Professional Role Expectations Research Articles

Sources of stress, coping strategies and associated factors among Vietnamese first-year medical students.

This study aims to examine the sources of stress among first-year medical students; the frequency of their coping strategies; the factors associated with specific stressors and specific coping strategies adopted by the participants. We conducted a cross-sectional study with 409 first-year students at the University of Medicine and Pharmacy, Vietnam. The Vietnamese versions of the Higher Education Stress Inventory (V_HESI) and Brief Coping Orientation to Problems Experienced (V_Brief COPE) were validated and were used as measurement instruments for participants' sources of stress and coping strategies frequencies. The survey comprised questions of socioeconomic status, stress-related issues, the six sources of stress (using the V_HESI), and the nine coping strategies (using the V_Brief COPE). Among the six sources of stress, "Worries about future competence/endurance" had the highest mean score (3.02±0.64), while "Mismatch in professional role expectations" had the lowest score (1.60±0.53). "Financial concerns" and "Academic workloads" were also significant sources of stress. Regarding coping strategies, Self-distraction was most frequently adopted by the participants (2.80 ± 0.68). Problem-solving (2.72±0.53) and seeking Social support (2.62±0.70) were also common adaptive strategies. Avoidance (1.87±0.55) and substance-use (1.27±0.55) were the least frequent strategies. Students who experienced acute stress event were more likely to have financial concerns compared to others. Substance use was positively associated with stressors from "Mismatch in professional role expectations", "Non-supportive educational environment", "Having physical issues" and "Having part-time job". Self-blame was more frequent among students with "Worries about future competence/endurance", "Financial concerns", and "Academic workload". Male student tended to adopt humor strategy (β = 0.19, p = 0.02), while less likely to utilize religious practices (β = -0.21, p = 0.01). Two-thirds of the participants reported moderate to high levels of stress. "Worries about future competence/endurance" was the most concerned stressor, followed by "Academic workload", and "Financial concerns". The first-year medical students reported high frequency of utilization "Self-distraction", "Problem-solving" and "Social support" when confronting stress. The findings may help inform the school management to better support students' well-being.

Should I do this? Incongruence in the face of conflicting moral and role expectations

Moral incongruence—a misalignment between professional role expectations and personal moral values—is an important phenomenon in modern organizations. Though scholarly work has provided us with insights into broad forms of role incongruence, much less is known about the distinct characteristics of moral incongruence. Moreover, we lack understanding of how moral incongruence may shape employee attitudes and behaviors. Drawing on deonance theory and socio-cognitive theory, we develop a model explaining the role of moral incongruence in promoting employee prohibitive voice, withdrawal, and unethical role behavior through the mechanisms of moral outrage and moral disengagement. Examining potential boundary conditions, we also consider the roles of moral identity, self-interest, moral intensity, unethical climate, ethical leadership, and organizational identification. Given the ethical implications of moral incongruence and the significance of the phenomenon for organizations, this work has implications for both theory and practice.

Evaluation of the validity and reliability of the Nurses' Responsibility in Healthcare Quality Questionnaire: An instrument design study.

Nurses' awareness and acceptance of their professional responsibilities across the full breadth of safety and quality-related practices and behaviors are critical for high quality healthcare delivery. The purpose of this study was to develop and psychometrically test a new instrument to measure nurses' perceptions of their responsibilities related to healthcare quality. Participants were registered nurses, enrolled in a postgraduate program at an Australian university, who completed the Likert scale instrument with items developed from nurses' professional practice standards. Steps of pilot testing, item reduction, and confirmatory factor analysis resulted in a five-subscale, 55-item instrument with acceptable goodness-of-fit indices and good internal consistency reliability. Test-retest reliability demonstrated acceptable temporal stability. The Nurses Responsibilities in Healthcare Quality Questionnaire demonstrated acceptable validity and reliability. The instrument may assist education providers and health service managers to identify gaps between nurses' beliefs and professional role expectations, and evaluate the impact of educational and clinical initiatives designed to develop nurses' knowledge, skills, and attitudes related to healthcare quality.

