and mechanism of the professional identity formation, which in turn requires the accurate identification of components and structure of the concept of professional identity. Therefore, the aim of this study was to synthesize a static structural model for professional identity, based on the results of our previous research.

METHODS

In this study the theory or model construction methodology was used to synthesize a static structural model of professional identity formation for medical students. In this regard, the Walker and Avant method was followed through three steps: specifying focal concepts, reviewing the literature, and organizing concepts into an integrated and efficient representation.

RESULTS

In this study, based on the analysis of 9 selected conceptual models in the field of socialization and professional identity, first the key concepts of each model were extracted and then by carefully examining these concepts and determining their relationships and reviewing related texts, dimensions and components of professional identity were determined and presented in the form of a comprehensive structural static model.

CONCLUSION

The advantage of the proposed model over the existing models is the explicit presentation of the dimensions, constructs, and sub-constructs of the concept of professional identity. In addition, this model can be used as a general pattern in all non-medical professions.

Mentalisierungsfähigkeit und Empathie in der Psychiatrie – eine Sozialisationsfrage?

Berufliche Sozialisation entwickelt sich im Kontext der Persönlichkeitsentwicklung und vorhandener Bedingungen unterschiedlich. Das Aufrechterhalten der Mentalisierungsfähigkeit im beruflichen Alltag und vor allem in herausfordernden Situationen ist keine Selbstverständlichkeit, sondern abhängig von Umgebungsbedingungen. Die Übernahme von Verantwortung für die gewählte berufliche Tätigkeit erfordert eine Auseinandersetzung mit dem jeweils spezifischen Anforderungsprofil; es stellen sich Lern- und Entwicklungsaufgaben. Die Integration der beruflichen Identität im Rahmen förderlicher Umgebungsbedingungen bedeutet, sich als Teil dieser Gruppe(n) zu erleben. Aus gruppenpsychoanalytischer Sicht stellt die Identifikation mit einer Gruppe eine Verinnerlichung eines „guten Objekts“ dar, einer Gruppenrepräsentanz, welche in herausfordernden Situationen zugänglich ist. Dies kann die Mentalisierungsfähigkeit verbessern.