A longitudinal, narrative study of professional socialisation among health students.

PURPOSE: Interprofessional collaboration (IPC) among health professionals is well-recognised to enhance care delivery and patient outcomes. Emerging evidence suggests that the early socialisation of students in health professional programmes to teamwork may have a positive impact on their future as collaborative practitioners. With a purpose of contributing to growing evidence on the processes of professional identity construction, and to explore how early expectations and perceptions of IPC develop during professional socialisation and pre-licensure education, our study examined the early professional socialisation experiences among five groups of health professional students. METHOD: A qualitative, narrative approach was used to examine early professional socialisation among five programmes of health professional students (dentistry, medicine, nursing, pharmacy, physiotherapy) at an Atlantic Canadian University. In March and October 2016, students participated in interviews after first term (n = 44) and first year of study (n = 39). Interviews focused on participants' professional identify formation, as well as their perceptions and experiences of IPC. The authors analysed interview transcripts using narrative analysis. RESULTS: Findings identify that despite the espoused importance of IPC within health professional training, students have a limited understanding of their professional roles and are largely focused on developing a uniprofessional, vs. interprofessional identity. Clinical experiences, role models and exposure to teamwork are critical to contextualise collaborative practice and enhance the development of an interprofessional identity. CONCLUSIONS: Findings can be used to guide the development of curricula that promote interprofessional identity development and IPC during early professional socialisation.

Pre-entry perceptions of students entering five health professions: implications for interprofessional education and collaboration.

Dysfunctional interprofessional teams are a threat to health system performance and the delivery of quality patient outcomes. Implementing strategies that prepare future health professionals to be effective collaborators requires a comprehensive understanding of how early professional socialization and professional identity formation occur. We present findings from a qualitative study, grounded in narrative methodology, examining early professional socialization among students across five health professional programs (dentistry, medicine, nursing, pharmacy, physiotherapy) in the first year of health professional training. Between April and September 2015, students (n = 49) entering programs at an Atlantic Canadian University participated in one-on-one, audiotaped interviews starting before formal program orientation. Pre-entry interviews focused on factors influencing students' career choice and expectations of future profession and interprofessional collaboration (IPC). Findings revealed that many different experiences influenced participants' career choice and framed the social positioning of their future career (e.g., leadership, prestige, autonomy). Participant narratives revealed the existence of stereotypes pertaining to their chosen and other health professions. Study findings provided insights that may help strengthen initiatives to promote positive professional identity formation within the context of IPC. Implications of this research highlight the need for the early introduction of IPC including pre-entry recruitment messaging for prospective health professionals.

Climate change considerations are fundamental to management of deep-sea resource extraction.

Climate change manifestation in the ocean, through warming, oxygen loss, increasing acidification, and changing particulate organic carbon flux (one metric of altered food supply), is projected to affect most deep-ocean ecosystems concomitantly with increasing direct human disturbance. Climate drivers will alter deep-sea biodiversity and associated ecosystem services, and may interact with disturbance from resource extraction activities or even climate geoengineering. We suggest that to ensure the effective management of increasing use of the deep ocean (e.g., for bottom fishing, oil and gas extraction, and deep-seabed mining), environmental management and developing regulations must consider climate change. Strategic planning, impact assessment and monitoring, spatial management, application of the precautionary approach, and full-cost accounting of extraction activities should embrace climate consciousness. Coupled climate and biological modeling approaches applied in the water and on the seafloor can help accomplish this goal. For example, Earth-System Model projections of climate-change parameters at the seafloor reveal heterogeneity in projected climate hazard and time of emergence (beyond natural variability) in regions targeted for deep-seabed mining. Models that combine climate-induced changes in ocean circulation with particle tracking predict altered transport of early life stages (larvae) under climate change. Habitat suitability models can help assess the consequences of altered larval dispersal, predict climate refugia, and identify vulnerable regions for multiple species under climate change. Engaging the deep observing community can support the necessary data provisioning to mainstream climate into the development of environmental management plans. To illustrate this approach, we focus on deep-seabed mining and the International Seabed Authority, whose mandates include regulation of all mineral-related activities in international waters and protecting the marine environment from the harmful effects of mining. However, achieving deep-ocean sustainability under the UN Sustainable Development Goals will require integration of climate consideration across all policy sectors.

