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Lund University

MIROTS: Developing professional identity

Handbook

Intellectual Output 1: Professional Identity

As the deepening professional identity was identified as a key aim of the project, it was considered by the team to be an important outcome that required measurement. Professional identity is defined as the values, beliefs and attitudes that a group shares about the work they undertake (Adams et al 2006). It involves not only the perceptions of individuals within the group (Trede et al 2012) but is shaped by interactions with those outside the group (Turner and Knight 2015; Fortune 2000). Students in higher education health care programmes need to develop professional identity to become successful practitioners and prepare them for work.

Occupational Therapy as a professional group is relatively small and the variation between countries are huge. In many European countries there are less than 10 occupational therapists per 100.000 inhabitants, but in others there are more than 100 per 100.000 inhabitants. The core philosophies, paradigms and models in occupational therapy differ from the medical and biopsychosocial models that dominates the healthcare sector (Wilding and Whiteford 2008; Wilding and Whiteford 2007; Kinn and Aas 2009). Increasingly occupational therapists find themselves practicing in diverse areas of practice with groups and communities who are subject to occupational injustices. It is proposed that this presents challenges for students, novice and expert practitioners in describing their role and profession. Hence, it is of importance that educational institutions begin to consider how professional identity can be developed and supported during curricula.

Professional identity development is unlikely to be attributed to a single activity within curricula, it is multifaceted and dynamic. Earlier studies suggest that this is best done through practice placements, group work with peers, and discussions with educators. What seems to be common to all these experiences is the opportunities to reframe identities using a common language. Turner and Knight (2015) suggest that occupational therapists need to develop a community of practice through engaging in three strategies: 1) Ownership of a unique set of values and beliefs; 2) acceptance of a unique discourse and 3) reinforcement of the unique discourse through communities of practice. The three participating universities proposed that working together with small cohorts that share a common professional language, core philosophies and values may impact on the development of professional identity. To evaluate this the team reviewed psychometric tools and developed a new tool which sought to measure the impact of international activity on the development of professional identity. 

Tool Development and analysis

Following a review of the literature, it was concluded that there was not a suitable tool available but that two tools (Ashby et al 2016; Boehm et al 2015) addressed aspects of what it was wished to measure. Neither of these were psychometrically sound and neither covered all the areas that needed to be evaluated. It was decided to combine questions from both to develop an appropriate tool and to establish the psychometric properties of this. Ethical approval for the study was obtained. Questions from both questionnaires were combined and a four-point scale applied to all questions. The completed tool included some demographic information and details of additional relevant experience which could affect professional identity e.g. part time work, volunteering etc. The main body of the questionnaire addresses aspects of professional identity and a second section details the influence of enablers such as models of practice, Occupational Science, practice education, lecturers and clinical supervisors (appendix 6).

A pilot study was carried out with students who took part in the first exchange. The project planned to evaluate internal consistency and psychometric properties of the scale and then use it to evaluate if the physical and web-exchanges resulted in any change in professional identity for those who participated in them. In total 58 students completed the survey. Internal consistency of the scale was evaluated using Chronbach’s Alpha, the twenty-eight items yielded a Chronbach’s alpha of .775 the removal of 2 items improved internal consistency to Chronbach’s alpha of .807 indicating that the scale had very good internal consistency without these items. Factor analysis was then used to identify which items had most power to address the question of professional identity and what factors were more highly related. Questions identified as lowering internal consistency removed and results loaded on three factors. These were termed current personal professional identity, professional identity in practice and development of professional identity. The analysis was repeated including the two omitted items and these loaded onto a fourth factor confirming that they were inconsistent with the rest of the items on the scale. Particular facilitators to development of professional identity were occupation focused models (e.g. MOHO. PEOP), practice education, university-based educators, clinical occupational therapists, use of case studies and reflective practice.  On the other hand, self-directed learning, peers, group work and international learning activities were less frequently identified.

The process of developing this tool was presented at the Royal College of Occupational Therapists Conference, June 11-13th, Belfast, UK.

