BHL

Nurs Forum. 2020;55:447–472. wileyonlinelibrary.com/journal/nuf © 2020 Wiley Periodicals, Inc. | 447

DOI: 10.1111/nuf.12450

CONC E P T ANA L Y S I S

Professional identity: A concept analysis

Anita Fitzgerald PhD, RN, AGNP, CNE

School of Nursing, California State University,

Long Beach, California

Correspondence

Anita Fitzgerald, PhD, RN, AGNP, CNE, School

of Nursing, California State University, Long

Beach, CA 90802.

Email: anita.fitzgerald@csulb.edu

Abstract

The purpose of this study is to give clarity to the concept of professional

identity, drawing from health‐related fields to help provide a common language

and understanding for research and practice. Professional identity,

professionalism, professional socialization, and other related terms are often

used without a clear definition or with conflicting definitions. This can lead to

misunderstandings and assumptions that complicate research and confuse

educators and professionals in guiding novice members. Concept analysis.

Initially, 737 articles were identified by searching CINAHL, PubMed Central,

Google Scholar, Academic Search Complete, PsyINFO, and SocINDEX for the

period 2000 to 2019. Finally, 68 studies met the inclusion criteria, 60 of which

are discussed in this concept analysis. This concept analysis uses the method

described by Walker and Avant. This concept analysis clarifies the definition of

professional identity, using literature from health and related professions, as

containing the attributes: skills and functions; knowledge values and ethics;

personal identity; group identity; and the influence of the context of care. A

more clear definition of professional identity will help researchers to have more

precision in their analyses and provide mentors and educators with a clear goal.

K E YWORD S

concept analysis, health professions, nursing, occupational therapy, pharmacy, physicians,

professional identity, professional socialization, professionalism, social work

1 | INTRODUCTION

The term professional identity is often used in the literature without

a clear definition or with conflicting definitions. This can lead to

misunderstandings and assumptions that complicate research and

confuse educators and professionals in guiding novice members.

Researchers and scholars even use different terms to have the

same meaning, including professionalism (National League for

Nurses [NLN])1; professional self‐concept2; and professional

socialization,3,4 which defines the process rather than the concept

itself. A common understanding of this concept will aid in

recognizing the presence or lack of professional identity and

support its continued development. The purpose of this concept

analysis is to provide a conceptual definition of professional identity

using the Walker and Avant method.

1.1 | Background

Defining what it means to be a professional has never been easy, nor

has it ever been standardized.5‐8 Several prominent researchers in

the early 2000s offered definitions of professionalism in general.

Gardner and Shulman9 discussed the mutuality between professions

and society, asserting that professions gain autonomy and prestige

from societal recognition, and in exchange, perform services to

society through their professional actions. They described six char-

acteristics of a profession as a commitment to clients and society; a

specialized body of knowledge; a specialized and unique set of skills;

the ability to make judgments with integrity in environments of un-

certainty; growing new bodies of knowledge through experience; and

a community of professionals who perform oversight and monitoring

of professional practice. Similarly, van Oeffelt et al10 offered six

elements of being a professional, some of which overlap with Gard-

ner and Shulman.9 These include providing best practice for clients

and society; acting with integrity in any environment; keeping cur-

rent with the theory of practice; critical reflection on one's own

practice; contributing to the profession and other professionals; and

interacting with other professionals. These definitions are important

as they help to describe professional identity from the perspective of

the group and as an individual within that group.

Literature defining a nursing professional used some of the same

categories and terminology. In particular, many sources described the

interplay between being defined as a nursing professional and a re-

sponsibility to society. Landmark research by Benner et al,11 Edu-

cating Nurses: A Call for Radical Transformation, used various terms to

describe the concept of professional identity including formation,

reformation, socialization, and acquisition of professional values.

They employed the term formation as a description of the develop-

ment of nursing skills and abilities, and “a way of being and acting in

practice and in the world” (Benner et al11 p166). Willits and Clarke12

asserted that modern nursing meets all the criteria of a profession,

because it has a body of knowledge, professional recognition, com-

munity recognition, a code of ethics, and a community of profes-

sionals providing oversight and monitoring the conduct of its

members.

Styles,13 a well‐known leader in nursing education, credentialing,

and international nursing, preferred to use the term profession‐

building to describe nursing's attempts to be considered a profession.

She described six attributes to be recognized as a true profession:

higher education; a distinct practice; research‐based knowledge;

autonomy and accountability; a code of ethics; and an organized

association. She denoted the ways in which regulation both reflects

and serves the attributes of a profession. She posited that the

process of self‐regulation and self‐identification is central to the

independent practice of a profession.

Manojlovich and Ketefian14 described a nursing professional

as an autonomous practitioner with a specific body of knowledge

and a code of conduct, who values her work and derives a sense of

accomplishment from it. More recently, an Australian discussion

paper describing the development of a framework for clarifying

nursing professional identity found similar attributes.12 They de-

scribed nursing professional identity as including a body of

knowledge, community recognition, group belongingness, a code of

ethics, and community oversight of conduct. As shown in these

examples, definitions of professional identity have parallels from

which a common definition can be found. Attributes that are

common to several authors are described below. These include

actions and behaviors, knowledge and skills, values, beliefs and

ethics, context and socialization, and group and personal identity.

2 | PURPOSE

The purpose of this concept analysis of professional identity was to

clarify a term that is often used without an explicit definition, or at

other times used with conflicting description. This inconsistent use of

the concept makes it unclear and at times unserviceable. Adding

clarity to this sometimes‐vague concept promotes mutual under-

standing and adds precision to the concept.

3 | METHODS

The Walker and Avant Method15 was employed to understand the

concept of professional identity. This method involves the following

eight steps: (a) select a concept; (b) determine the aims or purposes

of analysis; (c) identify all uses of the concept as possible; (d) de-

termine the defining attributes; (e) identify a model case; (f) identify

borderline, related, contrary, invented, and illegitimate cases;

(g) identify antecedents and consequences; and (h) define empirical

referents (p170).

3.1 | Data collection

3.1.1 | Search methods

A literature search was performed in EBSCOhost using the data-

bases CINAHL, Academic Search Complete, PsyINFO, and So-

cINDEX. These databases were chosen for their focus on medical

and social science professions. In addition, PubMed and Google

Scholar searches were completed separately. The search terms

used were professional identity OR nursing professional identity OR

nursing professionalism OR professional identity in nursing, using the

Boolean logic and truncation to create the terms nurs* and pro-

fessional*. Emphasis was given to nursing terminology to ensure all

potential nursing‐related sources were found. Limiters included

research published between 2000 and 2019, English language

only, journals, academic journals, and books. Editorials and com-

mentary, dissertations, and textbooks were excluded from con-

sideration. The reference lists of salient articles were also

screened for the inclusion of publications not found in the original

search.

The EBSCOhost search provided the most literature used in this

concept analysis, specifically literature on nursing professional iden-

tity. After the initial broad search as described above, further

searches were conducted using more limited phrases and truncated

terms, for example, profession*, and nurs*, and the term definition.

This helped us to find articles that included a definition of the term

but were not identified initially. In PubMed, each term was searched

separately, again using truncation. This search revealed articles al-

ready found in EBSCOhost, but also provided more articles related

to medical and interprofessional practice. Lastly, a Google Scholar

search was conducted using the original four search terms listed in

the preceding paragraph. This database provided the fewest unique

articles. Noncommercial sources, or gray literature, were not in-

cluded in the search (see Table 1 for article search and exclusion

process).

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s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

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3.1.2 | Search outcome

The first search resulted in 737 citations, including research from all

professions. After screening by title, all duplicates were removed, as

were articles that did not focus on the definition or the work of the

entitled profession. In addition, articles focusing on law, teaching, and

counseling were removed to create a focus on health‐related fields. This

left 339 articles for further assessment. These 339 sources were

screened by abstract, again eliminating articles that did not provide a

definition of professional identity or a related concept. This left 203 ar-

ticles that were read or scanned for content. Based on this reading,

articles were eliminated that did not provide a definition of professional

identity, and the professions were further limited to nursing, medicine,

social work, occupational therapy, pharmacy, allied health, and pro-

fessionalism in general, leaving 68 sources that included a clear defini-

tion of the concept of professional identity. Other sources regarding

professional identity exist, looking at professional formation, activities for

its development, and other related topics, but were not included here,

as this concept analysis focuses on clarifying a definition of professional

identity. The research works included in this analysis were conducted in

the United States (15); Australia (13); the United Kingdom (10); Iran (7);

Canada (5); Israel (3); Norway (3); The Netherlands (3); Brazil (2); and

one each from China, India, Japan, New Zealand, Spain, Switzerland, and

Turkey. Of the 68 publications, 42 discussed nursing, 14 involved

physicians/medicine, 5 were about social workers, 2 about occupational

therapy, 1 about pharmacists, and 3 about health professions in general.

The remaining three discussed professions and professional identity in

general (this number adds up to 70 because two articles discussed

nursing and medicine). Of the 68 sources, 60 are discussed in this

concept analysis (see Table 2 for details on the included research).

4 | DEFINITIONS

According to the Merriam‐Webster's online dictionary (https://www.

merriam‐webster.com/dictionary/professional?utm_campaign=sd&

utm_medium=serp&utm_source=jsonld),18 the word “professional”

has four meanings in current usage: (a) “participating for gain or

livelihood in an activity or field of endeavor often engaged in by

amateurs”; (b) “of, relating to, or characteristic of a profession”; (c)

“following a line of conduct as though it were a profession”; and (d)

“one that is professional, especially one that engages in pursuit or

activity professionally.” It is these last three definitions that relate to

what research describes as the concept of professional identity.

In the literature, these definitions give meaning to the concept of

professional identity by clearly describing what a professional is.

Having the characteristic of a profession is a broad definition,

encompassing both the actions of a profession and the way in which

it is done. As such, most every definition in this analysis falls under

this definition. One who has conduct is as if in a profession again

refers to what one does and how one comports. The final definition

describes one who is or acts as a professional, which forms the basis

for individual and group identification as a professional.

5 | ATTRIBUTES

5.1 | Actions and behaviors

Many studies defined professional identity based on what profes-

sionals do; the behaviors and activities of the profession. The

stronger the identification with the behaviors and activities,

TABLE 1 Article search and exclusion process

3rd exclusion (by reading): ar�cles that did not provide clear defini�on; limited professions to nursing, medicine, social

work, occupa�onal therapy, pharmacy, allied health, and professionalism. Also included ar�cles found in references. (N = 68)

2nd exclusion (by abstract): ar�cles that did not provide defini�on (N = 203)

1st exclusion (by �tle): duplicates; ar�cles not focused on defini�on; excluded law, teaching, counseling (N = 339)

Ar�cles iden�fied in the consulted databases (N = 737)

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iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

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T A B L E

2 D et ai ls

o n id en

ti fi ed

re se ar ch

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

A d am

s, H ea

n ,S

tu rg is ,&

C la rk

In ve

st ig at in g th e fa ct o rs

in fl u en

ci n g P I o f fi rs t‐ ye

ar

h ea

lt h an

d so ci al

ca re

st u d en

ts

2 0 0 6

A lli ed

H ea

lt h

U K

Q u al it at iv e St u d y:

Q u es ti o n n ai re

o f st u d en

ts b eg

in n in g a

va ri et y o f h ea

lt h p ro fe ss io n s

u si n g 4 to o ls .S

am p le

si ze

– 1 2 5 4 (8 8 %

o f to ta l st u d en

ts )

A n al ys is : O rd in ar y Le

as t

Sq u ar es

(O LS

) re gr es si o n

m o d el .

‐‐D if fe re n ce s in

th e st re n gt h o f P I

ac ro ss

p ro fe ss io n s. ‐‐

Si gn

if ic an

t

va ri ab

le s:

ge n d er ; p ro fe ss io n ;

p re vi o u s w o rk

ex p er ie n ce

in

h ea

lt h ; u n d er st an

d in g o f te am

w o rk in g;

kn o w le d ge

o f

p ro fe ss io n ; an

d co

gn it iv e

fl ex

ib ili ty .

“A tt it u d es ,v

al u es ,k

n o w le d ge

,

b el ie fs

an d sk ill s th at

ar e

sh ar ed

w it h o th er s w it h in

a

p ro fe ss io n al

gr o u p ” (p 5 6 ).

A kh

ta r‐ D an

es h ,

B au

m an

n ,K

o lo ty lo ,

La w lo r, T o m p ki n s,

& Le

e

P er ce p ti o n s o f p ro fe ss io n al is m

am o n g n u rs in g fa cu

lt y an

d

n u rs in g st u d en

ts .

2 0 1 3

N u rs in g

C an

ad a

Q u al it at iv e St u d y:

Q ‐m

et h o d o lo gy

to id en

ti fy

co m m o n

vi ew

p o in ts

ab o u t

p ro fe ss io n al is m .2

4 n u rs in g

fa cu

lt y an

d 3 0 n u rs in g

st u d en

ts .A

n al ys is : Q ‐s o rt

an al yz ed

u si n g th e P Q

M et h o d

2 .1 1 te st ‐r et es t re lia

b ili ty .

C o n te n t va

lid it y as se ss ed

b y a

te am

o f d o m ai n ex

p er ts .

‐‐ F o u r vi ew

p o in ts :

1 . H u m an

is ts

2 . P o rt ra ye

rs

3 . F ac ili ta to rs

4 . R eg

u la to rs ‐‐

Se ve

n co

n se n su s

st at em

en ts

‐‐ M aj o r th em

es

in cl u d ed

co m m u n ic at io n ,

p er so n al

ap p ea

ra n ce ,

p ro fe ss io n al

co d es ,o

n go

in g

ed u ca ti o n ,i n te rd is ci p lin

ar y

co lla

b o ra ti o n , ab

ili ty

to ad

ap t,

le ad

er sh ip , ac co

u n ta b ili ty ,

ca ri n g,

an d p ro fe ss io n al

va lu es .

N o co

n se n su s ab

o u t th e

m ea

n in g o r d ef in it io n o f

p ro fe ss io n al is m ; G en

er al ly

re co

gn iz ed

d es cr ip to rs

o r

ch ar ac te ri st ic s, in cl u d in g

kn o w le d ge

, sp ec ia liz at io n ,

in te lle

ct u al

an d in d iv id u al

re sp o n si b ili ty ,a

n d w el l‐

d ev

el o p ed

gr o u p

co n sc io u sn es s.

B en

n er ,S

u tp h en

,

Le o n ar d ,&

D ay

E d u ca ti n g n u rs es : A

ca ll fo r

ra d ic al

tr an

sf o rm

at io n

2 0 1 0

N u rs in g

U S

B o o k:

O n e in

a se ri es

o f st u d ie s

kn o w n as

th e P re p ar at io n fo r

th e P ro fe ss io n s P ro gr am

fo r

th e A d va

n ce m en

t o f T ea

ch in g,

fu n d ed

b y th e C ar n eg

ie

F o u n d at io n N at io n al

N u rs in g

E d u ca ti o n St u d y.

B as ed

o n

d ir ec t o b se rv at io n o f

cl as sr o o m

an d cl in ic al

te ac h in g at

n in e en

tr y‐ le ve

l

n u rs in g p ro gr am

s, in te rv ie w s,

o b se rv at io n s, an

d n at io n al

su rv ey

s o f fa cu

lt y an

d

st u d en

ts .

‐‐ N u rs es

ar e u n d er ed

u ca te d fo r th e

d em

an d s o f p ra ct ic e;

p ra ct ic e‐

ed u ca ti o n ga

p .‐ ‐U

.S .n

u rs in g

p ro gr am

s ar e ve

ry ef fe ct iv e in

fo rm

in g P I an

d et h ic al

co m p o rt m en

t. ‐‐C

lin ic al

p ra ct ic e

as si gn

m en

ts p ro vi d e p o w er fu l

le ar n in g ex

p er ie n ce s, es p ec ia lly

in w h en

in te gr at ed

w it h

cl as sr o o m

te ac h in g.

‐‐U .S .

n u rs in g p ro gr am

s ar e n o t

ef fe ct iv e in

te ac h in g n u rs in g

sc ie n ce ,n

at u ra l sc ie n ce s, so ci al

sc ie n ce s, te ch

n o lo gy

,a n d th e

h u m an

it ie s.

T h e te rm

fo rm

at io n as

a

d es cr ip ti o n o f th e

d ev

el o p m en

t o f n u rs in g

sk ill s an

d ab

ili ti es ,a

n d “a

w ay

o f b ei n g an

d ac ti n g in

p ra ct ic e an

d in

th e

w o rl d ” (p 1 6 6 ).

