The professional subcultures of students entering medicine, nursing and pharmacy programmes

Horsburgh, Margaret; Perkins, Rod; Coyle, Barbara; Degeling, Pieter

doi:10.1080/13561820600805233

Cited by 67 publications

(58 citation statements)

References 12 publications

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“…The "pragmatic hierarchy" (Burford et al, 2013, p. 397), wherein experienced nurses mentor novice physicians, accurately characterizes the relationship between the nursing and medical students. In acknowledging their nursing counterparts' complementary (and at turns deeper) knowledge base and scope of practice, the medical students willingly abjured any stereotypical notions of medical superiority (Horsburgh et al, 2006;Page & Meerabeau, 2004). Where Burford et al (2013) view the pragmatic hierarchy as a temporary phenomenon, however, participants in this study regarded it as a foundation for future practice, in which a level playing field would be the rule and not the exception.…”

Section: Discussionmentioning

confidence: 99%

“…Student and staff accounts of the older MDs' disengagement from pilot are consistent with Becker, Hanyok and Walton-Moss's (2014) finding that older instructors with uniprofessional training are more turf-conscious and resistant to IP education, but this does not suggest these MDs were otherwise opposed to collaborative practice. The medical students, for their part, were eager to contribute to the pilot and to the research study, despite previous findings suggesting this cohort is inherently resistant to the goals of IPE and IP research (Horsburgh et al, 2006;Olson, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…Horsburgh et al (2006) find that pre-medical students are much less likely to embrace a collaborative, team-based approach to clinical work than their pre-nursing counterparts. Moreover, siloed, hierarchical discourses are no less prevalent in educational settings than they are within professional health care teams.…”

Section: Cultural Barriers To Ipementioning

confidence: 99%

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Leveling the Playing Field: An Interprofessional Rural Preceptorship Pilot for Students of Nursing and Medicine

Jackman

Yonge

Myrick

et al. 2018

JSR

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Despite the ubiquity of interprofessional education (IPE) in the health sciences, cultural barriers to collaboration and socialization across disciplines are pervasive and persistent. The Interprofessional Rural Preceptorship Pilot (IPRPP) was implemented over 18 months between 2014 and 2015, to deliver mutual, practice-based, collaborative experiences to students of nursing and medicine, and to capitalize on the multidisciplinary team ethos of rural settings in socializing these students into an interprofessional culture. Students; precepting nurses and physicians; unit managers; and faculty supplied qualitative research data through semistructured interviews and focus groups, to help determine the effectiveness of the IPRPP in achieving its ends. Thematic analysis of transcripts, field notes and memos revealed that the pilot: 1) induced all participants to reflect on cultural barriers to IPE, particularly in light of the more experienced, male physicians' apparent reluctance to buy into the pilot or the research study; 2) sensitized medical students to the scope of practice, roles and knowledge base of registered nurses and nursing students, whom they came to value as collaborators and teachers; and 3) inspired nursing students to take the lead in arranging interprofessional experiences, and to assert their viewpoints as equals within the multidisciplinary team. It was found that liminal (transitional) spaces and the frontline relaxation of traditional hierarchies-both widely acknowledged features of rural health care settings-contributed to these outcomes. The findings show that clinical settings have a significant impact on the interprofessional socialization of nursing and medical students, with implications for the design of future IPE initiatives.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Leveling the Playing Field: An Interprofessional Rural Preceptorship Pilot for Students of Nursing and Medicine

Jackman

Yonge

Myrick

et al. 2018

JSR

View full text Add to dashboard Cite

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“…Over the past twenty years, global health care systems have placed greater emphasis on improving patient care delivery [1] in response to averting medical errors. [2] And more than a decade ago the Institute of Medicine (IOM) suggested that coordinated and collaborative efforts to improve patient outcomes can best address the changing health care paradigm.…”

Section: Introductionmentioning

confidence: 99%

Interprofessional learning: Perceptions of first year health students

Honan

Fahs

Talwalkar

et al. 2015

JNEP

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Background: Shared learning among health professional students has the potential to improve collaboration and reduce medical errors resulting in improved patient outcomes. While organizational difficulties pose significant challenges to implementing interprofessional learning, negative student attitudes may pose the greatest barrier to change. Thus, the aim of this qualitative study was to determine perceptions of first year health students (medical, nursing, and physician associate) toward interprofessional learning. Methods and findings: Content analysis was used to identify the repetitive themes regarding the facilitators and barriers to interprofessional education (IPE). Krippendorff's method was used to analyze comments written in an open-ended survey completed by first year medical (48/101 or 48%), nursing (59/81 or 73%) and physician associate (19/35 or 54%) students representing a response rate of 58% from one university in New England. Conclusions: Five interrelated themes emerged: Barriers included: History as prologue and Misunderstanding of "others", versus Resistance to "others". Facilitators included: Personal characteristics, Professional characteristics and Educational characteristics. Unique to medical students is Self-conscious emotions, while Optimism is unique to nursing students. While students may be ready to transform our educational systems, attention must be focused on the learning environment and complex factors that will facilitate this transformation.

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“…12 Using the same methods, this paper reports on whether a cohort of students who have completed their training have different attitudes, beliefs and values from those entering their tertiary study.…”

mentioning

confidence: 99%

Attitudes, beliefs and values of students in undergraduate medical, nursing and pharmacy programs

Perkins¹,

Horsburgh²,

Coyle³

2008

Aust. Health Review

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First and final year students in medicine, nursing and pharmacy programs at the University of Auckland completed a questionnaire used in studies of professional subcultures. Before entering training, students differed in how they believed clinical work should be organised. The collectivist attitude of pharmacy students was greater among those completing their studies than it was among those commencing study. Doctors, nurses, pharmacists and other professional groups are expected to work in multidisciplinary teams to deliver high quality health services. This study suggests that the individualistic attitudes of medical students may need to be addressed during training if medical students are to graduate with a commitment to working in THE CLINICAL GOVERNANCE literature identifies quality improvement as a central concern of the management of contemporary health care organisations and the clinical staff who work in them. [1][2][3][4] Clinical governance includes an understanding that health professionals will support the systemisation of clinical work and subscribe to power sharing within multidisciplinary approaches to clinical work. Degeling and colleagues have described the subcultures of medicine, nursing and management arising from numerous studies in the United Kingdom, Australia, New Zealand and elsewhere. [5][6][7][8][9] These studies demonstrate that medical, nursing and managerial staff have different attitudes, beliefs and values with respect to how they believe clinical work should be undertaken, what leads to variations in its quality, the role of teams and what it means to be accountable for performance. Their work suggests that nurses believe that clinical work is best performed within a systems view of organisation, and further, that the health care organisation in which the work is being carried out needs to endorse and take ownership of the work systems. This is in contrast to medical practitioners who favour a more individualistic approach to the way work is organised and carried out. Mintzberg' s 10 conception of nurses is similar. He suggests that as a group nurses focus on

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The professional subcultures of students entering medicine, nursing and pharmacy programmes

Cited by 67 publications

References 12 publications

Leveling the Playing Field: An Interprofessional Rural Preceptorship Pilot for Students of Nursing and Medicine

Leveling the Playing Field: An Interprofessional Rural Preceptorship Pilot for Students of Nursing and Medicine

Interprofessional learning: Perceptions of first year health students

Attitudes, beliefs and values of students in undergraduate medical, nursing and pharmacy programs

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