The tool which has been developed has been shown to have sound internal consistency and incorporates three factors. Reliability has yet to be established as it was not possible to test for reliability as the numbers returned were too low. The data gathered thus far suggests that this will be a useful tool to track the development of professional identity as students progress through an occupational therapy programme or in relation to specific modules e.g. practice education.

Development of professional skills and competencies Survey

 

1. Approximately how many weeks of field work have you completed? ___________________

 

2. Please tick the areas of practice you have completed (you may tick more than one):

 

Hospital based physical health setting

Hospital based mental health setting

Hospital based learning disabilities setting

Community based physical health setting

Community based mental health setting

Community based learning disabilities setting

Primary health care setting

School

Prison

Emerging area of practice

 

 

3. Please indicate any current and/or past work experiences that are relevant to your current studies?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

4. What was the main influence(s) in your decision to become an occupational therapist?(please tick as many as apply)

 

I have wanted to be an occupational therapist for a long time

An occupational therapist I know personally influenced my career choice

An occupational therapist has treated myself or someone I know

Someone provided me with career advice

I was not accepted into my preferred career option

I did not know what else to do

Other (please specify)

 

 

 

  1. Please rate the following statements on a scale of 1-4 (1=Strongly disagree, 2=Disagree, 3=Agree, 4=Strongly agree)

     

Statement

1

Strongly disagree

2

Disagree

3

Agree

4

Strongly agree

At the beginning of the Occupational Therapy program I had a strong identity of becoming an occupational therapist

 

 

 

 

Today I strongly identify myself being an occupational therapist

 

 

 

 

I am looking forward to becoming an occupational therapist

 

 

 

 

Professional identity is an important element in being prepared for professional practice

 

 

 

 

 

 

 

  1. Please rate the following statements on a scale of 1-4 (1=Strongly disagree, 2=Disagree, 3=Agree, 4=Strongly agree). At this point in my education I feel equipped to:

     

Statement

 

 

1

Strongly disagree

2

Disagree

3

Agree

4

Strongly agree

Contribute to the development of an inclusive society through enabling occupation and occupational justice

 

 

 

 

Be creative and adaptable to a range of settings within local and global contexts

 

 

 

 

Work in a culturally diverse world

 

 

 

 

Be competent in professional communication and behavior

 

 

 

 

Be confident and competent in applying OT theory and knowledge to practice and

implementation to individuals, communities & populations

 

 

 

 

Have a core understanding of occupation and its impact on health and wellbeing for

individuals, communities and populations

 

 

 

 

Demonstrate a desire to address health inequities

 

 

 

 

 

 

 

 

 

  1. Please select your responses to the following statements

     

Statement

1

Strongly disagree

2

Disagree

3

Agree

4

Strongly agree

As an occupational therapy student I have had the opportunity to value and use occupation-based practice / theory

 

 

 

 

Occupational therapy is too diverse to have a clear professional identity

 

 

 

 

I would prefer occupational therapy to have a more distinct definition

 

 

 

 

I feel confident in describing occupational therapy

 

 

 

 

I believe overcoming challenging situations and/or experiences fosters professional growth

 

 

 

 

 

  1. Please rate your level of agreement/disagreement with the following statements, how have the following statements  in your program enhanced your development as a professional.

Statement

1

Strongly disagree

2

Disagree

3

Agree

4

Strongly agree

Occupation focused models, e.g. MOHO, CMOP-E, PEO (P)

 

 

 

 

Occupational science

 

 

 

 

Practice education/fieldwork

 

 

 

 

University-based educators, ie lectures/professors

 

 

 

 

Clinical occupational therapists during practice education/fieldwork

 

 

 

 

International learning activities

 

 

 

 

Peers

 

 

 

 

Group-work

 

 

 

 

Self-directed learning

 

 

 

 

Reflective practice

 

 

 

 

Use of case studies

 

 

 

 

 

 

Learning Points

1. Student compliance with requests for research is unpredictable, so more options for review of the data is required

2. The research ethics requirements for different Universities should be considered. Some universities require ethics approval for research involving students, but others do not. So advance planning across all partners is essential to allow for differing timeframes and requirements.

3. Consideration could be given to handing out hard copies of surveys for students to fill in (if they wish) at the end of a lecture. This may improve response rates.