B es t &

W ill ia m s

P I in

in te rp ro fe ss io n al

te am

s:

F in d in gs

fr o m

a sc o p in g

re vi ew

2 0 1 9

N u rs in g

A u st ra lia

Sc o p in g re vi ew

: 1 6 p ap

er s

an al yz ed

(c u lle

d fr o m

4 8 2

‐‐ C re at in g a P I is a so ci al

ac ti vi ty .‐ ‐

C h al le n ge

s in cl u d ed

co n fl ic t

fr o m

a la ck

o f re co

gn it io n ,

O n e' s p ro fe ss io n al

se lf ‐

p er ce p ti o n .

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ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

p ap

er s) .P

I an

d le ad

er sh ip

an d

m an

ag em

en t.

d iv er si ty ,o

r fa u lt lin

es .‐ ‐S

tr o n g

le ad

er sh ip

is im

p o rt an

t an

d

th er e is

a n ee

d to

ac ti ve

ly

m an

ag e th e in te gr at io n o f

d if fe re n t p ro fe ss io n al s.

B in ya

m in

G ro w in g fr o m

d ile

m m as :

D ev

el o p in g a P I th ro u gh

co lla

b o ra ti ve

re fl ec ti o n s o n

re la ti o n al

d ile

m m as .

2 0 1 8

O cc u p at io n al

T h er ap

y

Is ra el

Q u al it at iv e St u d y:

C o lla

b o ra ti ve

re fl ec ti o n (r ef le ct iv e w ri ti n g,

sh ar in g,

an d d is cu

ss io n ). D at a

co lle

ct ed

fr o m

1 2 gr o u p s, o ve

r

6 ye

ar s. 3 9 2 ca se s an

d 1 9 6

p er so n al

re fl ec ti o n s as

p ar t o f

u n d er gr ad

u at e cl as sw

o rk .

A n al ys is : B as ed

o n n ar ra ti ve

in q u ir y,

u si n g th em

at ic

an al ys is .

F o u n d si x o ve

ra rc h in g re la ti o n al

d ile

m m as

fo r n o vi ce

O T s:

Se tt in g b o u n d ar ie s fo r p at ie n ts ;

co p in g w it h p at ie n t re si st an

ce ;

h an

d lin

g p h ys ic al

av er si o n ;

d ef in it io n o f th e th er ap

is t' s ro le ;

w h et h er

o r n o t to

in cl u d e th e

fa m ily

; co

lla b o ra ti o n o r

d if fe re n ti at io n w it h o th er

h ea

lt h

th er ap

is ts .

U se s Ib ar ra 's (1 9 9 9 ) d ef in it io n :

th e co

n st el la ti o n o f

at tr ib u te s, b el ie fs ,v

al u es ,

m o ti ve

s, an

d ex

p er ie n ce s

th ro u gh

w h ic h p eo

p le

d ef in e th em

se lv es

in a

p ro fe ss io n al

ro le .

B o ch

at ay

In d iv id u al

an d co

lle ct iv e

st ra te gi es

in n u rs es ’s tr u gg

le

fo r P I

2 0 1 8

N u rs in g

Sw it ze r‐

la n d

E th n o gr ap

h ic

st u d y:

C o n st ru ct iv is t gr o u n d ed

th eo

ry ap

p ro ac h .T

w o n u rs in g

te am

s in

Sw is s te ac h in g

h o sp it al .F

ie ld

o b se rv at io n s

w it h fi el d n o te s an

d

se m is tr u ct u re d in te rv ie w s.

A n al ys is : R ef in ed

th e

id en

ti fi ed

th em

es in

an

it er at iv e fa sh io n .U

se d A tl as .t i

1 .6

fo r co

d in g.

‐‐ F o u n d an

ad ap

ta ti o n o f P I fr o m

an

in d iv id u al

to a co

lle ct iv e

vi ew

p o in t: in d iv id u al ly ,n

u rs es

fo rm

ed th ei r P I th ro u gh

re co

gn it io n fr o m

o th er

n u rs es .‐ ‐

C o lle

ct iv el y,

n u rs es

st re ss ed

th ei r sp ec if ic it y an

d th ei r w o rk ,

w h ic h se t th em

ap ar t fr o m

o th er

h ea

lt h ca re

p ro fe ss io n al s.

In d iv id u al s’ ef fo rt s to

m ak

e

th ei r w o rk

m ea

n in gf u l to

th em

se lv es , th e

p ro fe ss io n al

va lu es

th at

d if fe re n ti at e th em

fr o m

o th er

gr o u p s.

B ro w n e,

W al l, B at t, &

B en

n et t

U n d er st an

d in g p er ce p ti o n s o f

n u rs in g P I in

st u d en

ts

en te ri n g an

A u st ra lia

n

u n d er gr ad

u at e n u rs in g

d eg

re e

2 0 1 8

N u rs in g

A u st ra lia

Q u al it at iv e St u d y:

U se d d ra w in g

an d m in d m ap

p in g ex

er ci se s.

A n al ys is : T h em

at ic

an al ys is

an d gr o u p in g.

U se d a m o d if ie d

ve rs io n o f R o se 's cr it ic al

vi su al

m et h o d o lo gy

fr am

ew o rk

(2 0 0 1 ) as

p ro p o se d b y

G u ill em

in (2 0 0 4 ).

F o u r ke

y th em

es w er e id en

ti fi ed

: to

b e a n u rs e,

I h av

e to

lo o k th e

p ar t; to

b e a n u rs e,

I h av

e to

p er fo rm

in a va

ri et y o f ro le s;

to

b e a n u rs e,

I h av

e to

co n n ec t

w it h o th er s;

an d to

b e a n u rs e,

I

h av

e to

ca re

fo r m ys el f.

A p er so n 's p er ce p ti o n o f

th em

se lv es

w it h in

a

p ro fe ss io n o r th e co

lle ct iv e

id en

ti ty

o f th e p ro fe ss io n .

B u rf o rd ,M

o rr o w ,

R o th w el l, C ar te r, &

Il lin

g

P ro fe ss io n al is m

ed u ca ti o n

sh o u ld

re fl ec t re al it y:

F in d in gs

fr o m

th re e h ea

lt h

p ro fe ss io n s

2 0 1 4

M ed

ic in e

U K

Q u al it at iv e R es ea

rc h : T w en

ty

fo cu

s gr o u p s w it h 1 1 2

st u d en

ts an

d ed

u ca to rs

fr o m

p ar am

ed ic s, o cc u p at io n al

th er ap

y, an

d p o d ia tr y.

‐‐ In te rp er so n al ly , p ro fe ss io n al

b eh

av io r n o t d ef in ed

b y w h at

is

d o n e,

b u t b y th e ab

ili ty

to se le ct

w h at

to d o .‐ ‐S o ci al ly ,

p ro fe ss io n al

m o d el s gi ve

T h re e el em

en ts

o f P I: ‐‐

In d iv id u al : b el ie fs

o r

fu n d am

en ta lv

al u es

fo rm

ed

ea rl y.

‐‐I n te rp er so n al :

d ep

en d en

t o n co

n te xt u al

(C o n ti n u es )

FITZGERALD | 451

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nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

A n al ys is : F ra m ew

o rk

an al ys is .

T h en

,a ll tr an

sc ri p ts

w er e

co d ed

u si n g N V iv o ve

rs io n 9 .

d ef in it io n to

w h at

is a

p ro fe ss io n al

ev en

b ef o re

th e

p er so n jo in s th e gr o u p‐ ‐P

I

d ev

el o p m en

t is

sh ap

ed b y

ed u ca ti o n ,e

xp er ie n ce

an d

p ro fe ss io n al

d ev

el o p m en

t, an

d is

re lia

n t o n co

n te xt .

fa ct o rs .‐ ‐S o ci et al /

In st it u ti o n al : r/ t

co m m u n it y ex

p ec ta ti o n s,

to o rg an

iz at io n al

cu lt u re s

(i n cl u d in g m an

ag em

en t

su p p o rt ), an

d to

lo ca lw

o rk ‐

gr o u p n o rm

s.

B u rf o rd ,&

R o se n th al ‐

St o tt

St er eo

ty p in g an

d th e

d ev

el o p m en

t o f cl in ic ia n s’

p ro fe ss io n al

id en

ti ti es

2 0 1 7

M ed

ic in e

U K

B o o k ch

ap te r:

Lo o ks

at : 1 ,P

I as

so ci al

id en

ti ty . 2 ,T

h e ro le

o f

st er eo

ty p es

in P I

d ev

el o p m en

t. 3 ,I n te rg ro u p

re la ti o n s an

d co

n fl ic t. 4 ,H

o w

th es e th re e p o in ts

af fe ct

m ed

ic al

ed u ca ti o n .

‐‐ P I is an

in d iv id u al 's se lf ‐c o n ce p t in

te rm

s o f m em

b er sh ip

in a

p ro fe ss io n al

gr o u p .‐ ‐

St er eo

ty p es

ca n af fe ct

b eh

av io r

so th at

in d iv id u al s b eh

av e in

lin e

w it h st er eo

ty p es .‐ ‐In

te rg ro u p

re la ti o n s an

d co

n fl ic t af fe ct

P I

d ev

el o p m en

t th ro u gh

b ia s,

st at u s, an

d id en

ti fi ca ti o n o f se lf

an d o th er s as

su p er io r o r

su b o rd in at e. ‐‐S

o ci al id en

ti ty

an d

st er eo

ty p in g ar e m ea

n s o f

tr an

sm it ti n g an

d es ta b lis h in g

gr o u p n o rm

s.

A ty p e o f so ci al

id en

ti ty ; an

in d iv id u al 's

se lf ‐c o n ce p t

d ef in ed

in te rm

s o f h is

o r

h er

m em

b er sh ip

o f a

p ro fe ss io n al

gr o u p .

C la rk so n &

T h o m p so n

‘S o m et im

es I d o n 't fe el

lik e an

o st eo

p at h at

al l’‐

a

q u al it at iv e st u d y o f fi n al

ye ar

o st eo

p at h y st u d en

ts '

p ro fe ss io n al

id en

ti ti es

2 0 1 7

M ed

ic in e

U K

Q u al it at iv e re se ar ch

:

C o n st ru ct iv is t gr o u n d ed

th eo

ry .S

em is tr u ct u re d

in te rv ie w s w it h ei gh

t fi n al ‐

ye ar

o st eo

p at h y st u d en

ts .

A n al ys is : C o n cu

rr en

t d at a

co lle

ct io n an

d an

al ys is .

F o cu

se d co

d in g to

d ef in e fi ve

ca te go

ri es .

F iv e m ai n ca te go

ri es

to d es cr ib e P I:

ap p ro ac h to

p t. ca re ; vi ew

o f

o st eo

p at h y;

le ar n in g ex

p er ie n ce ;

vi ew

o f p ra ct ic al

sk ill s;

P I

d ev

el o p m en

t co

n ti n u u m .

T h e co

n st ru ct io n o f a p er so n 's

ex p er ie n ce ,q

u al it ie s,

b el ie fs ,a

n d va

lu es

th at

d ef in e th ei r

p ro fe ss io n al

ro le .

C o o k,

G ilm

er ,&

B es s

B eg

in n in g st u d en

ts ’ d ef in it io n s

o f n u rs in g:

A n in d u ct iv e

fr am

ew o rk

o f P I

2 0 0 3

N u rs in g

U S

Q u al it at iv e St u d y:

B eg

in n in g

n u rs in g st u d en

ts ’ d ef in it io n s

o f n u rs in g.

1 0 9 p ar ti ci p an

ts .

A n al ys is : Q u al it at iv e

d es cr ip ti ve

ap p ro ac h .

N o n n u m er ic al ; U n st ru ct u re d

D at a;

In d ex

in g,

Se ar ch

in g,

&

T h eo

ri zi n g (N

U D *I ST

N 4

C la ss ic ) (1 9 9 7 ) co

m p u te r

T h re e m aj o r th em

es o f p er so n al

d ef in it io n s: ‐‐ N u rs in g as

a: ve rb

‐‐ ca ri n g,

n u rt u ri n g,

te ac h in g,

im p le m en

ti n g,

as se ss in g/

an al yz in g,

ad vo

ca ti n g,

an d

m an

ag in g;

‐‐ N u rs in g as

a no

un –

p ro fe ss io n ,h

o lis ti c sy st em

,

co n n ec ti n g,

sy st em

,d el iv er y

sy st em

,a n d d is ci p lin

e; ‐‐

N u rs in g

as a tr an

sa ct io n ‐‐

p ro m o ti o n o f

P er so n al

id en

ti ty

as a

fr am

ew o rk

fo r P I. P I in

n u rs in g is th e d ev

el o p m en

t

w it h in

n u rs es

o f an

in te rn al

re p re se n ta ti o n o f p eo

p le ‐

en vi ro n m en

t in te ra ct io n s

in th e ex

p lo ra ti o n o f

h u m an

re sp o n se s to

ac tu al

o r p o te n ti al

h ea

lt h

p ro b le m s.

452 | FITZGERALD

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nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

p ro gr am

.L in co

ln &

G u b a

(1 9 8 5 ) m et h o d .

h ea

lt h ,t re at m en

t o f ill n es s,

p re ve

n ti o n o f ill n es s, an

d

p ro m o ti o n o f se lf ‐c ar e.

C o st a F er n an

d es ,S

al es

d a Si lv a,

R o ci n ei d e

F er re ir a d a Si lv a,

M ar ti n s T o rr es ,d

e

A ra u jo

D ia s, &

M ag

al h âe

s M o re ir a

Id en

ti ty

o f p ri m ar y h ea

lt h ca re

n u rs es : P er ce p ti o n o f “d o in g

ev er yt h in g. ”

2 0 1 8

N u rs in g

B ra zi l

Q u al it at iv e R es ea

rc h :

Se m is tr u ct u re d in te rv ie w s

w it h 4 8 p ri m ar y h ea

lt h ca re

n u rs es

fr o m

B ra zi l. A n al ys is :

D is co

u rs e an

al ys is

(O rl an

d i, 2 0 1 3 ).

‐‐ N u rs es

as so ci at e th ei r P I w it h th e

m ea

n in g o f th e w o rd

“e ve

ry th in g”

(t h ey

h av

e to

d o

ev er yt h in g;

in d o in g ev

er yt h in g

th ey

d o n o t h av

e a d is ti n ct

id en

ti fi ca ti o n ).

P I is

as so ci at ed

w it h th e

co n te xt

in w h ic h o n e

p er fo rm

s sp ec if ic

ac ti vi ti es ,

to w h o m

th es e ac ti o n s ar e

d ir ec te d ,a

n d w h at

re su lt s

fr o m

th es e ac ti vi ti es .

C ri gg

er &

G o d fr ey

F ro m

th e in si d e o u t: A

n ew

ap p ro ac h to

te ac h in g P I

fo rm

at io n an

d p ro fe ss io n al

et h ic s

2 0 1 4

N u rs in g

U S

D is cu

ss io n P ap

er : T o in tr o d u ce

th e F ra m ew

o rk

fo r N u rs e

P ro fe ss io n al s (F rN

P ) an

d th e

St ai r‐ St ep

M o d el

o f

P ro fe ss io n al

T ra n sf o rm

at io n .

‐‐ T h e F rN

P co

m b in es

th e th re e

m ai n et h ic al

tr ad

it io n s:

p ri n ci p le d et h ic s (r u le s) ,

u ti lit ar ia n et h ic s (o u tc o m es ) an

d

vi rt u e et h ic s (s it u at ed

). ‐‐

T h e

St ai r‐ St ep

M o d el

o f P ro fe ss io n al

T ra n sf o rm

at io n d es cr ib es

a

p ro ce ss

o f P I d ev

el o p m en

t an

d

h o w

F rN

P p ra ct ic e d ec is io n s ar e

n es te d w it h in

th es e va

ry in g

le ve

ls o f P I fo rm

at io n .

B ei n g a m em

b er

o f a

p ro fe ss io n w it h

re sp o n si b ili ti es

to so ci et y,

p at ie n ts ,o

th er

p ro fe ss io n s,

an d o n es el f. T w o

p ar ad

ig m s:

So ci al

‐‐t h e

in fl u en

ce o f so ci al

ex p ec ta ti o n s ex

p re ss ed

as

n u rs in g re gu

la ti o n s,

st an

d ar d s, an

d

in te rv en

ti o n s;

P sy ch ol og ic al

‐‐ in te rn al iz in g vi rt u es

o f

th e p ro fe ss io n ,s u ch

as

co u ra ge

, in te gr it y,

an d

co m p as si o n .

C ru es s, C ru es s,

B o u d re au

,S n el l, &

St ei n er t

R ef ra m in g m ed

ic al

ed u ca ti o n to

su p p o rt

P I fo rm

at io n

2 0 1 4

M ed

ic in e

C an

ad a

D is cu

ss io n P ap

er : A u th o rs

p ro p o se

th at

a p ri n ci p le

go al

o f m ed

ic al

ed u ca ti o n b e th e

d ev

el o p m en

t o f a P I.