What influences practitioners\u2019 readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework

BackgroundContemporary health policy is shifting towards remotely delivered care. A growing need to provide effective and accessible services, with maximal population reach has stimulated demand for flexible and efficient service models. The implementation of evidence-based practice has been slow, leaving many services ill equipped to respond to requests for non-face-to-face delivery. To address this translation gap, and provide empirically derived evidence to support large-scale practice change, our study aimed to explore practitioners’ perspectives of the factors that enhance the delivery of a NICE-recommended psychological intervention, i.e. guided self-help by telephone (GSH-T), in routine care. We used the Theoretical Domains Framework (TDF) to analyse our data, identify essential behaviour change processes and encourage the successful implementation of remote working in clinical practice.MethodThirty-four psychological wellbeing practitioners (PWPs) from the UK NHS Improving Access to Psychological Therapies (IAPT) services were interviewed. Data were first analysed inductively, with codes cross-matched deductively to the TDF.ResultsAnalysis identified barriers to the delivery, engagement and implementation of GSH-T, within eight domains from the TDF: (i) Deficits in practitioner knowledge, (ii) Sub-optimal practitioner telephone skills, (iii) Practitioners’ lack of beliefs in telephone capabilities and self-confidence, (iv) Practitioners’ negative beliefs about consequences, (v) Negative emotions, (vi) Professional role expectations (vii) Negative social influences, and (viii) Challenges in the environmental context and resources. A degree of interdependence was observed between the TDF domains, such that improvements in one domain were often reported to confer secondary advantages in another.ConclusionsMultiple TDF domains emerge as relevant to improve delivery of GSH-T; and these domains are theoretically and practically interlinked. A multicomponent approach is recommended to facilitate the shift from in-person to telephone-based service delivery models, and prompt behaviour change at practitioner, patient and service levels. At a minimum, the development of practitioners’ telephone skills, an increase in clients’ awareness of telephone-based treatment, dilution of negative preconceptions about telephone treatment, and robust service level guidance and standards for implementation are required. This is the first study that provides clear direction on how to improve telephone delivery and optimise implementation, aligning with current mental health policy and service improvement.

Tensions and the Teacher’s Role in Student Teacher Identity Development in Primary and Subject Teacher Curricula

ABSTRACTThis paper describes a 2-year follow-up study on teacher identity development in different types of teacher education programmes. Teacher identity development was analysed with a focus on student teachers’ views of teacher’s roles and tensions experienced during their studies. Student teachers (n = 20) were interviewed at the beginning and end of the master-level studies. Three types of tensions were identified: (1) conception of self versus professional role, (2) role expectations versus university training, (3) and multiple professional role expectations. The follow-up study showed that tensions tended to accumulate to some extent. However, successful consolidation of tensions appeared to depend on how the student teachers were able to recognise resources at their disposal, with implications for organisation of reflection support in teacher education.

Professional role expectations and related feelings when solving pedagogical dilemmas: a comparison of pre- and in-service teachers

This study investigated teachers’ professional identity development. Using Dialogical Self Theory and a socio-cultural semiotic mediational perspective, we focused on pre- and in-service teachers’ communication of professional role expectations and related feelings when solving pedagogical dilemmas to reveal aspects of their professional identity construction. Data were collected from 102 pre- and 90 in-service teachers by asking them to solve seven pedagogical dilemmas. We report: (1) how pre- and in-service teachers solved pedagogical dilemmas in terms of communicating professional role expectations and related feelings; (2) how pre- and in-service teachers differed in the feelings they reported and the solutions they gave when solving pedagogical dilemmas; and (3) how the communication of professional role expectations and feelings was related to pre- and in-service teachers’ work experience. Finally, we discuss the implications of our study for initial and continuing teacher education programmes.

“Let’s Sit Forward”: Investigating Interprofessional Communication, Collaboration, Professional Roles, and Physical Space at EmergiCare

ABSTRACTCommunication is key to hospital emergency department (ED) caregiving. Interventions in ED processes (and health care organizing in general) have struggled when they have ignored the professional role expectations that enable and constrain providers with patients and each other. Informed by a communication as design (CAD) approach, this study explored the intersections of professional roles, physical space, and communication at EmergiCare—an academic medical center and level-1 trauma center hospital. Based on an ethnographic analysis of field notes from 70 hours of shadowing at the EmergiCare ED, this study identified two specific communication patterns, “case talk” and “comfort talk,” that reflect different logics for communication in health care organizing. The findings indicate (a) that case and comfort talk have different status and therefore different influence in EmergiCare ED interprofessional communication and (b) that the arrangement of physical space at EmergiCare ED reflects the requirements of case talk more so than comfort talk. These findings have important implications for theory and practice, including the importance of considering the macro-discursive construction of professional roles reified in the arrangement of work space.

