Skip to main content

Advertisement

Log in

From being a nurse to becoming a ‘different’ doctor

  • Published:
Advances in Health Sciences Education Aims and scope Submit manuscript

Abstract

Using interpretative phenomenological analysis to make meaning of the experiences of three highly qualified registered nurses who had enrolled in an undergraduate medical programme, this study provides insight into their personal journeys of wanting to become ‘different’ doctors. In so doing, they conceptualised their future selves as adding clinical reasoning and diagnostic skills to the patient-centred caring ethic of their nursing practice, becoming a multi-skilled community member or helping to fix the health care culture. By customising their identities, e.g. by splinting (aligning with their stronger nursing identity), by enriching current nursing practice with newly acquired theory as medical students or by patching a perceived deficiency (i.e. patient-centredness) in medicine, they tailored their identities. Their journeys had, however, not been the natural progression they had anticipated, threatened by perceived and/or real intrinsic (e.g. working as nurses whilst studying medicine) and extrinsic (e.g. interprofessional rivalry) factors. Rather than being accepted as legitimate newcomers to the medical profession, the women sometimes felt like intruders. Some nursing colleagues accused them of desertion. In response, they generally withheld their identities as nurses or medical students, compartmentalising their group membership. This study has highlighted the role of personal (e.g. prior experience; agency; resilience; personality) and contextual factors in ‘becoming’ a doctor. A recommendation emerging from this study is the need for interprofessional learning in the medical curriculum to cultivate a health care culture of collaboration rather than competition. Future research is required in terms of how allied health professionals transition to medicine.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Andrew, N. (2012). Professional identity in nursing: Are we there yet? Nursing Education Today, 32, 846–849.

    Article  Google Scholar 

  • Australian Bureau of Statistics. (2015). 3412.0—Migration, Australia, 2013–2014. Retrieved February 22, 2016, from http://www.abs.gov.au/AUSSTATS/abs@.nsf/mf/3412.0.

  • Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioural change. Psychological Review, 84(2), 191–215.

    Article  Google Scholar 

  • Barbour, J. B., & Lammers, J. C. (2015). Measuring professional identity: A review of the literature and a multilevel confirmatory factor analysis of identity constructs. Journal of Professions and Organization, 2, 38–60.

    Article  Google Scholar 

  • Barr, H. (1998). Competent to collaborate: Towards a competency-based model for interprofessional education. Journal of Interprofessional Care, 12, 181–187.

    Article  Google Scholar 

  • Barrow, M., McKimm, J., & Gascoigne, S. (2011). The policy and the practice: Early-career doctors and nurses as leaders and followers in the delivery room. Advances in Health Sciences Education, 16, 17–29.

    Article  Google Scholar 

  • Benbassat, J. (2013). Undesirable features of the medical learning environment: a narrative review of the literature. Advances in Health Sciences Education, 18, 527–536.

    Article  Google Scholar 

  • Biggerstaff, D. L., & Thompson, A. R. (2008). Interpretive phenomenological analysis (IPA): A qualitative methodology of choice in healthcare research. Qualitative Research in Psychology, 5, 173–183.

    Article  Google Scholar 

  • Birks, M., Mills, J., Francis, K., Coyle, M., et al. (2010). Models of health service delivery in remote or isolated areas of Queensland: A multiple case study. Australian Journal of Advanced Nursing, 28(1), 25–33.

    Google Scholar 

  • Bridges, J. M. (1990). Literature review on the images of the nurse and nursing in the media. Journal of Advanced Nursing, 15, 850–854.

    Article  Google Scholar 

  • Cruess, R. L., Cruess, S. R., Boudreau, J. D., Snell, L., & Steinert, Y. (2014). Reframing medical education to support professional identity formation. Academic Medicine, 89(11), 1446–1451.

    Article  Google Scholar 

  • Cruess, R. L., Cruess, S. R., Boudreau, J. D., Snell, L., & Steinert, Y. (2015). A schematic representation of the professional identity formation and socialization of medical students and residents: A guide for medical educators. Academic Medicine, 90(6), 718–725.

    Article  Google Scholar 

  • Frost, H. D., & Regehr, G. (2013). “I am a doctor”: Negotiating the discourses of standardization and diversity in professional identity construction. Academic Medicine, 88(10), 1570–1577.

    Article  Google Scholar 

  • Goldie, J. (2012). The formation of professional identity in medical students: Considerations for educators. Medical Teacher, 34, e641–e648.

    Article  Google Scholar 

  • Hafferty, F. W., & Franks, R. (1994). The hidden curriculum, ethics teaching, and the structure of medical education. Academic Medicine, 69(11), 861–871.

    Article  Google Scholar 

  • Health Workforce Australia. (2012). Health Workforce Australia. Australia’s Health Workforce Series. Health Workforce by Numbers. Issue 1, February 2013. Retrieved August 6, 2014, from https://www.hwa.gov.au/sites/uploads/australias_health_workforce_series_doctors_in_focus_20120322.pdf.