W ay

s to

fo cu

s o n P I fo rm

at io n

(m ak

in g it in te n ti o n al ly

ta u gh

t,

n o t le ft

to ch

an ce )

A p ro ce ss

in w h ic h a

d ev

el o p in g p h ys ic ia n

in te rn al iz es

th e

ch ar ac te ri st ic s, va

lu es ,a

n d

n o rm

s o f th e p ro fe ss io n ,

an d as

a re su lt b eg

in s to

th in k,

fe el ,a

n d ac t as

a

p h ys ic ia n .

C ru es s, C ru es s, &

St ei n

Su p p o rt in g th e d ev

el o p m en

t o f

P I: G en

er al

p ri n ci p le s

2 0 1 6

M ed

ic in e

C an

ad a

D is cu

ss io n P ap

er : D es cr ib es

p ed

ag o gi ca l m et h o d s to

te ac h

P I fo rm

at io n .

Se le ct

C u rr ic u la r m et h o d s:

‐‐ E st ab

lis h P I as

an ed

u ca ti o n al

o b je ct iv e. ‐‐

C o m m u n it ie s o f

p ra ct ic e‐ ‐F

ac u lt y d ev

el o p m en

t‐ ‐

E n ga

ge st u d en

ts ‐‐

Sh ar e

re sp o n si b ili ty ‐‐ C re at e a

w el co

m in g co

m m u n it y‐ ‐

A p ro ce ss

in w h ic h a

d ev

el o p in g p h ys ic ia n

in te rn al iz es

th e

ch ar ac te ri st ic s, va

lu es ,a

n d

n o rm

s o f th e p ro fe ss io n ,

an d as

a re su lt b eg

in s to

(C o n ti n u es )

FITZGERALD | 453

17446198, 2020, 3, D ow

nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

E xp

lic it ly

ad d re ss

kn o w n fa ct o rs

fo r th e d ev

el o p m en

t o f P I

th in k,

fe el ,a

n d ac t as

a

p h ys ic ia n .

D ah

l &

C la n cy

M ea

n in gs

o f kn

o w le d ge

an d

id en

ti ty

in p u b lic

h ea

lt h

n u rs in g in

a ti m e o f

tr an

si ti o n :I n te rp re ta ti o n s o f

p u b lic

h ea

lt h n u rs es ’

n ar ra ti ve

s.

2 0 1 5

N u rs in g

N o rw

ay Q u al it at iv e R es ea

rc h : In te rv ie w s

w it h 2 3 N o rw

eg ia n p u b lic

h ea

lt h n u rs es

to d ef in e p u b lic

h ea

lt h n u rs in g kn

o w le d ge

an d

P I. A n al ys is :

P h en

o m en

o lo gi ca l

h er m en

eu ti cs .

T h re e th em

es em

er ge

d : ‐‐ B ei n g a

ge n er al is t: “k n o w in g a lit tl e

ab o u t a lo t” ; an

d u si n g cl in ic al

ju d gm

en t. ‐‐

B ei n g o n e w h o

em p o w er s:

fo cu

si n g o n

re so u rc es

an d co

p in g st ra te gi es ;

an d ‐‐

B ei n g o cc u p ie d w it h

in d iv id u al

p ro b le m

so lv in g.

W h en

ex p er ie n ce s in

n u rs es ’

w o rk

o ve

rl ap

w it h th e

ex p er ie n ce s o f o th er s, a

co m m o n P I is

fo rm

ed .P

I is

re la te d to

th e

ch ar ac te ri st ic s o f a

p ro fe ss io n al

gr o u p th at

d is ti n gu

is h es

it fr o m

o th er s

re ga

rd le ss

o f co

n te xt .

D ik m en

,K ar at aş ,A

rs la n ,

& A k

T h e le ve

l o f p ro fe ss io n al is m

o f

n u rs es

w o rk in g in

a h o sp it al

in T u rk ey

2 0 1 6

N u rs in g

T u rk ey

D es cr ip ti ve

E xp

lo ra to ry

St u d y:

8 9 n u rs es

in p u b lic

h o sp it al s in

T u rk ey

.B eh

av io ra l In ve

n to ry

F o rm

fo r P ro fe ss io n al is m

in

N u rs in g (B IP N ). A n al ys is : T h e

M an

n ‐W

h it n ey

U an

d th e

K ru sk al ‐W

al lis

te st s, as

n o n p ar am

et ri c te st s, u si n g

SP SS

ve rs io n 1 7 .

‐‐ F o u n d lo w

le ve

ls o f

p ro fe ss io n al is m

in th es e

n u rs es .‐‐

H ig h es t le ve

ls o f

p ro fe ss io n al

b eh

av io rs

w er e

co m p et en

ce an

d co

n ti n u in g

ed u ca ti o n .‐‐

Lo w es t w er e

au to n o m y,

p u b lic at io n ,a

n d

re se ar ch

.‐ ‐S

ta ti st ic al ly

si gn

if ic an

t d if fe re n ce

in B IP N

sc o re s fo r A D N ‐a

n d B SN

‐ p re p ar ed

n u rs es .

T h e m an

n er

o f th e w o rk

an d

th e b eh

av io rs

o f n u rs es

in

p ro vi d in g q u al it y ca re

an d

p at ie n t sa fe ty ; d ef in ed

th ro u gh

th ei r p ar ti cu

la r

b o d y o f kn

o w le d ge

,t h ei r

fo rm

al ed

u ca ti o n ,a

n d

ce rt if ic at io n .

F er re ll,

C h ri st ia n ,&

R ac h el

R eg

is te re d n u rs e ex

p er ie n ce s o f

n u rs in g P I: a q u al it at iv e

sy st em

at ic

re vi ew

p ro to co

l

2 0 1 7

N u rs in g

U S

P ro p o sa l fo r a Li te ra tu re

R ev

ie w – q u al it at iv e st u d ie s

th at

in ve

st ig at e th e

ex p er ie n ce s o f n u rs in g P I in

re gi st er ed

n u rs es

in n u rs in g

ca re

se tt in gs .

N o re su lt s av

ai la b le : p ro p o sa l o n ly .

U se s N LN

's d ef in it io n : P I

“i n vo

lv es

th e

in te rn al iz at io n o f co

re

va lu es

an d p er sp ec ti ve

s

re co

gn iz ed

as in te gr al

to

th e ar t an

d sc ie n ce

o f

n u rs in g.

T h e co

re va

lu es

b ec o m e se lf ‐e vi d en

t as

th e

n u rs e le ar n s, ga

in s

ex p er ie n ce ,a

n d gr o w s in

th e p ro fe ss io n .”

F o re n za

& E ck er t

So ci al

w o rk er

id en

ti ty : A

p ro fe ss io n in

co n te xt

2 0 1 6

So ci al

W o rk

U S

Q u al it at iv e R es ea

rc h : In d iv id u al

in te rv ie w s w it h 1 6 p ra ct ic in g

so ci al

w o rk er s. A n al ys is :

C o n te n t an

al ys is ,u

si n g N V iv o

1 0 an

d b y h an

d .

F in d in gs

fr o m

in te rv ie w s re ve

al 6

p ri m ar y th em

es an

d 2 1

su b th em

es ‐‐ D ef in in g th e

p ro fe ss io n ‐‐

Sh ar ed

p er sp ec ti ve

s‐ ‐P

u rs u it o f so ci al

w o rk ‐‐

P ra ct ic e ar ea

s‐ ‐M

ac ro

A fo rm

o f so ci al

id en

ti ty

th at

re la te s to

an in d iv id u al 's

em b o d im

en t o f gr o u p ‐

b as ed

va lu es

an d n o rm

s.

W h en

o n e em

b o d ie s th e

gr o u p ‐b as ed

va lu es

an d

454 | FITZGERALD

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nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

fo rc es ‐‐

B u ild

in g p ro fe ss io n al

ca p ac it y

n o rm

s o f a p ro fe ss io n al

co m m u n it y,

h e o r sh e is

as su m ed

to p o ss es s u n iq u e

sk ill s an

d ab

ili ti es .

F o ro u za d eh

,K ia n i, &

B az m i

P ro fe ss io n al is m

an d it s ro le

in

th e fo rm

at io n o f m ed

ic al

P I.

2 0 1 8

M ed

ic in e

Ir an

Li te ra tu re

R ev

ie w : D at ab

as es ,

su ch

as P u b M ed

, E ls ev

ie r,

G o o gl e Sc h o la r, O vi d ,S

ID ,a n d

Ir an

M ed

ex ,3

0 w er e as se ss ed

an d se le ct ed

fo r re vi ew

.

T h e fo rm

at io n o f P I is a p ro ce ss

w it h

th e fo llo

w in g d o m ai n s:

‐‐ P ro fe ss io n al is m ,‐ ‐D

ev el o p m en

t

o f a p er so n al

(p sy ch

o so ci al ) an

d

cu lt u ra l id en

ti ty .‐ ‐R

ec ip ro ca l

re la ti o n sh ip

b et w ee

n th e

fo rm

at io n o f a d es ir ab

le P I an

d

d ev

el o p m en

t an

d st re n gt h en

in g

o f p ro fe ss io n al is m .

P er m an

en tl y sh o w in g

at ti tu d es , va

lu es ,a

n d

co n d u ct s ex

p ec te d o f a

p er so n fo r th in ki n g,

ac ti n g,

an d fe el in g lik

e a d o ct o r.

A n in te gr at io n o f p er so n al

an d p ro fe ss io n al

va lu es .

C it ed

th e C ar n eg

ie

F o u n d at io n st u d y o n

ed u ca ti n g p h ys ic ia n s in

sa yi n g th at

P I is

th e sa m e

as th e d ev

el o p m en

t o f

p ro fe ss io n al

va lu es

G ar d n er

& Sh

u lm

an T h e p ro fe ss io n s in

A m er ic a

to d ay

: C ru ci al

b u t fr ag

ile .

2 0 0 5

P I

U S

In tr o d u ct io n to

a jo u rn al

d ed

ic at ed

to th e p ro fe ss io n s.

‐‐ G en

er ic al ly ,p

ro fe ss io n s co

n si st

o f

in d iv id u al s w h o ar e gi ve

n a

ce rt ai n am

o u n t o f p re st ig e an

d

au to n o m y in

re tu rn

fo r

p er fo rm

in g fo r so ci et y a se t o f

se rv ic es

in a d is in te re st ed

w ay

.‐‐ M o st

w o u ld

co n si d er

n u rs es ,

so ci al

w o rk er s, an

d te ac h er s as

m em

b er s o f cr it ic al ly

im p o rt an

t,

al b ei t le ss

p re st ig io u s,

p ro fe ss io n s. T h is

is ge

n er al ly

at tr ib u te d to

th e st at u s o f th o se

w h o m

th ey

se rv e, an

d to

th e fa ct

th at

th ei r ra n ks

h av

e lo n g b ee

n

p o p u la te d p ri m ar ily

b y w o m en

.

Si x ch

ar ac te ri st ic s o f a

p ro fe ss io n : ‐‐

a

co m m it m en

t to

cl ie n ts

an d

so ci et y,

‐‐ a sp ec ia liz ed

b o d y o f kn

o w le d ge

,‐ ‐a

sp ec ia liz ed

an d u n iq u e se t

o f sk ill s, ‐‐ th e ab

ili ty

to

m ak

e ju d gm

en ts

w it h

in te gr it y in

en vi ro n m en

ts

o f u n ce rt ai n ty ,‐ ‐g

ro w in g

n ew

b o d ie s o f kn

o w le d ge

th ro u gh

ex p er ie n ce ; ‐‐

a

co m m u n it y o f

p ro fe ss io n al s w h o p er fo rm

o ve

rs ig h t an

d m o n it o ri n g

o f p ro fe ss io n al

p ra ct ic e.

G o d d ar d ,d

e V ri es ,

M cI n to sh ,&

T h eo

d o si u s

P ri so n n u rs es ’ P I

2 0 1 9

N u rs in g

U K

Li te ra tu re

R ev

ie w : P ri so n

n u rs in g.

A n al ys is : N o an

al ys is

p ro ce d u re

d is cu

ss ed

.

B ro ad

th em

es :‐‐

Im ag

e, ro le ,c u lt u re ,

an d ed

u ca ti o n h av

e a d ir ec t

im p ac t o n th e d ev

el o p m en

t o f

P I.‐ ‐R

es ili en

ce an

d b u rn o u t ar e

im p ac te d b y a st ro n g P I o r it s

la ck .‐ ‐T

h e P Io

f p ri so n n u rs in g is

p o o rl y d ef in ed

w it h n o cl ea

r

U se s N ea

ry 's (2 0 1 4 ) d ef in it io n :

“P I is

th e co

n ce p t w h ic h

d es cr ib es

h o w

w e p er ce iv e

o u rs el ve

s w it h in

o u r

o cc u p at io n al

co n te xt

an d

h o w

w e co

m m u n ic at e th is

to o th er s”

(p 1 4 ). (C

o n ti n u es )

FITZGERALD | 455

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nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

ex p re ss io n o f th e ro le

w it h in

th e

n u rs in g p ro fe ss io n o r to

o th er

d is ci p lin

es .

G o ld ie

T h e fo rm

at io n o f P I in

m ed

ic al

st u d en

ts :C

o n si d er at io n s fo r

ed u ca to rs

2 0 1 2

M ed

ic in e

U K

D is cu

ss io n P ap

er : T h e p ro ce ss es

u n d er ly in g th e fo rm

at io n an

d

m ai n te n an

ce o f m ed

ic al

st u d en

ts ’ P I d ra w in g o n

co n ce p ts

fr o m

so ci al

p sy ch

o lo gy

.

‐‐ Id en

ti ty

fo rm

at io n is m ai n ly

so ci al

an d re la ti o n al

in n at u re .‐ ‐

E d u ca to rs ,a

n d th e w id er

m ed

ic al

so ci et y,

n ee

d to

m ax

im iz e o p p o rt u n it ie s in

re la ti o n al

se tt in gs .‐ ‐H

el p in g

st u d en

ts fo rm

,a n d su cc es sf u lly

in te gr at e th ei r p ro fe ss io n al

se lv es

is a fu n d am

en ta l o f

m ed

ic al

ed u ca ti o n .‐‐

St u d en

ts ’ P I

fo rm

at io n is

in fl u en

ce d m o re

b y

th e in fo rm

al an

d h id d en

cu rr ic u la

th an

fo rm

al te ac h in g

ex p er ie n ce s. ‐‐

R ec o m m en

d ed

:‐ in te ra ct io n w it h ap

p ro p ri at e ro le

m o d el s, ‐o

p p o rt u n it ie s to

ex p er im

en t ‐f

ee d b ac k o n

tr an

si ti o n al

id en

ti ti es .

P I is a so ci al

p ro ce ss

in n at u re .

It d ev

el o p s in

in te ra ct io n al

re la ti o n sh ip s an

d in

p ro fe ss io n al

co n te xt s in

es ta b lis h ed

co m m u n it ie s

su ch

as u n iv er si ti es ,

h o sp it al s, an

d co

m m u n it y‐

b as ed

ca re

o rg an

iz at io n s.

P ar t o f h o w

m ed

ic al

st u d en

ts d ef in e th ei r P I is

b y h o w

it co

m p ar es

w it h

an d d if fe re n ti at es

fr o m

o th er

gr o u p s;

m ed

ic al

st u d en

ts ar e in

a p ro ce ss

o f

d ef in in g n o t o n ly

w h o th ey

ar e b u t w h o th ey

ar e n o t.

G re go

ry ,&

A u st in

P h ar m ac is ts ’ la ck

o f p ro fe ss io n ‐

h o o d : P I fo rm

at io n an

d it s

im p lic at io n s fo r p ra ct ic e

2 0 1 9

P h ar m ac y

C an

ad a

Q u al it at iv e R es ea

rc h : 1 7

co m m u n it y p h ar m ac is ts

fr o m

O n ta ri o .S

em is tr u ct u re d

in te rv ie w s. A n al ys is : U se d

co n te n t an

al ys is

m et h o d s

d es cr ib ed

b y C h i, u se d b y

M ah

am ed

.

‐‐ P ar ti ci p an

ts re p o rt ed

lit tl e

re lia

n ce

o n P I‐‐ P er so n al

id en

ti ty

w as

m o re

im p o rt an

t th an

P I‐‐

La ck

o f se lf ‐c o n fi d en

ce ar o u n d

p o te n ti al

va lu e o f se lf ‐d is cl o su re

as a p h ar m ac is t‐ ‐R

el ia n ce

o n

in gr at ia ti o n an

d p er so n al

id en

ti ty

as ta ct ic s ra th er

th an

p ro fe ss io n al

kn o w le d ge

an d sk ill .

T h e p sy ch

o lo gi ca l an

d

in te rn al iz ed

se n se

o f

p ro fe ss io n h o o d .I n vo

lv es

th e es ta b lis h m en

t o f co

re

va lu es ,m

o ra l p ri n ci p le s,

se lf ‐a w ar en

es s, an

d se lf ‐

re gu

la ti o n .