Unravelling the Experience of Consultants at Work: a Pattern of Role Enactment Beyond Compliance

In this paper, we contribute to the study of the experience of consultants at work in two ways. First, we develop a framework of role analysis by identifying two core dimensions of consultants’ professional role expectations in the literature: knowledge, whether technical or relational, and commitment, both in terms of behaviour and endurance. Second, we go on to apply this framework to 28 interviews of consultants and former consultants, from junior consultant to partner, working or having worked for 15 different firms, in order to better understand how they enact their role along all its dimensions and all along their careers. It allows us to spot two different patterns of role enactment: complying and negotiating and to understand how they evolve over time. Finally, we discuss the trend, in the literature, to describe consultants as compliant and consulting firms as environments in which only weak forms of resistance can occur.

Perception of Nurse Caring, Skills, and Knowledge Based on Appearance

The objective of the study was to assess differences among perceptions of patients, nurses, nursing faculty, and nursing students regarding nurse caring, skill, and knowledge based on attire and level of visible body art. People often make judgments (positive and negative) based on how a person appears. Given somewhat more flexible dress codes for nurses, we wondered what type of perceptions a variety of stakeholders would have of nurses in different levels of attire. A descriptive comparative design was used. A convenience sample of 240 patients, nurses, students, and faculty were surveyed regarding their perceptions of a nurse based on appearance. Multivariate analyses of variance were calculated to determine if participants' perception of nurse caring, skill, and knowledge differed by scrub type or level of body art. For the entire sample, the nurse wearing the solid scrub was rated significantly more skilled and knowledgeable than a nurse wearing print or T-shirt attire. Students rated the nurse wearing the solid scrub and print scrub significantly more skilled and knowledgeable. They rated the print scrub higher, with faculty rating it lower. Nurses rated the T-shirt attire more caring than faculty. Patients rated the T-shirt attire more skilled than faculty and students. All subjects rated the nurse with the most body art (piercings and visible tattoo) the least caring, skilled, and knowledgeable. Nurses rated the most amount of body art more caring than patients and faculty. Students rated the most amount of body art more caring than patients and faculty. The conflict between the right to self-expression and professional role expectations during nurse and patient interactions is a difficult one. However, because a nurse's appearance can impact perceptions during an encounter, dress codes in the acute care setting should take this into account. To be perceived as skilled and knowledgeable, nurses should wear a solid colored uniform with limited visible body art.

Current Practices and Future Directions in Psychopharmacological Training and Collaboration in School Psychology

School psychologists frequently examine children who are prescribed psychotropic medications. With advanced training in psychological assessment and professional consultation, school psychologists may play an integral role in assisting with children’s psychopharmacological treatment regimens. In this vein, this article discusses various ways for school psychologists to overcome barriers to collaborating with physicians including, strategies to overcoming obstacles related to cross-discipline information sharing time or workload constraints, communication challenges, and professional role expectations. Finally, the article discusses ways for school psychology students or practitioners of school psychology to increase their knowledge of pediatric psychopharmacology relative to their current training or experience.

The Collaborative Healthcare Team: Tensive Issues Warranting Ongoing Consideration

To provide a qualitative assessment of those tensive issues that warrant ongoing consideration by physicians (MDs) and advanced practice nurses (APNs) currently working in professional pairings on an interdisciplinary healthcare team. Verbatim transcripts of semistructured interviews from five MDs and eight APNs. Questions related to what MDs and APNs should expect from others in the practice; what characteristics were valued in the colleagues with whom they were paired; and what improvements might enhance their association. Tensive issues were identified in five categories including autonomy and interdependence, professional role expectations, flexible role enactment, proactive problem solving, and action learning. By understanding the tensive issues that could potentially influence the quality of collaboration, MDs and APNs can consider communication measures geared toward strengthening their partnerships.

Ethical conflicts between residents and attending physicians.

