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PubMed2003

Relative professional roles in antenatal care: results of a survey in Scottish rural general practice.

There is evidence of variation and some ambiguity about self-perceived relative professional roles in antenatal care in the UK. There is little information about models of antenatal care provision in UK rural areas. In rural areas, in particular, women have limited choice in accessing health care professionals or alternative primary care delivery settings. In the light of a recent review of Scottish maternity services, it is important and timely to examine models of care and interprofessional working in antenatal care in rural areas. This study explores midwives' and GPs' perceptions about their relative professional roles in remote and rural general practice in Scotland. A questionnaire survey involving all 174 Scottish remote and rural general practices (using one definition of rurality) was conducted, followed by 20 interviews. At least one professional returned a completed questionnaire from 91% of rural practices. A number of areas of dissonance were noted between GPs' and midwives' perceptions of their roles in maternity care and, given the context of service provision, these may impact upon rural patients. Findings are relevant to wider debates on extending the primary care team and strengthening inter-disciplinary working, particularly in rural areas.

Family Practice↗
PubMed2002

Cross-boundary working: a macro-political analysis of the impact on professional roles.

This paper reviews the policy developments impacting on professional roles and boundaries in health and social care. A macro-political analysis is used to offer a challenging critique to many of the assumptions associated with cross-boundary working. It explores issues such as: whether or not new nursing roles are truly being developed to meet need; the myths and realities of interprofessional working; how competence can be assured; the need for new forms of professional regulation; the implications for professional education of initiatives such as national occupational standards and shared learning; planning the future health care workforce; and the need for rigorous and robust evaluation of service and role developments. Through this exploration the likely consequences of political and professional initiatives for both cross-boundary working and the profession of nursing itself are illuminated.

Clinical Competence↗
PubMed1989

[Professional role of the physician in health care].

The professional role of the doctor in health care was analyzed in terms of the peculiarities of the chilean social reality. Determining factors include tradition, the expectations of society and demands of health policies. Action fields and primary and delegated functions are identified. This may be important to help prevent the take over of some of these functions by other health professionals.

Chile↗
PubMed1987

Transition from student to physical therapist. Changes in perceptions of professional role and relationship between perceptions and job satisfaction.

A longitudinal study of 15 entry-level postbaccalaureate degree graduates was conducted to determine whether their perceptions of the professional role of the physical therapist and of self in that role changed after employment had begun and whether a relationship exists between these perceptions and job satisfaction. Data were collected by mail using a semantic differential test for measuring role perceptions and a questionnaire that included items related to job satisfaction and to demographic data. The return rate was 93%. At the time of data collection, the graduates had been employed for 12 to 18 months. The data on role perceptions were compared with data previously reported by Fincher Corb et al that had been collected on these same subjects when they entered the physical therapy education program and when they completed the program. Kendall's coefficient of concordance revealed significant differences (p less than .05) in three concepts relating to the professional role of the physical therapist and in one concept relating to self in that role. In each instance, the role perception score was lower after 12 to 18 months of employment. Job satisfaction scores were relatively high among the subjects. Spearman correlation coefficients calculated between job satisfaction and role perception scores revealed a positive and direct relationship between three role concepts and job satisfaction. Results of this study provide information about the professional socialization process in physical therapy.

Humans↗
PubMedDate not supplied

The caring occupational therapist: scope of professional roles and boundaries.

OBJECTIVE: This article links two dimensions of occupational therapy within the context of professionalism: the role of caring and the implications of occupational therapy being a predominantly female profession. METHOD: Seven occupational therapists representing various levels of professional experience were interviewed to determine (a) how female occupational therapists perceive caring and (b) the implications of this perception for professional role definitions. RESULTS: Participants' daily professional work role was determined by three factors: the interpretation of holistic philosophy in their everyday activities as occupational therapists, the influence of their caring attitude in broadening their responsibilities beyond the occupational therapists' role definition, and the organizational settings in which their work took place. CONCLUSION: The seven participants had a broad definition of the scope of their professional responsibilities and experienced difficulty defining the limits of their role. Caring is a central part of the occupational therapists' role; therefore, perceptions about caring are central to the role definition of occupational therapists.

