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‘Sometimes I don't feel like an osteopath at all’- a qualitative study of final year osteopathy students' professional identities

Published:September 15, 2017DOI:https://doi.org/10.1016/j.ijosm.2017.09.001

      Abstract

      Background

      Research suggests that professional identity has implications for standards of professionalism, patient care and work satisfaction. Professional identity develops during professional education and continues into working life. While osteopaths' professional identities and conceptions of practice have been outlined, the professional identities of osteopathic students are yet to be elucidated.

      Objectives

      To explore and describe final year osteopathy students' professional identities and their development.

      Method

      Semi-structured interviews were conducted with a purposive sample of eight final year osteopathy students from two osteopathic education institutions in the UK. Interviews were transcribed verbatim and constructivist grounded theory was used to conceptualise, collect and analyse data.

      Results

      Participants' professional identities varied and were illustrated by their thoughts and beliefs around their approach to patients, the osteopathic profession, learning experience and practice skills. There was also variation in the stages of development of participants' professional identities which lay on a continuum ranging from ‘under construction’, ‘transitioning’ and ‘constructed’.

      Conclusions

      The findings suggest that final year osteopathy students held differing professional identities, and four categories were constructed which describe this variation, these were: approach to patient care, view of osteopathy, learning experience and view of practical skills. Students' professional identities varied in their stages of development and related to three points along a profession identity continuum and are in accordance with role transition theory. A well-developed professional identity, which is also flexible in response to new knowledge and evidence, has positive connotations for students' confidence in practice, well-being and career success.