Practical policy solutions for the final stage of BBNJ treaty negotiations.

The oceans are facing a catastrophic decline in biodiversity. States are now in the final stage of negotiations for an implementing agreement under the United Nations Convention on the Law of the Sea to fill governance gaps for the conservation and sustainable use of marine biodiversity beyond national jurisdiction. This paper outlines the apparent areas of convergence and divergence between States on the 2019 draft treaty text. It outlines the contributions of the articles in this Special Issue "Biodiversity Beyond National Jurisdiction (BBNJ) Treaty: the Final Stage of Negotiations", which offer suggestions for breaking negotiation deadlocks and practical ideas for transformative governance change. As States prepare for the postponed fourth and final (planned) negotiating session, we hope that this Special Issue will offer a useful tool for decision-makers and other stakeholders by offering creative ideas for BBNJ governance and for reaching timely agreement on the BBNJ treaty text.

A Narrative Inquiry of Critical Events Supporting Professional Identity Formation in Introductory Pharmacy Practice Experiences.

OBJECTIVE: Professional identity formation (PIF) is the process of internalizing a profession's core values and beliefs so that one begins to think, act, and feel like a member of that profession. PIF occurs over an individual's professional socialization in stages, precipitated by critical moments or experiences. The purpose of this study was to answer the following: (1) What are the critical events for pharmacy student PIF in introductory pharmacy practice experiences?; and (2) How do these events support or challenge PIF? METHODS: This study used critical event narrative inquiry methodology. A critical event is an experience that creates a change in understanding and affects professional performance. Semistructured interviews were conducted with pharmacy students who completed introductory pharmacy practice experience rotations in community (first year) and hospital (second year) settings. Interviews were coded and analyzed using narrative analysis. RESULTS: Twelve first-year and 10 second-year students participated in this study. Narratives revealed that common experiential education experiences resulted in a deeper understanding of core role elements (ie, professional autonomy, responsibility, interprofessional collaboration, and patient-centered care), leading to changes in agency, knowledge, and anticipated future behaviors. While first-year participants' narratives mainly focused on understanding pharmacist roles ("what"), second-year participants focused on understanding the process to fulfill those roles ("how to"). Emotions, assuming responsibility, external validation, and preceptor guidance supported these events. CONCLUSION: Critical events in introductory pharmacy practice experiences affect and shape pharmacy students' PIF. These events are relevant to pharmacy education because these experiences can result in changes in knowledge, agency, or future behaviors for students.

Indicators, influences, and changes in professional identity formation in early experiential learning in community pharmacy.

BACKGROUND: Experiential education is a key area in the pharmacy curriculum that professional identity formation (PIF) occurs. However, little is known about PIF influences and supports for pharmacy students during early experiential placements. The study aimed to explore pharmacy student PIF in an early experiential rotation in community pharmacy using reflective writing. EDUCATIONAL ACTIVITY AND SETTING: First-year pharmacy students completed written reflections describing their professional identity and influencing experiences, before and after a four-week community introductory pharmacy practice experience. Qualitative content analysis of the written reflections was performed using three analytical approaches: (1) deductive coding based on professional identity indicators; (2) inductive coding to identify influences; and (3) inductive coding of field notes to identify changes between pre- and post-written reflections. FINDINGS: Twelve students participated. All participants described discrete professional attributes and behaviors and valuing a patient-centered approach as part of their professional identity. Participants reported observation of pharmacists, the curriculum, and previous work experience influenced PIF prior to the experiential rotation. A strong influencer of PIF during the rotation was observation of pharmacist preceptors, whereas participants' own experiences were described less often. Changes in professional identity among participants were subtle and categorized as affirmation, acquisition, and growth. SUMMARY: Pharmacy students' markers and influencers of PIF should be considered when developing curricular experiences and preceptor development that support PIF. The use of professional identity indicators and analysis of written reflections as a method to uncover PIF, shows promise and warrants further investigation.