Adult↗
PubMed1982

The professional role of physician's assistants in adult ambulatory care practices.

This article describes the methodology and findings of a national survey of Physician's Assistants (PAs) in adult, ambulatory care practices. Data on patient care roles and other professional activities were collected for a three-day period via a comprehensive self-reporting, log-diary instrument. Completing the instrument were 356 (50.4%) PAs. Survey results address the following questions: What is the typical work week for PAs? How do PAs allocate their time in a professional day? What direct patient care services do PAs provide? How productive are PAs with respect to number of patients seen and dollar income generated? In general, the data are consistent with the PA role model of a primary health care professional who provides basic health care services with an emphasis on patient counseling and disease prevention.

Ambulatory Care↗
PubMed2005

Ethnic identity and mentoring among Latinas in professional roles.

This study examined ethnic identity and mentoring (a known strategy to promote career success and advancement) in a sample of 103 Latina women with professional roles in the areas of business, academia, policy, and politics. Other variables examined included traditional gender roles and perceptions of professional success. Findings indicated that the women's ethnic identity was consistent with a bicultural profile; some received mentoring and, if given a choice, would prefer to be mentored by someone of similar ethnicity. This finding is critical and can allow researchers, service providers, and policy developers to apply culturally responsive strategies in communities and in organizations. Other hypotheses were not supported. A discussion of the findings, implications, and suggestions for future research are presented.

Acculturation↗
PubMed2006

The relationship between technology and changing professional roles in health care: A case-study in teledermatology.

Technology is often viewed as a way of bringing about change in professional roles in health care. While this was the case in the service that we studied, we would contend that there were organisational and cultural factors that were equally, if not more important. This was a qualitative study, using observation and interviews, of a relatively new service in teledermatology. Traditionally, patients with skin conditions that could not be managed by a primary care physician were referred to a hospital consultant dermatologist, often resulting in long waits for an outpatient appointment. This service replaced that system with referral to a specialist dermatology nurse, working in primary care. The nurses were supported by the option of a teledermatology referral to a hospital consultant, and the service was managed by a consultant nurse. We will discuss the movement in professional boundaries that we observed, how these movements were possible, why they took place, and the role that the technology played in this process.

Dermatology↗
PubMed2004

Setting and maintaining professional role boundaries: an educational strategy.

AIM: To develop and evaluate a programme focused on assisting medical students in setting and maintaining social and sexual boundaries, within their training and in future medical practice. CONTEXT: In response to allegations of sexual misconduct by medical practitioners, a teaching programme was implemented with, and evaluated by, final year medical students who were undertaking 9 weeks of community health and general practice experience. OUTCOME: The consensus of the students was that professional role boundary issues were complex, their professional ethos had been challenged, and there was a need to incorporate teaching about setting and maintaining role boundaries throughout all facets of the medical curriculum. RESULTS: The pilot programme was successful in engaging students in the process of developing teaching to assist in setting and maintaining social and sexual boundaries. Recommendations to formalise the programme were approved.

Education, Medical, Undergraduate↗
PubMed2004

Swedish medical students' views of the changing professional role of medical doctors and the organisation of health care.

Medical students will influence future health care considerably. Their professional orientation while at medical school will be related to their future professional development. Therefore, it is important to study this group's view of the role of medical doctors, especially because Swedish health care is currently undergoing major changes and financial cut backs. Here, the theoretical framework was contemporary theories of competence development, which has shown that people's understanding of their work influences their actions. The aim of this study was to describe medical students' views of their future professional role in health care. In total, 57 fourth-year medical students at a Swedish university were asked to write a short essay about how they conceptualised their professional role in future health care. Fifty-three students (93%) replied. The essays were analysed qualitatively in three steps and four themes were subsequently identified: the professional role in change, organisation of health care, working conditions and the possibilities of having a balanced life. Some factors mentioned that would strongly influence the professional role were being team leader, increased specialisation, supporting the patient and computer science and technology. The students expressed ambiguous feelings about power and leadership. The results indicate that the students share a rather dark view of both the medical profession and health care, which seems to be related to stress and financial cut backs. Mentoring, time for reflection and changes in the curricula might be needed.