  • Hewett, D. G., Watson, B. M., Gallois, C., Ward, M., & Leggett, B. A. (2009). Intergroup communication between hospital doctors: Implications for patient care. Social Sciences and Medicine, 69, 1732–1740.

    Article  Google Scholar 

  • Hilton, S. R., & Slotnick, H. B. (2005). Proto-professionalism: How professionalism occurs across the continuum of medical education. Medical Education, 39, 58–65.

    Article  Google Scholar 

  • Hoeve, Y. T., Jansen, G., & Roodbol, P. (2014). The nursing profession: public image, self-concept and professional identity. A discussion paper. Journal of Advanced Nursing, 70(2), 295–309.

    Article  Google Scholar 

  • Hogg, M. A., & Reid, S. A. (2006). Social identity, self-categorization, and the communication of group norms. Communication Theory, 16, 7–30.

    Article  Google Scholar 

  • Holden, M., Buck, E., Clark, M., Szauter, K., & Trumble, J. (2012). Professional identity formation in medical education: The convergence of multiple identities. HEC Forum, 24, 245–255.

    Article  Google Scholar 

  • Hornsey, M. J. (2008). Social identity theory and self-categorization theory: A historical review. Social and Personality Psychology Compass, 2(1), 204–222.

    Article  Google Scholar 

  • Hornsey, M. J., Oppes, T., & Svensson, A. (2002). “It’s OK if we say it, but you can’t”: Responses to intergroup and intragroup criticism. European Journal of Social Psychology, 32, 293–307.

    Article  Google Scholar 

  • Ibarra, H. (1999). Provisional selves: Experimenting with image and identity in professional adaptation. Administrative Science Quarterly, 44, 764–791.

    Article  Google Scholar 

  • Ibarra, H., & Barbulescu, R. (2010). Identity as narrative: Prevalence, effectiveness, and consequences of narrative identity work in macro work role transitions. Academy of Management Review, 35(1), 135–154.

    Article  Google Scholar 

  • Kaiser, R. (2002). Fixing identity by denying uniqueness: An analysis of professional identity in medicine. Journal of Medical Humanities, 23(2), 95–105.

    Article  Google Scholar 

  • Langendyk, V., Hegazi, I., Cowin, L., Johnson, M., & Wilson, I. (2015). Imagining alternative professional identities: Reconfiguring professional boundaries between nursing students and medical students. Academic Medicine, 90(6), 732–737.

    Article  Google Scholar 

  • Leong, J. (2014). From nurse to doctor: The career path less encouraged. Retrieved April 26, 2015, from http://blogs.einstein.yu.edu/from-nurse-to-doctor-the-career-path-less-encouraged/.

  • Levinson, D. J. (1981). loc. cit.

  • Lopez, K. A., & Willis, D. G. (2004). Descriptive versus interpretative phenomenology: Their contributions to nursing knowledge. Qualitative Health Research, 14(5), 726–735.

    Article  Google Scholar 

  • MacLeod, A. (2011). Caring, competence and professional identities. Advances in Health Sciences Education, 16, 375–394.

    Article  Google Scholar 

  • Mathews, B., & Bismark, M. M. (2015). Sexual harassment in the medical profession: Legal and ethical responsibilities. Medical Journal of Australia, 203(4), 189–192.

    Article  Google Scholar 

  • McKay, K. A., & Narasimhan, S. (2012). Bridging the gap between doctors and nurses. Journal of Nursing Education and Practice, 2(4), 52–55.

    Article  Google Scholar 

  • McLean, M., Johnson, P., Sargeant, S., & Green, P. (2015a). Simulated patients’ perspectives of and role in medical students’ professional identity development. Simulation in Health Care, 10(2), 85–91.

    Article  Google Scholar 

  • McLean, M., Johnson, P., Sargeant, S., & Green, P. (2015b). More than just teaching procedural skills: How RN clinical tutors perceive they contribute to medical students’ professional identity development. Australasian Medical Journal, 8(4), 122–131.

    Article  Google Scholar 

  • Monrouxe, L. V. (2009). Negotiating professional identities: Dominant and contesting narratives in medical students’ longitudinal audio diaries. Current Narratives, 1, 41–59.

    Google Scholar 

  • Monrouxe, L. V. (2010). Identity, identification and medical education: Why should we care? Medical Education, 44(1), 40–49.

    Article  Google Scholar 

  • Niemi, P. M. (1997). Medical students’ professional identity: Self-reflection during the preclinical years. Medical Education, 31, 408–415.

    Article  Google Scholar 

  • Pietkiewicz, I., & Smith, J. A. (2014). A practical guide to using interpretative phenomenological analysis in qualitative research psychology. Psychological Journal, 20(1), 7–14.