Conflicts between residents and attending physicians over ethical issues often occur and residents must attempt to navigate these perilous waters. A brief description of a conflict concerning informed consent and professional role expectations in a neonatal intensive care unit is presented. The discussion then explores contextual features that often shape such ethical conflicts and presents ways of understanding ethical conflicts that occur in the course of medical training. Constructive approaches for residents to engage in conflict resolution are offered.

The educational psychologist as practitioner-researcher: Reality or dream?

AbstractIt is almost five years since the publication of the Special Edition ofEducational and Child Psychology, 15(3)that contextualised the debate on the new paradigm methods for would-be educational psychology practitioner-researchers. Despite the exciting and constructive message conveyed, numerous studies, both concurrent and subsequent to the Special Edition, suggest that, whilst practitioner research is happening, it has still not become a demonstrable reality for the majority of educational psychologists and their services. More recent publications on the state of education research in general and the official Scottish review of the educational psychologist’s role that includes the research remit, add a fresh dimension to the discussion. In addition, the current uncertain climate for professional educational psychology practice is a function of a number of ongoing shifts in paradigms, training, professional role expectations, and legislation, and these factors may be contributing to this lack of progress as well as creating unprecedented opportunities. With particular reference to the context of educational psychology in Scotland, this paper reviews existing and new literature, and focuses on identifying the helps and hindrances to the development of a research ethos and practice within psychological services.

Management Skills for Directors of Nursing

What skills, tasks, and behaviors lead to effective management performance? The author reports a study in which directors of nursing were asked to assess their own skill performance and identify conflicts between management skills required of directors of nursing versus professional role expectations. Results provide a broader understanding of the director of nursing's role requirements and provide a validated base from which schools of nursing can plan curricula to prepare future nurse administrators.

The dream denied: Professional burnout and the constraints of human service organizations.

This article presents a conceptual model of burnout as a function of the organizational environments of human service environments. The conflict of professional role expectations with administrative policies accelerates the development of the syndrome. This perspective places secondary importance on client demands as a determinant of burnout. It also challenges individual-oriented approaches to the management of organizational stress. This conceptual review includes a consideration of measurement issues pertinent to the definition of the burnout syndrome. In the first place, the generalizability of burnout to people working outside of human services is limited by the relevance of the depersonalization component to their work. Secondly, a process model of burnout requires use of data analyses which address the interrelationships among the burnout components. The prevalence of burnout provides an indication of the extent to which the context of work is compatible with the aspirations of individuals. Changes in the nature and meaning of work have made careers more central to our sense of identity while making satisfaction with performance more difficult to obtain. I shall trace this theme through writings on burnout, and present a model of burnout in which organizational and cultural context are central concepts. Background on Burnout Research Burnout began as a colloquial term describing an emotionally depleted state among people in helping professions. The term first found its way into the psychological literature in an article by Freudenberger (1974) in an issue of the Journal of Social Issues he edited on people working in free clinics. The free clinic movement in the U.S. displayed in an extreme way many of the themes which continue to be central in burnout research. The dubious position of free clinics in medical and mental health systems at that time required

Personality Characteristics of Women of Distinction

Eight hundred and sixty-three women psychologists, scientists, artists and writers, and politicians were compared on the Sixteen Personality Factor Questionnaire through a multiple discriminant analysis. The four groups were set apart by personality characteristics adaptive to their professional role expectations. Politicians were more sociable, conscientious, self-controlled, and group-dependent; artists and writers were more affected by their feelings, spontaneous and natural, and inclined to follow their own urges; scientists were the more reserved, serious, and tough-minded; and psychologists were more flexible, liberal, and accepting. When contrasted with women in the general population, the four groups of career women were all found to be brighter, more assertive, more adventurous, and less conservative.

Confrontation and the professional maturation of dental students

The professional maturation process through which every dental student sould pass involves perception and identification of his professional role. The process is complicated at many points by conflicts between the student's own professional role expectations and the expectations of his teachers or of society. Confrontation is described as occurring daily in the dental-school environment; many confrontational situations occur on an impromptu basis in the course of interaction between the student and his classmates, his patients, and the faculty. Other confrontational situations can be arranged deliverately by the dental educator in order to provide clinical and social experiences for the student which ordinarily would not be included in the dental curriculum. By taking advantage of the particular student-instructor relationship existing during these confrontational situations, the dental educator can reap perhaps the greatest reward to be realized from an academic career--that of being able to take an active role in the professional maturation process of his students.