H ag

h ig h at ,B

o rh an

i,

R an

jb ar ,&

N as er i

E va

lu at in g th e fo rm

at io n o f P I

in Ir an

ia n n u rs in g st u d en

ts

af te r th e im

p le m en

ta ti o n o f

a n ew

cu rr ic u lu m

2 0 1 9

N u rs in g

Ir an

D es cr ip ti ve

C ro ss ‐S ec

ti o n al

St u d y:

2 2 1 st u d en

ts in

th e la st

th re e se m es te rs

o f n u rs in g

an d m id w if er y sc h o o l.

A n al ys is : In d ep

en d en

t t te st ,

o n e‐ w ay

A N O V A ,P

ea rs o n 's

co rr el at io n ,a

n d lin

ea r

re gr es si o n .

‐‐ T h e n u rs in g ed

u ca ti o n p ro gr am

in

Ir an

fa ile

d to

ad va

n ta ge

o u sl y

sh ap

e th e P I o f n u rs in g

st u d en

ts .‐‐

N ee

d to

in cr ea

se th e

ed u ca ti o n al

co n te n t re la te d to

P I.‐ ‐I m p ro vi n g th e so ci al

st at u s

o f n u rs es

ca n h el p to

en h an

ce

th e P I o f st u d en

ts .

P ro fe ss io n al

se lf ‐p er ce p ti o n

b as ed

o n at ti tu d es ,b

el ie fs ,

fe el in gs ,v

al u es ,

m o ti va

ti o n s, an

d

ex p er ie n ce s th at

ar e

re la te d to

a sp ec if ic

p ro fe ss io n .

456 | FITZGERALD

17446198, 2020, 3, D ow

nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

H at em

& H al p in

B ec o m in g d o ct o rs : E xa

m in in g

st u d en

t n ar ra ti ve

s to

u n d er st an

d th e p ro ce ss

o f P I

fo rm

at io n w it h in

a le ar n in g

co m m u n it y

2 0 1 9

M ed

ic in e

U S

Q u al it at iv e St u d y:

A n al ys is

o f 8 6

st u d en

t re fl ec ti o n s w ri tt en

d u ri n g th e fi n al

se ss io n o f

“B ec o m in g a P h ys ic ia n ”

cu rr ic u lu m .A

n al ys is :C

o n st an

t

co m p ar at iv e m et h o d ,a

rr iv in g

at co

n se n su s o n th em

es

th ro u gh

d is cu

ss io n .

N ar ra ti ve

th em

e ca te go

ri es :‐‐

P er fo rm

in g p h ys ic ia n ta sk s ca n

m ak

e o n e fe el

lik e a d o ct o r‐ ‐

D em

o n st ra ti n g ca ri n g is

a

fu n d am

en ta l ta sk

o f d o ct o rs ,‐‐

In te gr at in g p er so n al

id ea

ls w it h

p ro fe ss io n al

va lu es

p ro m o te s P I

fo rm

at io n ‐‐

N ev

er fe el in g lik

e a

d o ct o r.

U se s C ar n eg

ie F o u n d at io n

st u d y o f m ed

ic al

ed u ca ti o n

(2 0 1 0 ) d ef in it io n : “A

re p re se n ta ti o n o f se lf ,

ac h ie ve

d in

st ag

es o ve

r

ti m e d u ri n g w h ic h th e

ch ar ac te ri st ic s, va

lu es ,a

n d

n o rm

s o f th e m ed

ic al

p ro fe ss io n ar e in te rn al iz ed

,

re su lt in g in

in d iv id u al

th in ki n g, ac ti n g, an

d fe el in g

lik e a p h ys ic ia n .”

H el d al ,K

o n gs vi k,

&

H ål an

d

A d va

n ci n g th e st at u s o f n u rs in g:

R ec o n st ru ct in g p ro fe ss io n al

n u rs in g id en

ti ty

th ro u gh

p at ie n t sa fe ty

w o rk

2 0 1 9

N u rs in g

N o rw

ay Q u al it at iv e st u d y:

T w o gr o u p

in te rv ie w s, fo u r in d iv id u al

in te rv ie w s, an

d 5 h o f

o b se rv at io n in vo

lv in g 1 0

n u rs es

an d th re e p eo

p le

fr o m

h o sp it al

m an

ag em

en t.

A n al ys is : A d ‐h o c m ea

n in g

ge n er at io n an

d w h at

K va

le

ca lls

m ea

n in g co

n d en

sa ti o n .

T h e fo llo

w in g an

al yt ic al

ca te go

ri es

w er e d ev

el o p ed

:‐‐ R ec o n st ru ct in g tr u st ,‐ ‐

R ec o n st ru ct in g w o rk , ‐‐

R ec o n st ru ct in g va

lu es ,‐‐

R ec o n st ru ct in g p ro fe ss io n al

st at u s.

U se s D ad

ic h &

D o lo sw

al a

(2 0 1 8 ) d ef in it io n :

an aw

ar en

es s o f th e ro le

an d fu n ct io n s th at

o n e

p er fo rm

s o r is

ex p ec te d to

p er fo rm

in a so ci al

co n te xt

as a m em

b er

o f a p ar ti cu

la r

p ro fe ss io n .

H er ce lin

sk yj ,

C ru ic ks h an

k, B ro w n ,

& P h ill ip s

P er ce p ti o n s fr o m

th e fr o n t lin

e:

P I in

m en

ta l h ea

lt h n u rs in g

2 0 1 4

N u rs in g

A u st ra lia

Q u al it at iv e st u d y:

N at u ra lis ti c

st u d y;

In d iv id u al

se m is tr u ct u re d in te rv ie w s

w it h 1 1 m en

ta l h ea

lt h n u rs es

(M H N ) in

A u st ra lia

.A n al ys is :

T h em

at ic

an al ys is

b y al l

au th o rs .L

in co

ln &

G u b a

m et h o d (1 9 8 5 )

T h e P I o f M H N

re m ai n s p o o rl y

d ef in ed

,r eg

ar d le ss

o f th e

co n te xt

o f p ra ct ic e.

T h e in te gr at io n o f p er so n al

va lu es ,u

n d er st an

d in g an

d

m o ti va

ti o n s (o f th e M H N s) ,

an d th e in te rn al iz at io n o f

th e kn

o w le d ge

,s ki lls ,a

n d

at ti tu d es

w h ic h d ev

el o p as

p ar t o f th e n u rs es ’

p ro fe ss io n al

so ci al iz at io n .

te n H o ev

e, Ja n se n ,&

R o o d b o l

T h e n u rs in g p ro fe ss io n : P u b lic

im ag

e, se lf ‐c o n ce p t an

d P I. A

d is cu

ss io n p ap

er

2 0 1 4

N u rs in g

N et h er ‐

la n d s

D is cu

ss io n P ap

er (w

it h Li te ra tu re

R ev

ie w ). D at ab

as es

u se d :

Se ar ch

ed M E D LI N E ,C

IN A H L,

an d P sy cI N F O

1 9 9 7 to

2 0 1 0 .

1 2 1 6 re le va

n t st u d ie s, w it h 1 8

m ee

ti n g th e in cl u si o n cr it er ia .

‐‐ N u rs es

d er iv e se lf ‐c o n ce p t an

d P I

fr o m

th ei r p u b lic

im ag

e, w o rk

en vi ro n m en

t, w o rk

va lu es ,

ed u ca ti o n ,a

n d tr ad

it io n al

so ci al

an d cu

lt u ra lv

al u es .‐‐

T o im

p ro ve

th ei r p u b lic

im ag

e an

d to

o b ta in

a st ro n ge

r p o si ti o n in

h ea

lt h ca re

o rg an

iz at io n s, n u rs es

n ee

d to

in cr ea

se th ei r vi si b ili ty .

U se s th e d ef in it io n o f

(F ag

er m o en

1 9 9 7 ): th e

va lu es

an d b el ie fs

h el d b y

n u rs es

th at

gu id e h er /h is

th in ki n g,

ac ti o n s, an

d

in te ra ct io n s w it h th e

p at ie n t.

(C o n ti n u es )

FITZGERALD | 457

17446198, 2020, 3, D ow

nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

H o ld en

,B u ck ,L

u k,

A m b ri z,

B o is au

b in ,

C la rk ,M

ih al ic ,

Sa d le r, Sa

p ir e,

Sp ik e,

V in ce ,&

D al ry m p le

P I fo rm

at io n : C re at in ga

lo n gi tu d in al

fr am

ew o rk

th ro u gh

T IM

E

(T ra n sf o rm

at io n in

M ed

ic al

E d u ca ti o n )

2 0 1 5

M ed

ic in e

U S

D is cu

ss io n P ap

er : O n th e

d ev

el o p m en

t o f th e T IM

E

p ro gr am

.D ef in in g P IF

an d

d ev

el o p in g fr am

ew o rk .

A ss es sm

en ts

w it h in

th e fr am

ew o rk

fo r: ‐‐ p ro vi d in g fe ed

b ac k to

le ar n er s; ‐‐

ev al u at in g cu

rr ic u la r

an d ex

tr ac u rr ic u la r st ra te gi es

to

p ro m o te

P I; ‐‐ ad

va n ci n g

th eo

re ti ca l d ev

el o p m en

t.

U se s d ef in it io n b y W

ils o n

et al

1 6 : T h e in te gr at io n o f

p er so n al

va lu es ,m

o ra ls ,

an d at tr ib u te s w it h th e

n o rm

s o f th e p ro fe ss io n .

Jo h n so n ,C

o w in ,W

ils o n ,

& Y o u n g

P I an

d n u rs in g: co

n te m p o ra ry

th eo

re ti ca l d ev

el o p m en

ts

an d fu tu re

re se ar ch

ch al le n ge

s

2 0 1 2

N u rs in g

A u st ra lia

D is cu

ss io n P ap

er /L it er at u re

R ev

ie w : T h eo

re ti ca l

d is cu

ss io n o n th e co

n st ru ct

o f

P I an

d fa ct o rs

th at

in fl u en

ce

P I th ro u gh

o u t a ca re er

in

n u rs in g.

‐‐ E d u ca ti o n is

a ke

y p er io d to

n u rs in g p ro fe ss io n al

d ev

el o p m en

t‐ ‐S

tu d en

ts ga

in th e

kn o w le d ge

an d sk ill s th at

se p ar at e n u rs es

as p ro fe ss io n al

h ea

lt h ca re

w o rk er s fr o m

la y

p eo

p le .

A se n se

o f se lf th at

is d er iv ed

an d p er ce iv ed

fr o m

th e

ro le

n u rs es

ta ke

o n in

th e

w o rk

th at

th ey

d o .

K al et ,B

u ck va

r‐ K el tz ,

H ar n ik ,M

o n so n ,

H u b b ar d ,C

ro w e,

R .,

… Y in gl in g

M ea

su ri n g P I fo rm

at io n ea

rl y in

m ed

ic al

sc h o o l

2 0 1 7

M ed

ic in e

U S

M ix ed

M et h o d s R es ea

rc h : 1 3 2

en te ri n g m ed

st u d en

ts .

P ro fe ss io n al

Id en

ti ty

E ss ay

(P IE ); th e D ef in in g Is su es

T es t

(D IT 2 ); re fl ec ti o n . A n al ys is :

Sp ea

rm an

's an

d P ea

rs o n 's

co rr el at io n co

ef fi ci en

t o n e‐

w ay

(A N O V A ).

T h es e P IF

sc o re s d is tr ib u te d

si m ila

rl y to

n o vi ce

st u d en

ts in

o th er

p ro fe ss io n s. St u d en

ts

re fl ec te d o n th es e m ea

su re s in

m ea

n in gf u l w ay

s su gg

es ti n g

u ti lit y o f m ea

su ri n g P IF

sc o re s in

m ed

ic al

ed u ca ti o n .

A re p re se n ta ti o n o f se lf ,

ac h ie ve

d in

st ag

es o ve

r

ti m e d u ri n g w h ic h th e

ch ar ac te ri st ic s, va

lu es ,a

n d

n o rm

s o f th e m ed

ic al

p ro fe ss io n ar e in te rn al iz ed

.

La w so n ,K

n u d so n ‐

M ar ti n ,H

er n an

d ez ,

Lo u gh

,B en

es h ,&

D o u gl as

St u d en

t h ea

lt h ca re

cl in ic ia n s’

ill n es s n ar ra ti ve

s: P I

d ev

el o p m en

t an

d re la ti o n al

p ra ct ic e

2 0 1 7

N u rs in g

M ed

ic in e

U S

Q u al it at iv e St u d y:

G ro u n d ed

th eo

ry in te rv ie w ed

1 0 n u rs in g

st u d en

ts ,1

0 m ed

ic al

st u d en

ts ,

an d 1 0 M ed

F T st u d en

ts .

A n al ys is : Li n e‐ b y‐ lin

e co

d in g,

fo cu

se d co

d in g,

an al yt ic

m em

o s, an

d th eo

re ti ca lc o d in g

to co

n st ru ct

gr o u n d ed

th eo

ry .

F o u r co

m m o n ch

al le n ge

s st u d en

ts

fa ce d n av

ig at in g p er so n al

ex p er ie n ce s o f ill n es s an

d

co n n ec ti n g to

p at ie n ts : ‐‐

d is cr ep

an ci es

b et w ee

n id ea

l an

d

liv ed

ex p er ie n ce s. ‐‐

ch al le n ge

s

o f h ea

lt h ca re

w o rk

an d

cu lt u re .‐‐

n av

ig at in g p o w er

an d

h ie ra rc h y. ‐‐ d ev

el o p in g a sh el lo

f

p ri va

cy .

T h e re su lt o f th e

d ev

el o p m en

ta l p ro ce ss

th at

cu lm

in at es

in an

u n d er st an

d in g o f se lf

w it h in

a ch

o se n fi el d .

Le vy

,S h lo m o ,&

It zh

ak y

T h e ‘b u ild

in g b lo ck s’ o f P I

am o n g so ci al

w o rk

gr ad

u at es

2 0 1 4

So ci al

W o rk

Is ra el

Q u an

ti ta ti ve

St u d y:

1 6 0 so ci al

w o rk

st u d en

ts w h o w er e

ab o u t to

gr ad

u at e,

co m p le te d

si x su rv ey

s. A n al ys is : P at h

an al ys is (A M O S 5 p ro gr am

) to

an al yz e th e re se ar ch

m o d el .

‐‐ Sa

ti sf ac ti o n w it h su p er vi si o n

p o si ti ve

ly an

d d ir ec tl y re la te d to

P I. ‐‐

P er so n al

va lu es

an d

em p at h ic

co n ce rn

in d ir ec tl y

re la te d to

P I.‐ ‐P

er so n al

st re ss

n eg

at iv el y as so ci at ed

w it h P I.

A co

m p le x fa ct o r, w h ic h

in vo

lv es

in te rn al iz at io n o f

th e gr o u p 's va

lu es

an d

n o rm

s as

p ar t o f th e

in d iv id u al 's

o w n b eh

av io r

an d se lf ‐c o n ce p t.

Ly n eh

am ,&

Le ve

tt ‐

Jo n es

In si gh

ts in to

re gi st er ed

n u rs es '

p ro fe ss io n al

va lu es

th ro u gh

2 0 1 6

N u rs in g

A u st ra lia

Q u al it at iv e St u d y:

Se m is tr u ct u re d in te rv ie w s

F o u r m ai n p ro fe ss io n al

va lu es

id en

ti fi ed

: ‐‐

B ei n g p er so n ‐

P ro fe ss io na

l va lu es :S

ta n d ar d s

th at

d ef in e p ro fe ss io n al

458 | FITZGERALD

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nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

th e ey

es o f gr ad

u at in g

st u d en

ts

w it h 1 4 st u d en

ts .A

n al ys is :

D at a re ad

re p ea

te d ly

an d

w o rd

b y w o rd ,t h en

ca te go

ri ze d in to

fo u r ke

y

p ro fe ss io n al

va lu e gr o u p s.

ce n te re d .‐ ‐K

in d n es s an

d

ca ri n g. ‐‐

B ei n g in

co n tr o l.‐ ‐

C o m m it m en

t to

le ar n in g.

b eh

av io r, an

d p ri n ci p le s

an d id ea

ls th at

in fl u en

ce

m o ra l ju d gm

en t an

d gi ve

m ea

n in g an

d d ir ec ti o n to

cl in ic al

p ra ct ic e.

M ac In to sh

R ew

o rk in g p ro fe ss io n al

n u rs in g

id en

ti ty

2 0 0 3

N u rs in g

C an

ad a

G ro u n d ed

T h eo

ry St u d y:

E xp

er ie n ce d R N s w h o

gr ad

u at ed

fr o m

d ip lo m a

p ro gr am

s an

d en

ro lle

d in

b ac c

n u rs in g p ro gr am

.A n al ys is :

U se d su b st an

ti ve

an d

th eo

re ti ca l co

d in g (B ec k,

1 9 9 9 ), an

d co

n st an

t

co m p ar at iv e an

al ys is

(G la se r, 1 9 7 8 ).