    Google Scholar 

  • Pratt, M. G., Rockmann, K. W., & Kaufmann, J. B. (2006). Constructing professional identity: The role of work and identity learning cycles in the customization of identity amongst medical residents. Academy of Management Journal, 492, 235–262.

    Article  Google Scholar 

  • Pringle, J., Drummond, J., McLaffferty, E., & Hendry, C. (2011). Interpretative phenomenological analysis: A discussion and critique. Nurse Researcher, 18(3), 20–24.

    Article  Google Scholar 

  • Roccas, S., & Brewer, M. S. (2002). Social identity complexity. Personality and Social Psychology Review, 6(2), 88–106.

    Article  Google Scholar 

  • Romano, C. A., & Pangaro, L. N. (2014). What is a doctor and what is a nurse? A perspective for future practice and education. Academic Medicine, 89(7), 970–972.

    Article  Google Scholar 

  • Sarukkai, S. (2015). Challenges for STEM education in India. In O. Renn, N. C. Karafyllis, A. Hohlt, & D. Taube (Eds.), International science and technology education. Exploring culture, econonomy and social perceptions (pp. 69–84). New York: Routledge.

    Google Scholar 

  • Scott, K. M., Caldwell, P. H. Y., Barnes, E. H., & Barrett, J. (2015). Teaching by humiliation and mistreatment of medical students in clinical rotations: A pilot study. Medical Journal of Australia, 203(4), 185. doi:10.5694/mja15.00189.

    Article  Google Scholar 

  • Sims, D. (2008). Reconstructing professional identity for professional and interprofessional practice: A mixed methods study of joint training programmes in learning disability nursing and social work. Journal of Interprofessional Care, 25, 265–271.

    Article  Google Scholar 

  • Slay, H. S., & Smith, D. A. (2011). Professional identity construction: Using narrative to understand the negotiation of professional and stigmatized cultural identities. Human Relations, 64(1), 85–107.

    Article  Google Scholar 

  • Smith, J. A., & Osborn, M. (2008). Interpretive phenomenological analysis. In J. A. Smith (Ed.), Qualitative psychology: A practical guide to methods (2nd ed.). London: Sage Publications.

    Google Scholar 

  • Stryker, S., & Burke, P. J. (2000). The past, present, and future of an identity theory. Social Psychology Quarterly, 63(4), 284–297.

    Article  Google Scholar 

  • ten Hoeve, Y., Jensen, G., & Roodbool, P. (2014). The nursing profession: Public image, self-concept and professional identity. A discussion paper. Journal of Advanced Nursing, 70(2), 295–309.

    Article  Google Scholar 

  • Trede, F. (2012). Role or work-integrated learning in developing professionalism and professional identity. Asia-Pacific Journal of Cooperative Education, 1(3), 159–167.

    Google Scholar 

  • Trede, F., Macklin, R., & Bridges, D. (2012). Professional identity development: A review of the higher education literature. Studies in Higher Education, 37(3), 365–384.

    Article  Google Scholar 

  • Vågan, A. (2011). Towards a sociocultual perspective on identity formation in education. Mind, Culture, Activity, 18, 43–57.

    Article  Google Scholar 

  • Wald, H. S. (2015). Professional identity (trans)formation in medical education: Reflection, relationship, resilience. Academic Medicine, 90(6), 701–706.

    Article  Google Scholar 

  • Wald, H. S., Anthony, D., Hutchinson, T. A., Liben, S., Smilovitch, M., & Donato, A. A. (2015). Professional identity formation in medical education for humanistic, resilient physicians: Pedagogic strategies for bridging theory and practice. Academic Medicine, 90(6), 753–760.

    Article  Google Scholar 

  • Walton, M. M. (2015). Sexual equality, discrimination and harassment in medicine: it’s time to act. Medical Journal of Australia, 203(4), 167–169.

    Article  Google Scholar 

  • Weller, J. (2012). Shedding light on tribalism in health care. Medical Education, 46, 132–142.

    Article  Google Scholar 

  • Wenger, E. (1998). Communities of practice: Learning, meanings and identity. New York: Cambridge University Press.

    Book  Google Scholar 

  • Wilson, I., Cowin, L. S., Johnson, M., & Young, H. (2013). Professional identity in medical students: Pedagogical challenges to medical education. Teach and Learning in Medicine, 25(4), 369–373.

    Article  Google Scholar 

  • Wong, A., & Trollope-Kumar, K. (2014). Reflections: An inquiry into medical students’ professional identity formation. Medical Education, 48, 489–501.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michelle McLean.

Ethics declarations

Ethical approval

Ethics approval for the professional identity study was obtained from the University’s Human Research Ethics Committee (RO1537).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McLean, M. From being a nurse to becoming a ‘different’ doctor. Adv in Health Sci Educ 22, 667–689 (2017). https://doi.org/10.1007/s10459-016-9700-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10459-016-9700-y

Keywords

Navigation