Diss. (sammanfattning) Luleå : Univ. / Härtill 6 uppsatser.

This study examined student understanding and the ability to apply the six tenets of professionalism for pharmacy students before and after an educational intervention. The study population was third and fourth year pharmacy students at the North Dakota State University. Paired t-tests and z-tests were used to analyze the data. The results show that students were able to significantly improve their understanding of all of the six tents. Students were able to slightly improve their ability to apply all of the six tenets, with the exception of accountability, which showed a slight decrease. Differences between the third and fourth year classes was not significant. Gender differences were also not significant.

The Mexican War served as a social battleground for issues such as professionalism, racism, and anti-Catholicism for American regular and volunteer junior officers. Their reaction to these issues influenced and changed the nature of debates to destroy the regular army and close the military academy at West Point. Many in Congress and the United States held a deep-seated fear of the regular army that dated back to the colonial era. They feared that a standing army would become a tool of tyranny and destroy a republican government. Instead, many Americans preferred a volunteer system. They argued that volunteers were virtuous citizens who responded to danger and returned to civilian life when the danger was over. The Mexican War demonstrated that these ideals were not reality, though. Because of this, many in the United States realized that the regular army could safely exist within a republican government, and that the volunteers were not the virtuous patriots many thought. Both regular and volunteer officers reacted with bigotry toward their Catholic opponents in Mexico. Anti-Catholicism impacted the service experience of the junior officers in Mexico. As members of a mostly protestant nation, they pillaged and stole from the many Catholic churches that lay in their path. As members of what they viewed as a superior religion, many officers felt that the Catholic church and faith was a fair target during the Mexican War. Race impacted the service of the junior officers in Mexico. American officers created a racial hierarchy in Mexico that ranked the Mexican populace in various stages of whiteness. The highest social order consisted of those they viewed as white. The lower classes they viewed as a mix of African and Native American. Both regular and volunteers responded in the same manner to these issues.

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Background: Following the MPharm degree, the pre-registration training year is a critical time where the values, attitudes and behaviours of qualified pharmacists are inculcated. Given the paucity of research, a programme of work was undertaken to explore the process of professional socialisation and development of professionalism in trainees during the pre-registration year. Method: The programme of work, the first of its kind in pharmacy, explored the process of professional socialisation and development of professionalism in trainees prospectively during the 2011/12 pre-registration year. A purposive sample of 20 pre-registration trainee-tutor pairs - 14 from community and 6 from hospital pharmacy – were recruited across North West England. Semi-structured interviews and behavioural professionalism questionnaires were used longitudinally in four rounds of data collection during the training year and with newly qualified pharmacists (NQPs; formerly trainees). A cross-sectional survey was administered to 1706 trainees towards the end of the training year to examine areas explored in the longitudinal study, including behavioural professionalism, supervision and ‘patient mattering’. Interviews were analysed thematically using template and framework analyses, and the critical incident technique. Quantitative data was analysed using descriptive and multivariate analyses. Results: Findings demonstrated that many of trainees’ attitudes and values appeared to be fostered during their upbringing and were further shaped by the MPharm degree, laying out professional expectations for pharmacists. At the beginning of training, sector differences were apparent with more formalised inductions in place in hospital than community pharmacies, particularly independents. Previous pharmacy work experience, which all 20 trainees had undertaken during MPharm studies, facilitated the transition into training. Early on in the year, as trainees familiarised themselves with the organisation and working processes they were often supported by pharmacy technicians and other support staff and trainees worked effectively and in a professional manner with them throughout training. The application of clinical knowledge acquired from the MPharm degree was challenging, as recognised by trainees and tutors. With continued practice experience and increased responsibility and patient contact, abilities in applying clinical knowledge and communicating with patients improved, as did trainees’ confidence. Longitudinal ratings of behavioural professionalism increased significantly during training, as assessed by trainees and their tutors, and this was confirmed in the analysis of a representative sample of 347 trainees that were surveyed (response rate = 24.2%). Survey findings showed how elements of behavioural professionalism such as communication skills were more prone to development compared to, for example, appearance and interpersonal skills. Perceptions of supervision received during the training year were generally positive. The pre-registration tutor was a key source of support, as well as role model, throughout the year, particularly in community pharmacy. Hospital tutors had a more distant relationship with their trainees and relied on other pharmacists to supervise their trainees. Tutors were often considered to have the largest impact on the development of professionalism in trainees, particularly in community. When considering aspects of their supervision, hospital trainees rated their tutors significantly higher than those in community in ‘articulation’ and ‘exploration’, relating to asking trainees for rationale of actions and encouraging them to pursue learning goals, respectively. Differences between training sites, such as the pharmacy services being delivered and patient mix, were found as were trainees’ beliefs that they mattered to patients: community trainees believed they mattered more (e.g. were more helpful) to their patients than hospital trainees. Conclusions: The multiple methods employed in this programme of work revealed experiences trainees faced and contributing factors associated with their professional socialisation and development of professionalism. The findings led to recommendations for pharmacy education and training including: integrating university-based and work-based learning more closely, ensuring consistency in training experiences in different settings and sectors, improving training and support for staff involved in training and setting explicit standards relating to elements of professionalism. These are considered in the context of anticipated changes to the MPharm into a more integrated 5-year degree programme.