T h re e‐ st ag

e p ro ce ss

o f re w o rk in g

P I: ‐‐

A ss u m in g ad

eq u ac y. ‐‐

R ea

liz in g p ra ct ic e.

‐‐ D ev

el o p in g

a re p u ta ti o n .3

co n te xt u al

fa ct o rs

in fl u en

ce th e p ro ce ss : ‐‐

E xp

ec ta ti o n s. ‐‐ P er ce p ti o n o f

n u rs in g st at u s b y o th er s. ‐‐

A cc ep

ta n ce ,a

ss is ta n ce ,a

n d

ad vo

ca cy

fr o m

o th er s in

th e

w o rk p la ce .

P ro fe ss io na

l so ci al iz at io n:

P ro ce ss

w h er eb

y

in d iv id u al s ac q u ir e an

d

in te gr at e th e ex

p ec te d

kn o w le d ge

, b eh

av io rs ,

sk ill s, at ti tu d es ,v

al u es ,

ro le s, an

d n o rm

s d ee

m ed

ap p ro p ri at e an

d ac ce p ta b le

to th ei r ch

o se n p ro fe ss io n .

M an

o jlo

vi ch

,& K et ef ia n

T h e ef fe ct s o f o rg an

iz at io n al

cu lt u re

o n n u rs in g

p ro fe ss io n al is m :

Im p lic at io n s fo r h ea

lt h

re so u rc e p la n n in g

2 0 0 2

N u rs in g

U S

Se co

n d ar y D at a A n al ys is

(f ro m

N u rs in g R o le

P ro fe ss io n al is m

P ro je ct ). A n al ys is : M u lt ip le

re gr es si o n an

al ys is .B

iv ar ia te

m u lt ip le

lin ea

r re gr es si o n .

‐‐ N u rs in g p ro fe ss io n al is m

an d

st ro n g o rg an

iz at io n al

cu lt u re

ar e

tw o re so u rc es

fo r b et te r p at ie n t

o u tc o m es ‐‐ P er so n al

se n se

o f

ac co

m p lis h m en

t n o t fo u n d to

b e

m ea

n in gf u l to

n u rs in g

p ro fe ss io n al is m .‐‐

O rg an

iz at io n al

cu lt u re

p re d ic te d

1 6 %

o f th e va

ri an

ce .

A n au

to n o m o u s p ra ct it io n er ,

ar m ed

w it h a u n iq u e b o d y

o f kn

o w le d ge

,w h o

p ra ct ic es

w it h in

a sp ec if ie d

co d e o f co

n d u ct

an d

d er iv es

a se n se

o f

ac co

m p lis h m en

t fr o m

h is

o r h er

w o rk .

M ar ie t

P ro fe ss io n al

so ci al iz at io n

m o d el s in

n u rs in g

2 0 1 6

N u rs in g

In d ia

Li te ra tu re

R ev

ie w

o f co

n ce p tu al

m o d el s o n p ro fe ss io n al

so ci al iz at io n .

M o d el s ap

p ro p ri at e fo r b eg

in n in g

n u rs in g st u d en

ts :‐‐

H in sh aw

(1 9 7 6 ) D av

is M o d el

o f B as ic

St u d en

t So

ci al iz at io n .‐‐

B an

d u ra

(1 9 7 7 ) m o d el in g.

‐‐ B en

n er

(1 9 8 4 ) “n o vi ce

to ex

p er t. ”‐ ‐

T h ro w e &

F o u gh

t (1 9 8 7 )

D ev

el o p m en

ta l M o d el

o f

P ro fe ss io n al

So ci al iz at io n o f R N

st u d en

ts .•

E d en

s (1 9 8 7 )

E xp

la n at o ry

m o d el

o f

p ro fs o ci al iz at io n in

n u rs in g

P ro fe ss io na

l So ci al iz at io n:

T h e

p ro ce ss

o f in te rn al iz at io n

an d d ev

el o p m en

t o r

m o d if ic at io n o f

o cc u p at io n al

id en

ti ty .

A b so rb in g th e cu

lt u re

o f

n u rs in g (t h e ri te s, ri tu al s,

an d va

lu ed

b eh

av io rs

o f

th e p ro fe ss io n ).

M at th ew

s,

B ia lo ce rk o w sk i, &

M o lin

eu x

P I m ea

su re s fo r st u d en

t h ea

lt h

p ro fe ss io n al s‐ A

sy st em

at ic

2 0 1 9

A u st ra lia

Sy st em

at ic

R ev

ie w

o f ei gh

t P I

m ea

su re s id en

ti fi ed

in tw

o

‐‐ T h e re vi se d N u rs es ’ P ro fe ss io n al

V al u es

Sc al e an

d M ac le o d C la rk

P I Sc al e h ad

th e gr ea

te st

U se s d ef in it io n fr o m

A d am

s

et al

1 7 : “A

tt it u d es ,v

al u es ,

kn o w le d ge

, b el ie fs

an d

(C o n ti n u es )

FITZGERALD | 459

17446198, 2020, 3, D ow

nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

re vi ew

o f p sy ch

o m et ri c

p ro p er ti es

p h as es .A

n al ys is : C O SM

IN

ch ec kl is t.

p sy ch

o m et ri c ev

id en

ce .‐ ‐N

o

m ea

su re

fu lf ill ed

al l cr it er ia

in

th e C O SM

IN ch

ec kl is t.

sk ill s th at

ar e sh ar ed

w it h

o th er s w it h in

a

p ro fe ss io n al

gr o u p ” (p 5 6 ).

M cL ea

n F ro m

b ei n g a n u rs e to

b ec o m in g

a ‘d if fe re n t’ d o ct o r

2 0 1 7

N u rs in g

M ed

ic in e

A u st ra lia

In te rp re ta ti ve

P h en

o m en

o lo gi ca l

A n al ys is

(I P A ): In te rv ie w s

w it h th re e ex

p er ie n ce

re gi st er ed

n u rs es

en ro lle

d in

an u n d er gr ad

u at e m ed

ic al

p ro gr am

.A n al ys is : T h e IP A

p ro ce ss

su gg

es te d b y Sm

it h &

O sb o rn

(2 0 0 8 )

‐‐ H ig h lig

h te d th e ro le

o f p er so n al

an d co

n te xt u al

fa ct o rs

in

b ec o m in g a d o ct o r. ‐‐

R ec o m m en

d th e n ee

d fo r

in te rp ro fe ss io n al

le ar n in g in

m ed

ic al

cu rr ic u lu m

to cu

lt iv at e a

h ea

lt h ca re

cu lt u re

o f

co lla

b o ra ti o n ra th er

th an

co m p et it io n .

A re p re se n ta ti o n o f se lf ,

ac h ie ve

d in

st ag

es o ve

r

ti m e d u ri n g w h ic h th e

ch ar ac te ri st ic s, va

lu es ,a

n d

n o rm

s o f th e m ed

ic al

p ro fe ss io n ar e in te rn al iz ed

,

re su lt in g in

in d iv id u al

th in ki n g, ac ti n g, an

d fe el in g

lik e a p h ys ic ia n .

M ir ó ‐B o n et ,B

o ve

r‐ B o ve

r, M o re n o ‐

M u le t, M ir ó ‐B o n et ,

& Z af o rt ez a‐

La lle

m an

d

G en

ea lo gy

as a cr it ic al

to o lb o x:

D ec o n st ru ct in g th e P I o f

n u rs es

2 0 1 3

N u rs in g

Sp ai n

M ix ed

M et h o d s St u d y:

So u rc es :

fi ve

p ro fe ss io n al

co n d u ct

m an

u al s fo r n u rs es ’ tr ai n in g

p u b lis h ed

d u ri n g th e F ra n co

d ic ta to rs h ip

in Sp

ai n ; an

d si x

in te rv ie w s w it h n u rs in g

in st ru ct o rs

o r st u d en

ts at

th e

ti m e.

A n al ys is : F o u ca u ld ia n

co n ce p t o f ge

n ea

lo gy

as a

fr am

ew o rk .

‐‐ T h e ge

n ea

lo gi ca l fr am

ew o rk

ca n

b e u se d to

cr it iq u e n u rs es ’ P I.‐ ‐

T h e P I o f n u rs es

n o t b as ed

o n

su p p o se d u n iv er sa l va

lu es ,b

u t

lin ke

d to

lo ca l, h is to ri ca l

p ro ce ss es

o f n o rm

al iz at io n an

d

re si st an

ce . ‐‐

T h e P I o f n u rs in g is

co n st it u te d n o t o n ly

fr o m

a

gl o b al ly

in fo rm

ed p er sp ec ti ve

b u t al so

th ro u gh

d ai ly , lo ca lly

si tu at ed

p ra ct ic e.

E st ab

lis h m en

t o f a b o d y o f

kn o w le d ge

, w it h it s o w n

sc ie n ti fi c b as is ,w

h ic h

al lo w s n u rs es

to

d if fe re n ti at e th ei r

co n tr ib u ti o n to

th e h ea

lt h

sy st em

fr o m

th at

o f

p h ys ic ia n s ‐‐

A p ro ce ss

o f

so ci al iz at io n th at

w ill

le ad

n u rs es

to in te rn al iz e an

d

ac q u ir e ru le s, kn

o w le d ge

,

sk ill s, ro le s, va

lu es ,a

n d

cu lt u re

ch ar ac te ri st ic

o f,

an d u n iq u e to , th ei r

p ro fe ss io n .

M o lle

m an

& R in k

T h e an

te ce d en

ts an

d

co n se q u en

ce s o f a st ro n g P I

am o n g m ed

ic al

sp ec ia lis ts

2 0 1 5

M ed

ic in e

N et h er ‐

la n d s

Li te ra tu re

R ev

ie w : In tr o d u ce s a

co n ce p tu al

fr am

ew o rk

fo r

u n d er st an

d in g th e

an te ce d en

ts o f a st ro n g P I

am o n g m ed

ic al

sp ec ia lis ts

an d

it s co

n se q u en

ce s fo r th e

q u al it y o f h ea

lt h ca re .

‐‐ M ed

ic al

sp ec ia lis ts

w it h a st ro n g

P I ar e lik

el y to

fu n ct io n

d if fe re n tl y w it h in

an d o u ts id e

th ei r o w n d o m ai n .‐‐

P ro fe ss io n al

id en

ti ti es

o f d if fe re n t sp ec ia lt ie s

al re ad

y st ar t to

d iv er ge

in th e

fo rm

at io n p ro ce ss ,e

ar ly

in th e

ca re er s o f m ed

ic al

sp ec ia lis ts .

P I in

m ed ic al

sp ec ia lis ts :S

ee in g

se lf as

b el o n gi n g to

a

p ar ti cu

la r sp ec ia lt y.

Sh ar ed

fr am

e o f re fe re n ce ,

en d o rs e si m ila

r w o rk

n o rm

s an

d sa m e in te re st s

in m in d .V

al u e an

d

em p h as iz e ke

y fe at u re s o f

sp ec ia lt y,

su ch

as ce rt ai n

ex p er ti se ,v

al u es ,n

o rm

s,

b el ie fs ,a

tt it u d es ,a

n d

b eh

av io rs .

460 | FITZGERALD

17446198, 2020, 3, D ow

nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

N ei sh ab

o u ri ,A

h m ad

i, &

K az em

n ej ad

Ir an

ia n n u rs in g st u d en

ts ’

p er sp ec ti ve

s o n tr an

si ti o n to

P I: A

q u al it at iv e st u d y

2 0 1 7

N u rs in g

Ir an

Q u al it at iv e C o n te n t A n al ys is : In ‐

d ep

th u n st ru ct u re d in te rv ie w s

w it h 3 5 Ir an

ia n B SN

st u d en

ts .

A n al ys is : C o n te n t an

al ys is

ap p ro ac h b y G ra n eh

ei m

& Lu

n d m an

(2 0 0 4 ). T h e

M A X Q D A v. 1 0 so ft w ar e

(V E R B I G m b H , B er lin

,

G er m an

y) u se d fo r d at a

m an

ag em

en t.

F o u r th em

es (1 5 ca te go

ri es ): ‐‐

Sa ti sf ac ti o n w it h p ro fe ss io n al

p ra ct ic e,

‐‐ P er so n al

d ev

el o p m en

t. ‐‐

P ro fe ss io n al

d ev

el o p m en

t. ‐‐

A tt ai n in g

p ro fe ss io n al

co m m it m en

t. P I is

a

si gn

if ic an

t fa ct o r in fl u en

ci n g th e

d ev

el o p m en

t o f n u rs in g

ed u ca ti o n an

d p ra ct ic e.

B as ed

o n th e in d iv id u al 's

at ti tu d es , b el ie fs ,v

al u es ,

ex p er ie n ce s, an

d

m o ti va

ti o n s. A

fo rm

o f

so ci al

id en

ti ty

an d a

co m p o n en

t o f p er so n al

id en

ti ty . P I h as

a

re la ti o n sh ip

w it h th e

in d iv id u al 's

so ci al

st at u s,

in te rp er so n al

in te ra ct io n s,

an d in te rp re ta ti o n o f o n e' s

o w n ex

p er ie n ce s.

N at io n al

Le ag

u e fo r

N u rs in g

P ra ct ic al /V

o ca ti o n al

N u rs in g

P ro gr am

O u tc o m e:

P ro fe ss io n al

Id en

ti ty

2 0 1 0

N u rs in g

U S

F o u n d in

th e d o cu

m en

t re ga

rd in g

P ra ct ic al /V

o ca ti o n al

N u rs in g

P ro gr am

O u tc o m e.

D es cr ib es

th e en

d ‐o f‐p

ro gr am

,r o le ‐

sp ec if ic

co m p et en

ci es

P I “i n vo

lv es

th e in te rn al iz at io n

o f co

re va

lu es

&

p er sp ec ti ve

s re co

gn iz ed

as

in te gr al

to th e ar t &

sc ie n ce

o f n u rs in g.

T h e

co re

va lu es

b ec o m e se lf ‐

ev id en

t as

th e n u rs e le ar n s,

ga in s ex

p er ie n ce ,&

gr o w s

in th e p ro fe ss io n .”

P o rt er

& W

ilt o n

P I o f al lie

d h ea

lt h st af f

2 0 1 9

A lli ed

H ea

lt h

A u st ra lia

C ro ss ‐S ec

ti o n al

St u d y:

O n lin

e

q u es ti o n n ai re

o f P I: 2 2 6

re sp o n se s. A n al ys is :

D es cr ip ti ve

st at is ti cs

u si n g

M ic ro so ft

E xc el

ve rs io n 2 0 1 0 ,

SP SS

St at is ti cs

ve rs io n 2 3 .

R es p o n se s:

K ru sk al ‐W

al lis

te st .P

o st

h o c an

al ys es

u si n g a

se ri es

o f M an

n ‐W

h it n ey

U

te st s.

‐‐ Id en

ti fi ed

h ig h P I am

o n g al lie

d

h ea

lt h st af f ac ro ss

ea ch

w o rk fo rc e st ru ct u re .‐‐

St at is ti ca lly

si gn

if ic an

t

d if fe re n ce s b et w ee

n b ed

‐b as ed

al lie

d h ea

lt h st af f an

d

am b u la to ry

an d co

m m u n it y

al lie

d h ea

lt h st af f, b u t n o t

m en

ta l h ea

lt h al lie

d h ea

lt h st af f

U se s th e d ef in it io n b y Sl ay

&

Sm it h (2 0 1 1 ): “O

n e' s

p ro fe ss io n al

se lf ‐c o n ce p t

b as ed

o n at tr ib u te s, b el ie fs ,

va lu es ,m

o ti ve

s, an

d

ex p er ie n ce s”

(p 8 5 ).

R as m u ss en

,H en

d er so n ,

A n d re w ,&

C o n ro y

F ac to rs

in fl u en

ci n g re gi st er ed

n u rs es ’ p er ce p ti o n s o f th ei r

P I: A n in te gr at iv e lit er at u re

re vi ew

2 0 1 8

N u rs in g

A u st ra lia

In te gr at iv e Li te ra tu re

R ev

ie w :

In ve

st ig at in g fa ct o rs

in fl u en

ci n g R N s’ p er ce p ti o n s

o f th ei r P I. U se d P u b M ed

,

C IN

A H L,

E M B A SE

,a n d

Sc o p u s. A rt ic le s p u b lis h ed

b et w ee

n 2 0 1 2 &

2 0 1 7 .