      Keywords

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      References

        • Allen V.L.
        • Van de Vliert E.
        Role transitions: explorations and explanations.
        Springer Science & Business Media, 2012
        • Bishop F.L.
        • Smith R.
        • Lewith G.T.
        Patient preferences for technical skills versus interpersonal skills in chiropractors and physiotherapists treating low back pain.
        Fam Pract. 2013; 30: 197-203
        • Cant S.L.
        • Sharma U.
        Professionalization of complementary medicine in the United Kingdom.
        Complementary Ther Med. 1996; 4: 157-162
        • Charmaz K.
        Constructing grounded theory.
        SAGE Publications, 2014
        • Cotton A.
        Osteopathic principles in the modern world.
        Int J Osteopath Med. 2013; 16: 17-24
        • Coyne I.T.
        Sampling in qualitative research. Purposeful and theoretical sampling; merging or clear boundaries?.
        J Adv Nurs. 1997; 26: 623-630
        • Cutcliffe J.R.
        Methodological issues in grounded theory.
        J Adv Nurs. 2000; 31: 1476-1484
        • Darlow B.
        • Dean S.
        • Perry M.
        • Mathieson F.
        • Baxter G.D.
        • Dowell A.
        Easy to harm, hard to heal: patient views about the back.
        Spine. 2015; 40: 842-850
        • Darlow B.
        • Dowell A.
        • Baxter G.D.
        • Mathieson F.
        • Perry M.
        • Dean S.
        The enduring impact of what clinicians say to people with low back pain.
        Ann Fam Med. 2013; 11: 527-534
        • Darlow B.
        • Fullen B.M.
        • Dean S.
        • Hurley D.A.
        • Baxter G.D.
        • Dowell A.
        The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: a systematic review.
        Eur J Pain. 2012; 16: 3-17
        • Del Baño-Aledo M.E.
        • Medina-Mirapeix F.
        • Escolar-Reina P.
        • Montilla-Herrador J.
        • Collins S.M.
        Relevant patient perceptions and experiences for evaluating quality of interaction with physiotherapists during outpatient rehabilitation: a qualitative study.
        Physiotherapy. 2014; 100: 73-79
        • Dey I.
        Grounding grounded theory: guidelines for qualitative inquiry.
        Academic Press, 1999
        • Dwyer S.C.
        • Buckle J.L.
        The space between: on being an insider-outsider in qualitative research.
        Int J Qual methods. 2009; 8: 54-63
        • Elvey R.
        • Hassell K.
        • Hall J.
        Who do you think you are? Pharmacists' perceptions of their professional identity.
        Int J Pharm Pract. 2013; 21: 322-332
        • Evans D.W.
        Osteopathic principles: more harm than good?.
        Int J Osteopath Med. 2013; 16: 46-53
        • Feen-Calligan H.R.
        Constructing professional identity in art therapy through service-learning and practica.
        Art Ther. 2005; 22: 122-131
        • Figg-Latham J.
        • Rajendran D.
        Quiet dissent: the attitudes, beliefs and behaviours of UK osteopaths who reject low back pain guidance – a qualitative study.
        Musculoskelet Sci Pract. 2017; 27: 97-105
        • Fryer G.
        Teaching critical thinking in osteopathy–Integrating craft knowledge and evidence-informed approaches.
        Int J Osteopath Med. 2008; 11: 56-61
        • Hammond R.
        • Cross V.
        • Moore A.
        The construction of professional identity by physiotherapists: a qualitative study.
        Physiotherapy. 2016; 102: 71-77
        • Heath C.
        • Luff P.
        • Sanchez Svensson M.
        Video and qualitative research: analysing medical practice and interaction.
        Med Educ. 2007; 41: 109-116
        • Hunter B.
        • Warren L.
        Investigating resilience in midwifery.
        Royal College of Midwives, 2013
        • Ibarra H.
        Provisional selves: experimenting with image and identity in professional adaptation.
        Adm Sci Q. 1999; 44: 764-791
        • Ikiugu M.N.
        • Rosso H.M.
        Facilitating professional identity in occupational therapy students.
        Occup Ther Int. 2003; 10: 206-225
        • Irby D.
        Educating physicians for the future: carnegie's calls for reform.
        Med Teach. 2011; 33: 547-550
        • Kasiri-Martino H.
        • Bright P.
        Osteopathic educators' attitudes towards osteopathic principles and their application in clinical practice: a qualitative inquiry.
        Man Ther. 2016; 21: 233-240
        • Khapova S.N.
        • Arthur M.B.
        • Slay H.S.
        • Smith D.A.
        Professional identity construction: using narrative to understand the negotiation of professional and stigmatized cultural identities.
        Hum Relat. 2011; 64: 85-107
        • Kvale S.
        Doing interviews.
        SAGE Publications, 2008
        • Lincoln Y.S.
        • Guba E.G.
        Naturalistic inquiry.
        SAGE Publications, 1985
        • Lindquist I.
        • Engardt M.
        • Garnham L.
        • Poland F.
        • Richardson B.
        Physiotherapy students' professional identity on the edge of working life.
        Med Teach. 2006; 28: 270-276
        • Lindquist I.
        • Engardt M.
        • Richardson B.
        Learning to be a physiotherapist: a metasynthesis of qualitative studies.
        Physiother Res Int. 2010; 15: 103-110
        • Machin A.I.
        • Machin T.
        • Pearson P.
        Maintaining equilibrium in professional role identity: a grounded theory study of health visitors' perceptions of their changing professional practice context.
        J Adv Nurs. 2012; 68: 1526-1537
        • McCluskey A.
        Collaborative curriculum development: clinicians' views on the neurology content of a new occupational therapy course.
        Aust Occup Ther J. 2000; vol. 47: 1-10