Leadership style has been studied from various perspectives including transformational leadership and the components of leadership competencies needed to exhibit transformational styles. However, there was a gap in the literature on the influence of leadership style on nursing professional behaviors and overall professionalism. The purpose of this descriptive, phenomenological study was to understand and explore the beliefs, attitudes, and perceptions of staff nurses on leadership style and its influence on professional nursing behaviors working in an inpatient care unit at a tertiary care center. The theory of transformational leadership was the conceptual framework for the study. A phenomenological approach was used for the qualitative interview with data analysis using a descriptive method. A total of 8 nursing participants were interviewed revealing that nurses had similar thoughts on their perceptions of professional characteristics and leadership driving professional socialization. Nurses articulated a practical knowledge of professional activities with little to no connection to a larger sense of professional identity, theory in practice, and ethical obligations to the future of the profession of nursing. There is a noted lack of professionalism seen in the discipline of nursing. Professional registered nurses and heath care leaders in nursing can benefit from this study. Understanding how leadership style can influence nursing not only impacts positive social change and shapes the future of the discipline of nursing, but can also potentially impact patient care outcomes and patient.

Higher Education is influenced by society and workplace demands, which affects the structure of curricula. The literature review exposed a lack of understanding of knowledge in the Oral Hygiene occupational field. This led to a call to understand which knowledge is most valued by the Oral Hygienist and how it affects professional development. This necessitated the examination of knowledge located in curricula. The aim of this study was to study the perceptions of South African Oral Hygiene lecturers and the organisation of knowledge in curricula, in order to learn about current attempts to professionalise the field. The study makes use of a qualitative descriptive design. The study population is based at two universities, consisted of full-time lecturers teaching Oral Hygiene. Data collection and analysis comprised three methods: semi-structured questionnaires to examine the lecturers’ perceptions about knowledge; curriculum analysis gathering information about the curricula making use of a knowledge type analysis tool developed from the conceptual framework; and examination question analysis to assess the recontextualisation of knowledge from concepts or everyday knowledge of practice. The results show a comparison of lecturers’ perceptions and the organisation of knowledge in the curriculum suggest that although it is clear that the lecturers aspire to professionalise the field, the curricula and their own research identities promote the preparation of practitioners with technical skills. This is shown (inter alia) in the following findings about both curricula: ‘clinical applied knowledge’ is highly valued (UNIV1-73% and UNIV2-53%) with a small amount of time spent on ‘pure’ knowledge (UNIV1-8% and UNIV2-12%). The point to be made here is, that an emphasis on ‘Clinical Applied knowledge’ suggests that a large amount of time is spent on covering procedures for practice, which in turn is an indication that the two curricula are inclined towards preparing students for an occupational model of practice. The lecturers’ research identity focuses on knowledge borrowed from clinical practice. Lecturers use a unifying concept for practice and believe they are experts in clinical teaching. In conclusion, examining South African lecturers’ current views of the Oral Hygiene knowledge base and studying its organisation within different curricula reveal that the knowledge most valued in the field is Clinical Applied knowledge with less emphasis on pure knowledge and knowledge applied from the sciences. This study highlights that lecturers aspire to professionalise the field, even though curricula promote the preparation of practitioners with technical skills.