T h re e ca te go

ri es

in fl u en

ci n g

p er ce p ti o n s o f P I: ‐‐ th e se lf (t h e

n u rs e w h o en

ac ts

th e ro le

in

p ra ct ic e) ,‐ ‐t

h e ro le

(w h at

th e

n u rs e d o es ), ‐‐

th e co

n te xt

(t h e

p ra ct ic e se tt in g) .P

o o r al ig n m en

t

o f th es e ca te go

ri es

le ad

s to

st re ss ,t en

si o n ,a

n d u n ce rt ai n ty

af fe ct in g w o rk fo rc e re te n ti o n .

O n e' s p er ce p ti o n o f w h at

it

m ea

n s to

b e,

an d to

ac t, as

a n u rs e.

T ak

es p la ce

th ro u gh

ex p er ie n ce

an d

so ci al iz at io n an

d co

n ti n u es

th ro u gh

va ri o u s

p ro fe ss io n al

ex p er ie n ce s.

(C o n ti n u es )

FITZGERALD | 461

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nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

St ro n g al ig n m en

t le ad

s to

sa ti sf ac ti o n w it h th e n u rs in g

ro le ,i n cr ea

se d st af f re te n ti o n ,

an d im

p ro ve

d q u al it y o f ca re

an d

p at ie n t o u tc o m es .

Sc h m id t, &

M cA

rt h u r

P ro fe ss io n al

n u rs in g va

lu es : A

co n ce p t an

al ys is

2 0 1 8

N u rs in g

U S

C o n ce

p t A n al ys is : T o cl ar if y th e

m ea

n in g o f p ro fe ss io n al

n u rs in g va

lu es .A

n al ys is :

W al ke

r an

d A va

n t' s (2 0 1 1 )

m et h o d .

‐‐ P ro fe ss io n al

n u rs in g va

lu es

(h u m an

d ig n it y,

in te gr it y,

al tr u is m ,a

n d ju st ic e)

se rv e as

th e fr am

ew o rk

fo r st an

d ar d s,

p ro fe ss io n al

p ra ct ic e,

an d

ev al u at io n .‐‐

P er so n al

an d

p ro fe ss io n al

va lu es

ar e m o d if ie d

w h en

st u d en

ts fo rm

a

p ro fe ss io n al

n u rs in g id en

ti ty .

P ro fe ss io na

l N ur si ng

V al ue s:

Im p o rt an

t p ro fe ss io n al

n u rs in g p ri n ci p le s o f

h u m an

d ig n it y,

in te gr it y,

al tr u is m , an

d ju st ic e th at

se rv e as

a fr am

ew o rk

fo r

st an

d ar d s, p ro fe ss io n al

p ra ct ic e,

an d ev

al u at io n .

Sh lo m o ,L

ev y,

& It zh

ak y

D ev

el o p m en

t o f P I am

o n g so ci al

w o rk

st u d en

ts : C o n tr ib u ti n g

fa ct o rs

2 0 1 2

So ci al

W o rk

Is ra el

Q u an

ti ta ti ve

St u d y:

1 6 0 so ci al

w o rk

st u d en

ts ab

o u t to

co m p le te

B SW

d eg

re es . Si x

Q u es ti o n n ai re s. A n al ys is :P

at h

an al ys is

(T h e A M O S 5

p ro gr am

) w as

u se d to

an al yz e

th e re se ar ch

m o d el .

‐‐ T h e h ig h er

th e sa ti sf ac ti o n w it h

su p er vi si o n ,t h e le ss

si gn

if ic an

t

so ci al

va lu es

w er e to

P I. ‐‐ T h e

h ig h er

th e sa ti sf ac ti o n w it h

su p er vi si o n ,t h e lo w er

th ei r

le ve

ls o f se lf ‐d if fe re n ti at io n .

A co

m p le x fa ct o r, w h ic h

in vo

lv es

in te rn al iz at io n o f

th e gr o u p 's va

lu es

an d

n o rm

s as

p ar t o f th e

in d iv id u al 's

o w n b eh

av io r

an d se lf ‐c o n ce p t.

Se o ,&

K im

P I o f K o re an

n u rs e p ra ct it io n er s

in th e U n it ed

St at es .

2 0 1 7

N u rs in g

U S

Q u al it at iv e St u d y o f se ve

n

K o re an

N P s in

th e U n it ed

St at es .A

n al ys is : U se d th e lif e

h is to ry

re se ar ch

m et h o d .

F iv e th em

es re ga

rd in g th ei r P I as

N P s: ‐‐

P at ie n t‐ ce n te re d

th in ki n g‐ ‐R

es p o n si b ili ty

fo r

p at ie n t ca re ‐‐

D ed

ic at ed

lif e‐ ‐

D ili ge

n ce ,‐ ‐F

ee lin

gs o f

ac h ie ve

m en

t. *O

f th es e,

p at ie n t‐

ce n te re d th in ki n g o ve

rr id in g

th em

e.

T h e ch

ar ac te ri st ic s th at

d el in ea

te th e ro le

an d

fu n ct io n o f a gi ve

n

p ro fe ss io n

Sh o h an

i &

Z am

an za d eh

N u rs es ' at ti tu d e to w ar d s

p ro fe ss io n al iz at io n an

d

fa ct o rs

in fl u en

ci n g it

2 0 1 7

N u rs in g

Ir an

D es cr ip ti ve

St u d y:

1 8 5 n u rs es

w o rk in g in

h o sp it al s in

Ir an

.

A n al ys is : SP

SS so ft w ar e,

d es cr ip ti ve

, an

d in fe re n ti al

st at is ti cs .

‐‐ N u rs es ’ at ti tu d es

o n

p ro fe ss io n al is m

at av

er ag

e le ve

l.

‐‐ Si gn

if ic an

t st at is ti ca l

re la ti o n sh ip

b et w ee

n :‐ le n gt h o f

se rv ic e an

d at ti tu d e to w ar d s

p ro fe ss io n al iz at io n ‐

p ar ti ci p at io n in

se lf ‐

em p o w er m en

t tr ai n in g co

u rs es

an d at ti tu d e to w ar d

p ro fe ss io n al iz at io n .

P ro fe ss io n al iz at io n in cl u d es

th e ap

p lic at io n o f

kn o w le d ge

an d sk ill s,

ca rr yi n g o u t st an

d ar d

ac ti vi ti es ,l ea

d er sh ip ,s el f‐

d is ci p lin

e, p ro fe ss io n al

co m m it m en

t, an

d so ci al

va lu es .

462 | FITZGERALD

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nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

Sn el gr o ve

N u rs in g w o rk

in N H S D ir ec t:

C o n st ru ct in g a n u rs in g

id en

ti ty

in th e ca ll‐ ce n te r

en vi ro n m en

t

2 0 0 9

N u rs in g

U K

M ix ed

M et h o d s R es ea

rc h :

Se co

n d ar y d at a an

al ys is

an d

fo cu

s gr o u p s. A n al ys is : B as ed

o n H ar re

& V an

La n ge

n h o ve

(1 9 9 9 ) In d u ct iv e th em

at ic

an al ys is

F o u r m ai n th em

es id en

ti fi ed

: ‐‐

C la im

in g a n u rs in g id en

ti ty

an d

th e im

p o rt an

ce o f p re vi o u s

ex p er ie n ce ‐‐ H o lis ti c n u rs in g‐ ‐

In se cu

ri ty

an d u n ce rt ai n ty ‐‐

C la im

in g n ew

sk ill s

A n in d iv id u al 's

co n ce p ti o n o f

w h at

it m ea

n s to

b e an

d ac t

as a p ro fe ss io n al ,t h at

is ,

re la te d to

th e id eo

lo gy

o f a

p ro fe ss io n ; W

h at

co n st it u te s a p ro fe ss io n

o r n o t.

St yl es

R eg

u la ti o n an

d p ro fe ss io n ‐

b u ild

in g:

A p er so n al

p er sp ec ti ve

2 0 0 5

N u rs in g

U S

G u es t ed

it o ri al

‐‐ Id en

ti fi es

el em

en ts

o f a

p ro fe ss io n ‐‐

Su p p o rt s re gu

la ti o n

as a w ay

to st re n gt h en

p ro fe ss io n s. Se

lf ‐r eg

u la ti o n an

d

se lf ‐id

en ti fi ca ti o n is

ce n tr al

to

th e in d ep

en d en

t p ra ct ic e o f a

p ro fe ss io n .

D es cr ib ed

si x at tr ib u te s to

b e

re co

gn iz ed

as a tr u e

p ro fe ss io n :

1 . h ig h er

ed u ca ti o n ;

2 . a d is ti n ct

p ra ct ic e;

3 . re se ar ch

‐b as ed

kn o w le d ge

;

4 . au

to n o m y an

d

ac co

u n ta b ili ty ;

5 . a co

d e o f et h ic s;

6 . an

o rg an

iz ed

as so ci at io n

Su n ,G

ao ,Y

an g,

Z an

g,

& W

an g

T h e im

p ac t o f p ro fe ss io n al

id en

ti ty

o n ro le

st re ss

in

n u rs in g st u d en

ts : A

cr o ss ‐

se ct io n al

st u d y

2 0 1 6

N u rs in g

C h in a

Q u an

ti ta ti ve

St u d y:

U se d th re e

q u es ti o n n ai re s an

d

d em

o gr ap

h ic

q u es ti o n s, w it h

4 7 4 st u d en

ts fr o m

3 sc h o o ls .

A n al ys is : C ro n b ac h 's α,

E p iD

at a E n tr y v3

.1 ,S

P SS

,

P ea

rs o n co

rr el at io n ,p

o in t‐

b is er ia l co

rr el at io n ,m

u lt ip le

lin ea

r re gr es si o n an

al ys is ,a

n d

re la ti ve

fr eq

u en

cy .

‐‐ A

h ig h er

le ve

l o f p ro fe ss io n al

id en

ti ty

w as

re la te d to

a lo w er

le ve

l o f ro le

st re ss .‐ ‐A

ge ,b

ei n g

th e o n ly

ch ild

o r n o t, ed

u ca ti o n

le ve

l an

d h av

in g ex

p er ie n ce

in

co m m u n it y o rg an

iz at io n s h ad

si gn

if ic an

t co

rr el at io n s w it h th e

ro le

st re ss

sc o re s.

A fo rm

o f so ci al

id en

ti ty : P I

co n ce rn s gr o u p

in te ra ct io n s in

th e

w o rk p la ce

an d re la te s to

h o w

p eo

p le

co m p ar e an

d

d if fe re n ti at e th em

se lv es

fr o m

m em

b er s o f o th er

p ro fe ss io n al

gr o u p s.

T ak

as h im

a &

Sa ek

i P ra ct ic al

ac ti o n s sh ap

ed b y th e

in te rn al

st ru ct u re s o f

o cc u p at io n al

th er ap

is ts ’

p ro fe ss io n al

id en

ti ti es

2 0 1 9

O cc u p at io n al

T h er ap

y

Ja p an

Q u al it at iv e st u d y:

G ro u n d ed

th eo

ry se m is tr u ct u re d ,

in te rv ie w s w it h 3 0 p ra ct ic in g

O T s. A n al ys is : R el at io n sh ip s

b et w ee

n p ar ti ci p an

ts ’ ty p es

o f

in te rn al

st ru ct u re s an

d th ei r

p ra ct ic es .

‐‐ T h re e ty p es

o f p ro fe ss io n al

id en

ti ti es

w it h si x p ro p er ti es .‐‐

O f th e th re e ty p es

o f P I, th e

th er ap

ie s o f th o se

w h o se

ty p o lo gy

w as

co n si st en

t w it h

fl ex

ib ili ty

ar e th e m o st

b en

ef ic ia l

fo r cl ie n ts .

T h e ac q u is it io n o f “t h e

ch ar ac te r, d is p o si ti o n s,

b el ie fs ,v

al u es ,w

ay s o f

kn o w in g,

an d w ay

s o f

se ei n g”

th at

ch ar ac te ri ze

a

p ro fe ss io n ”

(H o o p er ,2 0 0 8 , p 2 2 8 ).

T h o m p so n ,C

o o k,

&

D u sc h in sk y

“I 'm

n o t su re

I'm a n u rs e” : A

h er m en

eu ti c

p h en

o m en

o lo gi ca l st u d y o f

n u rs in g h o m e n u rs es ’ w o rk

id en

ti ty

2 0 1 8

N u rs in g

U K

H er m en

eu ti c P h en

o m en

o lo gi ca l

St u d y:

In te rv ie w s w it h 1 3

n u rs in g h o m e n u rs es

in N o rt h

E as t E n gl an

d .A

n al ys is :

C o n te n t an

al ys is

b y al l

au th o rs .

‐‐ N u rs es ’ w o rk

ac ti vi ti es

an d

p ro fe ss io n al

gr o u p id en

ti ty

in fl u en

ce th ei r w o rk

id en

ti ty .‐ ‐

W h en

w o rk

ac ti vi ti es

an d

p ro fe ss io n al

gr o u p id en

ti ty

d o

n o t al ig n w it h ro le

ex p ec ta ti o n s

D ef in ed

in te rm

s o f th e

m ea

n in g at ta ch

ed to

th e

ta sk s an

d ac ti vi ti es

o f th e

w o rk : w h en

id en

ti fi ca ti o n

w it h th e gr o u p is

st ro n g,

se lf ‐id

en ti fi ca ti o n as

a

(C o n ti n u es )

FITZGERALD | 463

17446198, 2020, 3, D ow

nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

w o rk

id en

ti ty

m ay

b e

co m p ro m is ed

.

p ro fe ss io n al

is

st re n gt h en

ed .

V ai sm

o ra d i, Sa

ls al i, &

A h m ad

i

P er sp ec ti ve

s o f Ir an

ia n m al e

n u rs in g st u d en

ts re ga

rd in g

th e ro le

o f n u rs in g

ed u ca ti o n in

d ev

el o p in g a P I:

A co

n te n t an

al ys is

st u d y

2 0 1 1

N u rs in g

Ir an

Q u al it at iv e St u d y:

Se m i‐

st ru ct u re d in te rv ie w s w it h 1 4

Ir an

ia n m al e n u rs es .A

n al ys is :

C o n te n t an

al ys is

(G ra n h ei m

&

Lu n d m an

,a p p ro ac h ‐2

0 0 4 )

T h re e m ai n th em

es : ‐‐

“r ea

lit y–

ex p ec ta ti o n

in co

m p at ib ili ty .” ‐‐ “b ei n g

su p p o rt ed

b y th e ed

u ca ti o n al

sy st em

.” ‐‐ “n u rs in g im

ag e

re ct if ic at io n .”

Se lf ‐id

en ti fi ca ti o n w it h a

p ro fe ss io n .

va n O ef fe lt ,R

u ijt er s,

va n H ee

s, &

Si m o n s

P I, a n eg

le ct ed

co re

co n ce p t o f

p ro fe ss io n al

d ev

el o p m en

t

2 0 1 8

P I

N et h er ‐

la n d s

B o o k C h ap

te r/ M ix ed

M et h o d

St u d y O n lin

e su rv ey

o f th re e

gr o u p s:

H R D

p ro fe ss io n al s

(2 7 ), p ro fe ss io n al s (9 0 ), an

d

m an

ag er s (2 6 ). In

st ag

e 2 ,i n ‐

d ep

th in te rv ie w s w it h H R D

p ro fe ss io n al s.

D ef in ed

3 Se

lv es :‐‐

T h e m at er ia ls el f

is ab

o u t re sp o n si b ili ty

an d

o w n er sh ip ;‐ ‐T

h e sp ir it u al

se lf is

ab o u t w h at

m ak

es o n e ti ck

(p as si o n s) ;‐‐

T h e so ci al

se lf is

ab o u t h o w

o n e is

a m em

b er

o f

co m m u n it ie s/ a gi ve

an d ta ke

.

Id en

ti fi ca ti o n w it h a gr o u p gi ve

s

in p u t in to

w h o o n e is

as a

p ro fe ss io n al .

Si x el em

en ts

o f a p ro fe ss io n al :

‐‐ p ro vi d in g b es t p ra ct ic e

fo r cl ie n ts

an d so ci et y,

‐‐ ac ti n g w it h in te gr it y in

an y

en vi ro n m en

t, ‐‐

ke ep

in g

cu rr en

t w it h th eo

ry o f

p ra ct ic e,

‐‐ cr it ic al

re fl ec ti o n o n o n e' s

p ra ct ic e, ‐‐

co n tr ib u ti n g to

th e p ro fe ss io n an

d o th er

p ro fe ss io n al s, ‐‐

in te ra ct in g

w it h o th er

p ro fe ss io n al s.

W ac ke

rh au

se n

C o lla

b o ra ti o n ,P

I an

d re fl ec ti o n

ac ro ss

b o u n d ar ie s

2 0 0 9

P I

N o rw

ay R ev

is ed

an d ex

p an

d ed

ve rs io n o f

C o n fe re n ce

ke yn

o te

p re se n ta ti o n Su

m m ar iz es

p ar ts

o f re se ar ch

o ve

r 1 0 to

1 5 ye

ar s.