        • McGivern G.
        • Fischer M.D.
        • Palaima T.
        • Spendlove Z.
        • Thomson O.
        • Waring J.
        Exploring and explaining the dynamics of osteopathic regulation, professionalism and compliance with standards in practice.
        General Osteopathic Council, 2015
        • McGrath M.C.
        From distinct to indistinct, the life cycle of a medical heresy. Is osteopathic distinctiveness an anachronism?.
        Int J Osteopath Med. 2013; 16: 54-61
        • McGrath M.C.
        A global view of osteopathic practice–mirror or echo chamber?.
        Int J Osteopath Med. 2015; 18: 130-140
        • Monrouxe L.V.
        Identity, identification and medical education: why should we care?.
        Med Educ. 2010; 44: 40-49
        • Morrow G.
        • Burford B.
        • Rothwell C.
        • Carter M.
        • McLachlan J.
        • Illing J.
        Professionalism in healthcare professionals. Report to the health and care professions council.
        HCPC, London2014
        • Öhman A.
        • Solomon P.
        • Finch E.
        Career choice and professional preferences in a group of Canadian physiotherapy students.
        Adv Physiother. 2002; 4: 16-22
        • Orb A.
        • Eisenhauer L.
        • Wynaden D.
        Ethics in qualitative research.
        J Nurs Scholarsh. 2001; 33: 93-96
        • Paulus S.
        The core principles of osteopathic philosophy.
        Int J Osteopath Med. 2013; 16: 11-16
        • Penney J.N.
        The Biopsychosocial model: redefining osteopathic philosophy?.
        Int J Osteopath Med. 2013; 16: 33-37
        • Petty N.J.
        • Scholes J.
        • Ellis L.
        Master's level study: learning transitions towards clinical expertise in physiotherapy.
        Physiotherapy. 2011; 97: 218-225
        • Professional Standards Authority
        Professional identities and regulation: a literature review.
        Professional Standards Authority, 2016
        • Richardson B.
        Professional development: 1. Professional socialisation and professionalisation.
        Physiotherapy. 1999; 85: 461-467
        • Richardson B.
        Professional development: 2. Professional knowledge and situated learning in the workplace.
        Physiotherapy. 1999; 85: 467-474
        • Richardson B.
        • Lindquist I.
        • Engardt M.
        • Aitman C.
        Professional socialization: students' expectations of being a physiotherapist.
        Med Teach. 2002; 24: 622-627
        • Schein E.H.
        • Schein E.
        Career dynamics: matching individual and organizational needs.
        Addison-Wesley Reading, MA1978
        • Stenberg G.
        • Fjellman-Wiklund A.
        • Ahlgren C.
        ‘I am afraid to make the damage worse’ – fear of engaging in physical activity among patients with neck or back pain – a gender perspective.
        Scand J Caring Sci. 2014; 28: 146-154
        • Stern D.T.
        • Papadakis M.
        The developing physician—becoming a professional.
        N. Engl J Med. 2006; 355: 1794-1799
        • Tanti C.
        • Stukas A.A.
        • Halloran M.J.
        • Foddy M.
        Social identity change: shifts in social identity during adolescence.
        J Adolesc. 2011; 34: 555-567
        • Thomson O.P.
        • Collyer K.
        ‘Talking a different language’–A qualitative study on low back pain patients' interpretation of the language used by student osteopaths.
        Int J Osteopath Med. 24, June 2017; : 3-11
        • Thomson O.P.
        • Petty N.J.
        • Moore A.P.
        Clinical reasoning in osteopathy–more than just principles?.
        Int J Osteopath Med. 2011; 14: 71-76
        • Thomson O.P.
        • Petty N.J.
        • Moore A.P.
        Reconsidering the patient-centeredness of osteopathy.
        Int J Osteopath Med. 2013; 16: 25-32
        • Thomson O.P.
        • Petty N.J.
        • Moore A.P.
        Clinical decision-making and therapeutic approaches in osteopathy–a qualitative grounded theory study.
        Man Ther. 2014; 19: 44-51
        • Thomson O.P.
        • Petty N.J.
        • Moore A.P.
        Osteopaths' professional views, identities and conceptions – a qualitative grounded theory study.
        Int J Osteopath Med. 2014; 17: 146-159
        • Thomson O.P.
        • Petty N.J.
        • Moore A.P.
        A qualitative grounded theory study of the conceptions of clinical practice in osteopathy–a continuum from technical rationality to professional artistry.
        Man Ther. 2014; 19: 37-43
        • Thomson O.P.
        • Petty N.J.
        • Scholes J.
        Grounding osteopathic research – introducing grounded theory.
        Int J Osteopath Med. 2014; 17: 167-186
        • Timoštšuk I.
        • Ugaste A.
        Student teachers' professional identity.
        Teach Teach Educ. 2010; 26: 1563-1570
        • Tong A.
        • Sainsbury P.
        • Craig J.
        Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.
        Int J Qual Health Care. 2007; 19: 349-357
        • Tyreman S.
        Valuing osteopathy: what are (our) professional values and how do we teach them?.
        Int J Osteopath Med. 2008; 11: 90-95
        • Tyreman S.
        Re-evaluating ‘osteopathic principles’.
        Int J Osteopath Med. 2013; 16: 38-45
        • Vaughan B.
        • Moore K.
        • Macfarlane C.
        • Grace S.
        Australian osteopathic students' perceptions of interprofessional relationships.
        Int J Osteopath Med. 2017; 23: 11-21
        • Willetts G.
        • Clarke D.
        Constructing nurses' professional identity through social identity theory.
        Int J Nurs Pract. 2014; 20: 164-169
        • Wong A.
        • Trollope-Kumar K.
        Reflections: an inquiry into medical students' professional identity formation.
        Med Educ. 2014; 48: 489-501