Background: Professionalism, in today’s context, is a determinant of fitness-to-practise of doctors. Many professional and governing bodies around the world have emphasised the need for educating medical students explicitly about professionalism. In fostering professionalism, the institutional culture plays a concealed but vital role. Although the institutional professionalism culture should be explored and understood there was no suitable measure for use in the context of UK undergraduate medical education. The aim of this project was to develop a valid, reliable and practical measure of institutional professionalism culture. Methods and results: The project was conducted in two phases. In the first phase, forty six attributes of professionalism were identified in a literature review. These attributes were surveyed among a nationally representative quota sample of 954 members of the UK general public. They identified 44 attributes as important. With a principal component analysis, three facets to professionalism were identified: the relationship of doctors with patients (clinicianship) and co-workers (workmanship), and the behaviour of doctors in society (citizenship). By analysing the survey responses of 368 UK medical professionals using the Content Validity Index, 28 attributes were identified to represent each facet (clinicianship 10, workmanship 11, and citizenship 7). In the second phase, the 28 attributes were included in an online measure (Dundee Barometer of Institutional Professionalism) with a rating scale based on the Theory of Planned Behaviour (TPB), and field-tested among the faculty and students of the Dundee Medical School. Based on the TPB, questions on personal attitude, institutional expectation and achievability in relation to each attribute were included. The field-test received 212 responses. The measure demonstrated high internal consistencies at both measure and facet levels. It appeared that the professionalism culture in Dundee Medical School was patient-centred, teamwork-oriented and society oriented. A principal component analysis helped reduce the number of items to 15 with five attributes representing each facet. A generalisability study predicted a highly acceptable reliability with the 15 items. The reaction of respondents towards the measure was positive. Conclusions: The Dundee Barometer of Institutional Professionalism (DBIP) is the first quantitative measure of the culture of professionalism in UK medical schools. It was developed with the consensus of both professionals and the general public, and used a theory-based rating scale (hence high validity). It is shown to be reliable with 15 items. The DBIP is a practical measure as it is easy to administer and is acceptable to respondents. The construct validity of the DBIP and its ability to distinguish differences in professionalism culture are areas of future research.

<p>Inom ambulanssjukvården förekommer i olika sammanhang begreppet professionalism. En profession kännetecknas av att den har samhällelig sanktion, egen kultur, auktoritet, etiska regler och systematisk teori. De inom professionen verksamma utövarnas beslut styrs av allmänhetens behov. Ambulanssjuksköterskan är en relativt ny profession och yrkesrollen är under konstant utveckling. Yrkesrollen skiljer sig delvis från andra sjuksköterskor med en ständigt varierande arbetsmiljö. Syftet med denna kvalitativa studie var att undersöka ambulanssjuksköterskors uppfattningar av professinalism. Metoden var intervjuer som kvalitativ datainsamlingsmetod och som forskningsansats valdes fenomenografi. Sju specialistsjuksköterskor arbetande inom ambulanssjukvård intervjuades och i analysen framkom fem kategorier: förväntningar, patientens behov styr vården, uppträdande, att ta ansvar samt en dynamisk ambulanssjuksköterska. Under diskussionen togs det sista steget i analysen och ledde fram till konklusionen att professionalism uppfattas som ett dynamiskt och mångfacetterat fenomen som är en del av utövaren och syftar till att göra gott för patienten.</p>