‐‐ D is cu

ss es

th re e th em

es :‐ T h e

an at o m y o f P I‐ F o rm

s o f id en

ti ty

p o ss es si o n ‐W

ay s o f ac q u ir in g

P I‐‐

In te rp ro fe ss io n al

co lla

b o ra ti o n is

b o th

n ec es sa ry

an d d es ir ab

le .I n tr ap

ro fe ss io n al

b ar ri er s an

d o b st ac le s to

in te rp ro fe ss io n al

co lla

b o ra ti o n .‐‐

D is cu

ss ed

m ic ro le ve

l (t h e le ve

l

o f th e p ra ct it io n er ) an

d

m ac ro le ve

l (t h e p u b lic

fa ce

o f a

p ro fe ss io n ) o f P I.

O n th e m ic ro le ve l: ta ki n g o n th e

b eh

av io r o f o th er s in

th e

p ro fe ss io n ; d o in g,

ta lk in g,

an d p er fo rm

in g as

o th er s in

gr o u p .O

n th e m ac ro le ve l: a

co m b in at io n o f th e

p ro fe ss io n 's o ff ic ia l

re co

gn it io n ,t h e p u b lic

p er ce p ti o n o f th e

p ro fe ss io n , re la te d

p ro fe ss io n s’ vi ew

o f th e

p ro fe ss io n in

q u es ti o n ,a

n d

th e se lf ‐im

ag e le ad

er s an

d

id eo

lo gi st s ex

p lic it ly

p ro m o te .

W en

'C ar in g’ ‐a n u n d er st an

d in g o f P I

b y fi rs t‐ ye

ar n u rs in g

st u d en

ts

2 0 1 6

N u rs in g

N ew

Z ea

la -

n d

Q u al it at iv e St u d y:

Se m is tr u ct u re d in te rv ie w s

w it h 3 fi rs t‐ ye

ar ad

u lt n u rs in g

st u d en

ts . A n al ys is : T h em

at ic

‐‐ P I ce n te re d st ro n gl y o n ca ri n g

ra th er

th an

re co

gn iz in g th e

ac ad

em ic

re q u ir em

en ts

fo r

n u rs es

to b e ca p ab

le an

d

T h e in d iv id u al 's p er ce p ti o n o f

fi tt in g in to

a p ro fe ss io n al

gr o u p ,s u ch

as n u rs in g.

A n

in d iv id u al 's

p er ce p ti o n s,

464 | FITZGERALD

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ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

an al ys is .( H o ls te in

&

G u b ri u m ,2

0 1 1 ).

co m p et en

t in

co n te m p o ra ry

p ra ct ic e. ‐‐

A ll p ar ti ci p an

ts

id en

ti fi ed

a se n se

o f “c ar in g”

as

th e b as is

o f th ei r u n d er st an

d in g

o f P I.

b el ie fs ,v

al u es ,k

n o w le d ge

,

an d at ti tu d es

to w ar d th e

n u rs in g p ro fe ss io n .

W ile

s ‘N o t ea

si ly

p u t in to

a b o x’ :

C o n st ru ct in g P I

2 0 1 3

So ci al

W o rk

U K

Q u al it at iv e St u d y:

Se m is tr u ct u re d in te rv ie w s,

se ve

n st u d en

ts .A

n al ys is :

D is co

u rs e an

al ys is

(E d le y,

2 0 0 1 ; P o tt er

& W

et h er el l,

1 9 8 7 ). F o u ca u ld ia n th eo

ry an

d

co n ve

rs at io n an

al ys is .

C o m m o n u sa ge

s o f P I: ‐‐

In re la ti o n

to d es ir ed

tr ai ts ,‐‐

T h ro u gh

d ev

el o p in g a se n se

o f sh ar ed

id en

ti ty

w it h o th er

so ci al

w o rk er s, ‐‐

A lt er n at iv el y,

as a

p ro ce ss

o f in d iv id u al

d ev

el o p m en

t.

A p ro ce ss

in w h ic h ea

ch

in d iv id u al

co m es

to h av

e a

se n se

o f th em

se lv es

as a

so ci al

w o rk er .

W ile

s &

V ic ar y

P ic tu ri n g so ci al

w o rk ,p

u zz le s

an d p as si o n : E xp

lo ri n g an

d

d ev

el o p in g tr an

sn at io n al

p ro fe ss io n al

id en

ti ti es

2 0 1 8

So ci al

W o rk

U K

F in d in gs

fr o m

a w o rk sh

o p o f

so ci al

w o rk er s fr o m

d if fe re n t

co u n tr ie s. 1 5 p ar ti ci p an

ts w it h

a ra n ge

o f so ci al

w o rk

ro le s.

C o lle

ct iv e id en

ti ty

sh ar ed

ac ro ss

n at io n al

b o u n d ar ie s T h em

es :‐‐

A n im

p er fe ct

fi t. ‐‐ O ve

r th e

h o ri zo

n .‐‐

T en

si o n s w it h in

th e

so ci al

w o rk

ro le .‐‐

T en

si o n s

b et w ee

n p er so n al

an d P I.

T h re e m ea

n in gs :‐‐

D es ir ed

st an

d ar d s an

d

co m p et en

ce s;

‐‐ A

co lle

ct iv e se n se

o f w h at

it

m ea

n s to

b e a so ci al

w o rk er ;‐‐

Su b je ct iv e

m ea

n in g fo r ea

ch

p ra ct it io n er

W ill et ts

& C la rk e

C o n st ru ct in g n u rs es ’ P I th ro u gh

so ci al

id en

ti ty

th eo

ry

2 0 1 4

N u rs in g

A u st ra lia

D is cu

ss io n P ap

er :P

ro p o se d so ci al

id en

ti ty

th eo

ry (S IT ) as

a

va lu ab

le re se ar ch

fr am

ew o rk

to as si st

w it h cl ar if yi n g an

d

d es cr ib in g th e P I o f n u rs es .

‐‐ G ro u p b el o n gi n gn

es s as

a

co n se q u en

ce o f

in te rp er so n al – in te rg ro u p

co n ti n u u m .‐‐

G ro u p id en

ti ty

sa lie

n ce .‐‐

C o m p le xi ti es

o f

in d iv id u al s an

d th ei r m u lt ip le

so ci al

id en

ti ti es .‐ ‐S

it u at io n al

re le va

n ce

an d su b je ct iv it y o f

th es e id en

ti ti es .

M o d er n n u rs in g m ee

ts th e

re co

gn iz ed

cr it er ia

o f

p ro fe ss io n : ‐b o d y o f

kn o w le d ge

;‐p ro fe ss io n al

re co

gn it io n ;‐c

o m m u n it y

re co

gn it io n ; ‐a

co d e o f

et h ic s;

‐a co

m m u n it y o f

p ro fe ss io n al s p ro vi d in g

o ve

rs ig h t an

d m o n it o ri n g

th e co

n d u ct

o f it s

m em

b er s.

W ils o n ,C

o w in ,J o h n so n ,

& Y o u n g

P I in

m ed

ic al

st u d en

ts :

P ed

ag o gi ca l ch

al le n ge

s to

m ed

ic al

ed u ca ti o n

2 0 1 3

M ed

ic in e

A u st ra lia

Li te ra tu re

R ev

ie w : So

u rc es :

C IN

A H L P lu s w it h F u llt ex

t an

d

M E D LI N E .K

ey w o rd s:

m ed ic al

st ud

en ts , do

ct or s /p hy

si ci an

s, P I

‐‐ E xp

lo re d so ci al iz at io n ,

co m m u n it ie s o f p ra ct ic e,

cl in ic al

se tt in gs ,a

n d p at ie n t an

d o th er

h ea

lt h ca re

p ro fe ss io n al

in te ra ct io n s. ‐‐

M ed

ic al

ed u ca ti o n n ee

d s to

b e

re sp o n si ve

to ch

an ge

s in

P I fr o m

T h e in te gr at io n o f p er so n al

va lu es ,m

o ra ls ,a

n d

at tr ib u te s w it h th e n o rm

s

o f th e p ro fe ss io n . (C o n ti n u es )

FITZGERALD | 465

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nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

T A B L E

2 (C o n ti n u ed

)

A u th o r

T it le

Y ea

r D is ci p lin

e C o u n tr y

M et h o d o lo gy

M ai n F in d in gs

D ef in it io n o f P ro fe ss io n al

Id en

ti ty

(P I)

fa ct o rs

w it h in

m ed

ic al

st u d en

t

o r so ci et y.

W o o d s, C as h in ,&

St o ck h au

se n

C o m m u n it ie s o f p ra ct ic e an

d

th e co

n st ru ct io n o f th e

p ro fe ss io n al

id en

ti ti es

o f

n u rs e ed

u ca to rs :A

re vi ew

o f

th e lit er at u re

2 0 1 6

N u rs in g

A u st ra lia

Li te ra tu re

R ev

ie w

So u rc es :

C IN

A H L,

M E D LI N E ,

C O C H R A N E ,E

B SC

O ,

E m er al d ,P

ro q u es t, an

d

G o o gl e Sc h o la r. 2 9 3 p ee

r‐ re vi ew

ed jo u rn al

p ap

er s,

cu lle

d to

6 3 .

‐‐ A

co m m u n it y o f p ra ct ic e ca n h el p

p eo

p le

co lla

b o ra te

to w ar d

co m m o n go

al s an

d p u rp o se . ‐‐

N u rs e ed

u ca to rs

ca n b en

ef it

fr o m

p ro fe ss io n al

lit er at u re

th at

h ig h lig

h ts

co lle

ct iv e an

d ac ti ve

p ro ce ss es

o f in d iv id u al

an d

sh ar ed

id en

ti ty

fo rm

at io n .

B as ed

o n th e va

lu es

an d

et h ic al

st an

d ar d s th at

d ef in e th e p ro fe ss io n an

d

th e n ee

d fo r so ci al iz at io n

to id en

ti fi ed

b en

ch m ar ks ;

ar is es

fr o m

p er so n al

kn o w le d ge

th ro u gh

n eg

o ti at ed

ex p er ie n ce s

w it h in

a p ar ti cu

la r

co m m u n it y.

W o rt h in gt o n ,

Sa la m o n so n ,

W ea

ve r, &

C le ar y

P re d ic ti ve

va lid

it y o f th e

M ac le o d C la rk

P I Sc al e fo r

u n d er gr ad

u at e n u rs in g

st u d en

ts

2 0 1 3

N u rs in g

A u st ra lia

Q u an

ti ta ti ve

R es ea

rc h u si n g th e

M ac le o d C la rk

P I Sc al e

(M C P IS ‐9 ), co

m p ar ed

w it h

st u d en

t d ro p ‐o u t ra te s 1 2

m o n th s la te r. A n al ys is : SP

SS

ve rs io n 1 7 .0 1 C at te ll' s sc re e

te st ,C

ro n b ac h 's α,

Lo gi st ic

re gr es si o n .

‐‐ St at is ti ca lly

si gn

if ic an

t h ig h er

P I

sc o re s fo r: fe m al es ; p re vi o u s

n u rs in g‐ re la te d vo

ca ti o n al

tr ai n in g;

re p o rt ed

n u rs in g as

th ei r fi rs t ch

o ic e;

o r en

ga ge

d in

n u rs in g‐ re la te d p ai d w o rk .‐‐

P I

h as

a d ir ec t re la ti o n sh ip

w it h

st u d en

t re te n ti o n in

th e n u rs in g

p ro gr am

.

K n o w le d ge

,b el ie fs ,a

n d sk ill s

co m m o n to

a p ro fe ss io n al

gr o u p .

Y az d an

n ik ,Y

ek ta ,&

So lt an

i

N u rs in g P I: A n in fa n t o r o n e

w it h A lz h ei m er

2 0 1 2

N u rs in g

Ir an

Q u al it at iv e R es ea

rc h : 2 3

se m is tr u ct u re d in te rv ie w s an

d

4 fo cu

s gr o u p s w it h 2 0 n u rs es

an d 2 p h ys ic ia n s in

Ir an

.

A n al ys is : D is co

u rs e an

al ys is ,a

p o st st ru ct u ra lis m

h yb

ri d

m et h o d o f La

cl au

an d M o u ff e,

an d F ai rc la u gh

ap p ro ac h .

‐‐ N u rs in g P I fo rm

ed b as ed

o n

cu lt u ra l so ci al

st ru ct u re ,v

al u es ,

an d b el ie fs

o f th e go

ve rn in g

h ea

lt h sy st em

.‐ ‐N

u rs es

d o n o t

sh o w

se lf ‐c o n ce p t th at

in d ic at es

d is ti n ct iv e an

d d ev

el o p in g

id en

ti ty .

A co

n ce p t o f n u rs in g an

d

fu n ct io n in g as

a n u rs e,

in cl u d in g kn

o w le d ge

an d

sk ill s, se lf ‐c o n ce p t,

ex p er ie n ce s, an

d th e so ci al

im ag

e o f th e p ro fe ss io n .

A ls o ,P

I as

a fo rm

o f so ci al

id en

ti ty ,i n w h ic h th e gr o u p

cr ea

te s p ro fe ss io n al

id ea

ls

an d va

lu es

th at

ar e sh ar ed

am o n g th e p ro fe ss io n al s in

th at

gr o u p .

Z ar sh en

as ,S

h ar if ,

M o la ze m ,K

h ay

ye r,

Z ar e,

& E b ad

i

P ro fe ss io n al

so ci al iz at io n in

n u rs in g:

A q u al it at iv e

co n te n t an

al ys is

2 0 1 4

N u rs in g

Ir an

Q u al it at iv e R es ea

rc h :

Se m is tr u ct u re d in te rv ie w s an

d

fo cu

s gr o u p s w it h 4 3 n u rs es .

A n al ys is : In d u ct iv e co

n te n t

an al ys is ,a

n d u n an

im o u s

ag re em

en t o f th e re se ar ch

er s.

In n u rs in g, se n se

o f b el o n gi n g an

d P I

co n tr ib u te s to

p ro fe ss io n al

so ci al iz at io n ; it is su gg

es te d th at

th es e fa ct o rs ,w

h ic h im

p ro ve

so ci al iz at io n in

n u rs es ,b

e ta ke

n

in to

ac co

u n t b y au

th o ri ti es .

T h e w ay

in w h ic h an

in d iv id u al

vi ew

s h im

/h er se lf as

a

n u rs e,

w h o ca n p er fo rm

n u rs in g fu n ct io n s sk ill fu lly

an d re sp o n si b ly .

466 | FITZGERALD

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nloaded from https://onlinelibrary.w

iley.com /doi/10.1111/nuf.12450 by Southern C

ross U niversity, W

iley O nline L

ibrary on [23/10/2023]. See the T erm

s and C onditions (https://onlinelibrary.w

iley.com /term

s-and-conditions) on W iley O

nline L ibrary for rules of use; O

A articles are governed by the applicable C

reative C om

m ons L

icense

the greater the professional identity, and in many cases the stronger

the job satisfaction. Rasmussen et al19 discussed how the activities of

a nurse, such as the provision of patient‐centered care, problem‐ solving, multitasking, and clear communication give the nurse a

feeling of empowerment and bolster professional identity. Thompson

et al18 defined professional identity in terms of the meaning attached

to the tasks and activities of the work. They studied nursing home

nurses and found that many had uncertainty about their identity

since the tasks they performed were different from the expected

characteristics of being a nurse. Participants described a feeling of

isolation and exclusion from the profession, which in turn affected

their job satisfaction and identification as a nurse. Heldal et al20

described how the functions and performance of a role give defini-

tion to professional identity. They stated that the professional

identity is context‐dependent, therefore, as work practices and

knowledge change, so does one's identity. This is illustrated by their

finding that some nurses in this study found increased professional

status after initiating a patient safety program.

Dahl and Clancy21 defined professional identity in the public

health nurses they studied as how those nurses experience and de-

scribe their practice. When experiences in their work overlap with

the experiences of others, a common professional identity is formed.

Wackerhausen22 described professional identity on both a macro and

a microlevel. On the microlevel, the level of the practitioner, a pro-

fessional was defined by taking on the behavior of others in the

profession; doing, talking, and performing as others in the group.

Wackerhausen22 found that while education and theoretical knowl-

edge were important, it is through shared behavior that one is fully

acknowledged as a member of a profession. Dikmenet al23 described

nursing professionalism as the manner of the work and the behaviors

of nurses in providing quality care and patient safety. Zarshenas

et al4 described professional identity as deriving in part from viewing

oneself as able to perform nursing functions skillfully and re-

sponsibly. One participant in their research described this as feeling

useful to the profession, which increased her sense of belonging.