Delivery of Health Care↗
PubMed1990

Professional role and autonomy in physiotherapy. A study of Swedish physiotherapists.

A study of 163 physiotherapists' conception of their professional role and autonomy and the implications for their work has been completed. About half (55%) felt that physicians and other staff members primarily expected them to act as independent professionals, while about one-third (34%) felt that they were expected to undertake treatment after referral from or discussion with the physician. Most physiotherapists (86%) were firmly in control of their treatment methods, but had somewhat restricted freedom in deciding whom to treat, and when to terminate treatment. The majority (96%) regarded their professional tasks as being important for others. Few (14%) had carried out any systematic evaluation of their methods and results--hence few obtained any objective feedback from their work, which is believed to affect the quality of work, as well as work motivation and job satisfaction.

Adult↗
PubMedDate not supplied

The deployment of information technology in clinical laboratories and its impact on professional roles.

New information technology is deployed in hospital clinical laboratories to increase both the quality and efficiency of laboratory operations. Although total laboratory expenses may rise as a result of technology deployment, the average cost per test may decline. S-curves can be used to illustrate the effects of new information technology--such as a laboratory information system (LIS)--on the useful output and use of resources in laboratories. Major changes are now occurring as a result of the deployment of information technology, most notably in the area of automated information management. The role of laboratory professionals must be modified in response to this new information environment. The generation of information within clinical laboratories should be considered as the beginning--not the end--of the responsibility of laboratory professionals.

Clinical Laboratory Information Systems↗
PubMed2001

Principles and narrative in forensic psychiatry: toward a robust view of professional role.

Recent debates in the ethics of forensic psychiatry have centered on the applicability of traditional medical ethics to forensic practice. Two prominent theories, one taking a principled approach and another taking a narrative approach, have attempted to resolve the tension between medical and legal settings. In this article we contend that the two theories are related closely and work at two different levels: principles at the level of theory and narrative at the level of application. We offer an approach to forensic ethics that reconciles competing theoretical views by relating professional role and personal integrity.

Adult↗
PubMed1994

Ethical dilemmas and professional roles in occupational medicine.

Occupational medicine presents ethical dilemmas between worker health and corporate goals, for both physicians and managers. Physicians in occupational practice recognize conflict between 'moralist' and 'utilitarian' ethical positions. This paper analyzes the relation of professional roles to ethical interpretations by occupational physicians, based on their own and medical ethicists' formulations of dilemmas. Physicians' conflicting responsibilities to workers as patients and to corporate practices and policy are reviewed in the context of occupational risk and the critical anthropology of health.

Administrative Personnel↗
PubMed2004

The professional role of breast cancer nurses in multi-disciplinary breast cancer care teams.

Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses' unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses' innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role.

Attitude of Health Personnel↗
PubMedDate not supplied

Clinical and professional role development among experienced pediatric nurses: the pediatric medical nursing certificate program.

ISSUES AND PURPOSE: The development of a multiunit-based certificate program to promote retention by increasing experienced pediatric nurses' knowledge, skills, and professional role development through a blend of didactic, clinical, and mentoring components. CONCLUSIONS: The certificate group demonstrated an increase in knowledge and skill, advanced leadership role acquisition, promotion, certification, and graduate school matriculation, and achieved a 95% retention rate within the organization. PRACTICE IMPLICATIONS: With support from management and multidisciplinary team members, a certificate program like this can be implemented in a variety of settings and specialties.

Certification↗