5.2 | Knowledge and skills

Researchers also defined professional identity by what professionals

know, their knowledge and skills. When discussing professions in

general, van Oeffelt et al10 developed a model of professional iden-

tification that integrates expertise, a theory of knowledge, and pro-

fessional learning as key components in the professional self. Van

Oeffelt et al10 posited that these form the basis of professionalism,

which then supports the values of the profession and the social

context. Dikmen et al23 defined professions through their particular

body of knowledge, their formal education, and certification. These

authors asserted that it is the extent of knowledge, more than simply

experience, that ensures nurses are able to maintain a level of pro-

fessionalism in a rapidly advancing health care environment.

Yazdannik et al24 included knowledge and skills among other traits

when they defined nursing professional identity as a concept of

nursing and functioning as a nurse. This definition included the

self‐concept, experiences, and social image of the profession.

Benner et al11 described the development of professional iden-

tity, or formation in their words, as occurring when students acquire

and use knowledge to act with skilled know‐how. When this occurs,

Benner et al11 stated that students have a stronger association with

the social contract nurses have to care for vulnerable people. Wor-

thington et al25 defined professional identity in terms of the knowl-

edge, beliefs, and skills common to a professional group. They used

the nine‐item Macleod Clark Professional Identity Scale (MCPIS‐9) to measure professional identity in nursing students in Australia. The

MCPIS‐9 was developed in 2006 to measure professional identity in

healthcare professionals and includes elements such as cognitive

flexibility and self‐reported knowledge.1,26 Worthington et al25 found

that the higher the levels on the MCPIS‐9, the higher the professional

identity, which translated into increased retention rates for partici-

pants in their study.

5.3 | Values, beliefs, and ethics

The characteristics most often cited as defining a profession are

values, beliefs, and ethics. Forty‐two of the sixty‐eight articles iden-

tified for this concept analysis cited such definitions. The NLN1

outlined this clearly in their outcomes and competencies document,

describing how knowledge alone is insufficient; professionalism in-

cludes internalizing the core values and beliefs of the profession as

well as understanding the context of the practice. Schmidt and

McArthur26 asserted that nurses must internalize values to develop

and sustain a professional identity. In discussing professional identity

for nurses, Woods et al8 focused on the values and ethical standards

that define the nursing profession and the need for socialization to

these benchmarks. MacIntosh27 described the elements of nursing

professionalism in experienced nurses as including social values, a

code of ethics, a mechanism for self‐regulation, and members

who are motivated by altruism and committed to the profession.

MacIntosh27 reflected on the stages of development of such attri-

butes, noting that values and ethics come only after confidence in

one's skills and know‐how.

In reference to physicians, Forouzadeh et al28 described pro-

fessional identity as integration of personal and professional values.

They cited the Carnegie Foundation study on educating physicians in

saying that professional identity is the same as the development of

professional values. Kalet et al29 described various sources, including

the Carnegie study, that define professional identity in terms of the

values, norms, and beliefs of the profession that must be committed

to and internalized. They measured professional formation in novice

medical students and found that strength in moral reasoning and a

commitment to professional values make students less vulnerable to

situational factors that challenge their professionalism.

Values, beliefs, and ethics were discussed in every discipline in-

cluded in this concept analysis. In social work, Forenza and Eckert30

found that the majority of their student participants identified

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value‐based concepts, such as social justice and empathy, as defining

the profession. In discussing the development of a self‐identity as an

occupational therapist, Binyamin31 described how students must

identify with the goals, values, and beliefs to make a professional

commitment. Binyamin31 asserted that alignment with these goals,

values, and beliefs helps students learn to navigate the various

relational dilemmas they encounter in their work. Gregory and

Austin32 defined professional identity formation in pharmacists as an

establishment of core values, moral principles, self‐awareness, and

self‐regulation. They described these attributes of professional

identity as important in pharmacy, as it is in medicine and other

professions, because the work is “messy,” and there are often no

clear‐cut answers.

5.4 | Context and socialization

Given that professional identity includes entry into a community of

practice, many researchers asserted that professional identity

cannot be separated from social identity. Thompson et al33

discussed how the work role has a social identity rather than an

individual identity, therefore, when identification with the group is

strong, self‐identification as a professional is strengthened. Many

definitions of professional identity described a compact between

society and the professional.9,34‐36 Similarly, Crigger and

Godfrey37 described professional identity, in part, as being a

member of a profession with responsibilities to society, patients,

other professions, and oneself. Other studies discussed the need

for self‐regulation and self‐identification.8,9,13,14 Heldal et al20

stated that autonomy, which includes self‐regulation and taking

responsibility, is important to professional identity. Their study

also linked autonomy to the daily routines in a given workplace,

giving nurses both professional and clinical autonomy.

Similar to the research on social identity, studies described the

influence of the context in which professional identity is formed.

Goldie38 stated how professional identity develops in interactional

relationships and in professional contexts. For medical students,

Goldie38 found that this occurs in established communities such as

universities, hospitals, and community‐based care organizations.

Authors from Spain discussed nursing during the time of the Franco

dictatorship and the influence this had on nursing professional

identity.39 They described how professional identities are not stable

but are fundamentally affected by the political, cultural, and historical

realities that surround them. Crigger and Godfrey37 defined two

paradigms of professional identity—the social and the psychological.

They asserted that the social paradigm comes from the influence of

social expectations, expressed as nursing regulations, standards, and

interventions.

A related theme was to define professional identity by how it

compares with and differentiates from other groups. Goldie38 de-

scribed how medical students are in a process of defining not only

who they are but who they are not. Dahl and Clancy21 defined the

characteristics of a professional group that distinguishes it from

others regardless of context. They posited that this differentiation

from other groups gives the profession a distinct identity and the

professionals within that group a means to professional identity. In

interviews with nurses about their professional identity, Bochatay40

found that many discovered meaning in their work through the

professional values that differentiate them from other groups.

5.5 | Group and personal identity

Group identity was found to be a defining characteristic in many

sources. This refers to the profession being recognized by society,

and by the association each member can develop a professional

identity within that group. Adams et al,17 an oft‐cited reference for

subsequent research on professional identity, stated that the inter-

disciplinary nature of healthcare work makes social identity theory a

useful framework for the development of professional identity. Their

study asserted that those within each discipline are influenced by and

differentiate themselves from others that collaborate in patient care.

Yazdannik et al24 also wrote about professional identity as a form of

social identity, describing how the group creates professional ideals

and values that are shared among the professionals in that group.

Molleman and Rink39 researched medical specialists and found most

had a strong connection to their particular specialty. From this, they

derived a secure professional identity as a member of that specialty.

A corollary found in the literature is self‐identification by the

individual as being part of a profession and therefore having

professional identity. Van Oeffelt et al10 began their model of

professional identity with the individual, how one identifies with

others and separates oneself from others. This study asserted that

identification with a group gives input into who one is as a pro-

fessional. When Crigger and Godfrey37 wrote about the psycho-

logical aspects of nursing, they were referring to the individual

internalizing the virtues of the profession, such as courage, in-

tegrity, and compassion. By this, the study found, participants

identified as being part of the profession of nursing. Rasmussen

et al19 conducted a literature review of nursing professional

identity encompassing articles published between 2012 and 2017.

They found that the studies supported the idea that nursing pro-

fessional identity takes place through experience and socialization

and continues through various professional experiences. Cruess

et al35 wrote about a similar process happening in the training of

physicians. Their definition of professional identity described a

process in which a developing physician internalizes the char-

acteristics, values, and norms of the profession, and as a result

begins to think, feel, and act as a physician.

6 | MODEL CASE

A model case of a person with a well‐developed professional identity

has all the defining attributes of the concept. This hypothetical model

case involves Maria, a nurse with 7 years of experience. She is able to

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perform all the functions of her job and is confident in the patient care

area. Maria graduated from an accredited nursing program and passed

the NCLEX licensing exam on her first try, proving she has the knowl-

edge to provide safe and effective care. Other nurses on her unit often

turn to Maria for her opinion and feedback about patient care. Maria is

seen as a person of high moral and ethical status. She has shown

commitment to her job and her patients. She has good relationships and

is respected by the other nurses and healthcare staff. She regularly gets

commendation by patients, stating she shows them respect, provides

good care, protects their privacy, and puts their interests first. She is

proud to be a nurse at her hospital and often recommends it to others

as a good place to work. Maria enjoys being recognized as a nurse both

at work and outside the hospital, and often volunteers to talk about her

work at the career day at her local high school.

7 | BORDERLINE CASE

A borderline case of professional identity contains many of the

elements, but not all of them. This hypothetical case is about

Ethan. Ethan works with Maria, and they went to the same nursing

school. Ethan did not really want to be a nurse, but his parents

recommended it to him as a good career. He comes to work just in

time for shift change and never volunteers for overtime. He is seen

as a “good enough” nurse but has been known to talk about

patients he dislikes when in the hospital cafeteria. He agrees with

his parents that nursing is a good career and stays in his job for the

money and job security. He fixes and sells classic motorcycles on

the side and would 1 day like to make this his full‐time job.

8 | CONTRARY CASE

A contrary case of professional identity has none of the character-

istics of the concept. The term “nurse” is used very loosely by the

general public, referring to anyone who provides care to the ill or

aging. This contrary case is Jennifer, who works as a Certified Nur-

sing Assistant (CNA) at an assisted living center. When asked what

she does, Jennifer says that she is a “nurse” but is vague about where

she works. At her work, she helps residents with ambulation, bathing,

and other personal needs, but only when specifically requested. She

can often be seen asking residents and their families if they have the

need for a personal assistant. She would like to leave her current job

and work with an individual in their home. She feels this would be

easier than what she now does. She has let her CNA license lapse

because she has not completed her continuing education courses and

figures she will correct this when asked by her employer.

9 | ANTECEDENTS

Antecedents of professional identity must occur or be in place

before the concept occurs. There are requirements of a profession,

including an educational degree, certification, or both, denoting the

proper knowledge to perform the work of the profession.9‐11,41,42

To be determined as a profession, there must be shared ethics and

standards that define the work, the knowledge, and the values for

the profession.8,27‐29,31,32,35,37 For nursing, these are included in the

American Nurses Association Nursing Code of Ethics. Because

professional identity is so closely associated with social identity,

there must be a supportive community of practice.4,21,27,37,38,43

Persons with a strong professional identity would consider them-

selves as a member of this group and have been socialized and/or

mentored into the work.34 Rasmussen et al19 gave a comprehensive

description of antecedents to professional identity, including au-

tonomy, responsibility, confidence, clinical judgment, the ability to

collaborate with others, and the organizational structure and re-

sources. The research found that if any of these antecedents are

missing, it will be difficult, at times impossible, for a person to de-

velop a healthy professional identity.

Zarshenas et al4 studied nurses at all levels, including stu-

dents, and found that a sense of belonging to a profession led

students to try harder in school. Similarly, Crigger and Godfrey37

and Cruess et al35 both stated that intentional teaching of pro-

fessional identity strengthens success, promotes trust, and im-

proves outcomes in professional education. Role models and

clinical supervisors were found to have an impact (either positive

or negative) on a Student's developing professional identity.4,16,44

Shlomo et al44 found that satisfaction with one's educational su-

pervisor was the strongest influence on professional identity

formation.

10 | CONSEQUENCES

The consequences of professional identity are both explicitly

mentioned and alluded to in much of the literature. In some cases,

the authors stated the result of a strong professional identity, and in

others, they discussed the consequences of a lack of professional

identity. Van Oeffelt et al10 listed a variety of consequences found in

the literature, including higher immunity to stress, enhanced

self‐confidence, more successful careers, and a more positive attitude

that makes the professional less affected by a poor work environ-

ment. Rasmussen et al19 identified that the sense of belonging that

comes from professional identity can lead to job satisfaction and

feelings of achievement.

In the clinical setting, a strong professional identity was found to

be good for patient safety20; resulted in better practice and patient

outcomes14,19,39,45,46; increased satisfaction with practice19,34,43,47;

decreased stress48; and improved retention and recruitment of

practitioners.19,34,45,49,50 MacIntosh27 described how a supportive

workplace increased nurses' professional identity.

Sources described the lack of professional identity as risking a

superficial commitment to the profession leading to poor‐quality nursing care,51 moral distress, and values dissonance.52 A weak

professional identity was found to increase stress20 and decrease

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self‐confidence and decision‐making ability.32 And when there are

low rates of professional identity, there is the risk of allowing others

to define the profession.49

11 | EMPIRICAL REFERENTS

Empirical referents are things that allow us to see and measure

professional identity. They are tangible evidence of the existence of

the concept. There are a variety of screening tools that measure

professional identity, including the Clarity of Professional Identity

(CPI), the Macleod Clark Professional Identity Scale (MCPIS), the

Nurse Self‐Concept Questionnaire (NSCQ), the Nurses' Professional

Values Scale—Revised (NPVS‐R), the Professional Identity Five Fac-

tor Scale (PIFFS), the Professional Identity Scale for Nursing Students

(PISNS), the Professional Self Identity Questionnaire (PSIQ), and the

Values Survey (TVS). Using an extensive literature review, Matthews

et al53 analyzed the reliability and validity of the above‐mentioned

tools. The NPVS‐R, TVS, the PISNS, and the NSCQ were designed for

nursing students so their generalizability is limited. The authors

found that the MCPIS was the best tool for a range of health pro-

fessions and the NPVS‐R was the best measurement for nursing

professional identity.

12 | DISCUSSION

Definitions of professional identity used in the literature vary greatly

when there is an explicit definition at all. This can lead us to confu-

sion and miscommunication and assumptions that researchers and

readers all share a collective understanding. The ability to designate

and support professional identity is important; therefore, a common

language is essential. Evaluation of the literature reveals common

themes and characteristics among those studies that give an explicit

definition of professional identity. These include the ability to

perform the functions of the profession; knowledge, as evidenced by

education and/or certification; identification with a community of

practice and with the values and ethics of the profession; and

personal identification as a professional within an identified

professional group. There is overlap in these themes; however, no

resource includes them all.

Many sources discussed the positive effect of the context or

social environment on the development of professional iden-

tity.4,17,24,49,54,55 Woods et al8 specifically cited the need for com-

munities of practice to help develop a professional identity. In

medical education, there is a developing philosophy that professional

identity must be intentionally taught, not left to chance.35 Goldie38

was an early proponent of training in professional identity in medical

schools, calling it fundamental to medical education. Burford et al56

portrayed the potentially nurturing influence of the environment

in medical school by stating, “professionalism is grown, not

made” (p361).

Various sources described the ways in which interdisciplinary

training can either benefit or clash with professional identity.

McLean57 stated that interdisciplinary training helps professions

understand each other and can benefit the professional identity of

those in each group. Both Adams et al17 and Haghighat et al34 de-

scribed how it can help professionals to know themselves better and

therefore it supports self‐concept and self‐esteem. Molleman and

Rink39 found that interdisciplinary training decreased the threat to

professional identification when a person was criticized because it

helped professionals understand each other. Wackerhausen22 was

the only source to find that interprofessional training could be ne-

gative. He stated it can be a barrier to professional identity in that

the professional groups have no shared language, which could lead to

perceived competition. However, he contended that this deficit can

be overcome in part due to the benefits of interdisciplinary training

such as friendship and its positive effect on the immune system.

Multiple sources described professional identity as an evolving

process.5,7,17,34,35,37,58,59 While some said it begins before training in

medicine17,34 or in nursing7,59; others described it as beginning with

formal education in the profession.35 However, all cited the im-

portant interplay between the educational and training process and

professional identity. Research in education found that the devel-

opment of a professional identity leads to students trying harder,4

having more success,37 and to greater retention of students.25

Vaismoradi et al60 found an increase in professional identity in stu-

dents who felt support from the educational institution, particularly

by feeling trusted and being defended. Threats to professional

identity can come from discrepancies between ideals and rea-

lity,27,60,61 particularly when there are incongruities between the

didactic and clinical portions of education.

13 | CONCLUSION

Professional identity has been shown to be important to a variety

of health‐related professions; however, none has created an

agreed‐upon definition of the term. This risks inconsistent and

unsupported development of professional identity within the

professions. There are many common themes throughout the lit-

erature, which could make the task of formalizing this concept

easier. These include actions and behaviors, knowledge and skills,

values, beliefs and ethics, context and socialization, and group and

personal identity. This concept analysis strove to give some clarity

to the use of the concept of professional identity drawing from a

variety of health‐related fields. Having a common understanding

and a common language will help in research and in education,

career training, and the continued development of professional

identity, which ultimately improves patient outcomes and in-

creases satisfaction with one's practice.

ORCID

Anita Fitzgerald http://orcid.org/0000-0002-2057-6643

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AUTHOR BIOGRAPHY

Anita Fitzgerald, PhD, RN, AGNP, CNE is an Assistant Professor

at California State University, Long Beach.

How to cite this article: Fitzgerald A. Professional identity:

A concept analysis. Nurs Forum. 2020;55:447–472.

https://doi.org/10.1111/nuf.12450

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