High seas treaty within reach.

The ocean is Earth's greatest climate mitigator, but it cannot do its work without biodiversity. Yet, accelerating climate change, unsustainable fishing, and widespread plastic and other pollutants, combined with increased resource demands, are threatening life throughout our global ocean. This is particularly acute in the two-thirds of the ocean (the high seas and seabed below) located beyond national boundaries, and as such, no state can solve these problems alone. Since 2018, member states of the United Nations have been crafting an international treaty to protect high-seas biodiversity and to ensure that human pressures are kept to a level that sustains this variety. Last month, the fifth and supposedly final session of the UN Intergovernmental Conference fell short of this goal. Unfortunately, disagreements on fundamental issues meant that negotiators ran out of time. Achieving a timely treaty requires resuming the dialogue as soon as possible with more visible public and political support to surmount remaining hurdles.

Physiotherapy: an active, transformational, and authentic career choice.

Background: This paper arises from a larger study exploring early professional socialization across five professions: physiotherapy, nursing; dentistry; pharmacy; and medicine. Purpose: To explore the process of physiotherapy student professional identity development and the evolution of expectations and views of interprofessional practice in the first year of their program. Methods: One-on-one interviews at three time points: after being accepted into the physiotherapy program and before classes began (T1; n = 12); after term one (T2; n=9) and on completion of year one (T3; n = 7). Analyses employed narrative methodology, guided by anticipatory socialization and professional identity theories. Results: At T1, participants described their path towards physiotherapy, indicating career satisfaction as the core of their choice. Expectations of practice aligned with the normative social positioning of the profession. T2 and T3 interviews revealed that their pre-entry conceptualization of practice was both challenged and positively reinforced, leading them either to being satisfied with, or questioning their choice. Clinical placements created the most meaningful opportunities to understand their roles both as individual professionals and members of a collaborative team. Conclusion: Findings revealed the complex process of professional socialization in physiotherapy students with implications for admissions and formal and IPE curricula.

Sarcasm and emoticons: Comprehension and emotional impact.

Most theorists agree that sarcasm serves some communicative function that would not be achieved by speaking directly, such as eliciting a particular emotional response in the recipient. One debate concerns whether this kind of language serves to enhance or mute the positive or negative nature of a message. The role of textual devices commonly used to accompany written sarcastic remarks is also unclear. The current research uses a rating task to investigate the influence of textual devices (emoticons and punctuation marks) on the comprehension of, and emotional responses to, sarcastic versus literal criticism and praise, for both unambiguous (Experiment 1) and ambiguous (Experiment 2) materials. Results showed that sarcastic criticism was rated as less negative than literal criticism, and sarcastic praise was rated as less positive than literal praise, suggesting that sarcasm serves to mute the positive or negative nature of the message. In terms of textual devices, results showed that emoticons had a larger influence on both comprehension and emotional impact than punctuation marks.

Integrating Climate Change Resilience Features into the Incremental Refinement of an Existing Marine Park.

Marine protected area (MPA) designs are likely to require iterative refinement as new knowledge is gained. In particular, there is an increasing need to consider the effects of climate change, especially the ability of ecosystems to resist and/or recover from climate-related disturbances, within the MPA planning process. However, there has been limited research addressing the incorporation of climate change resilience into MPA design. This study used Marxan conservation planning software with fine-scale shallow water (<20 m) bathymetry and habitat maps, models of major benthic communities for deeper water, and comprehensive human use information from Ningaloo Marine Park in Western Australia to identify climate change resilience features to integrate into the incremental refinement of the marine park. The study assessed the representation of benthic habitats within the current marine park zones, identified priority areas of high resilience for inclusion within no-take zones and examined if any iterative refinements to the current no-take zones are necessary. Of the 65 habitat classes, 16 did not meet representation targets within the current no-take zones, most of which were in deeper offshore waters. These deeper areas also demonstrated the highest resilience values and, as such, Marxan outputs suggested minor increases to the current no-take zones in the deeper offshore areas. This work demonstrates that inclusion of fine-scale climate change resilience features within the design process for MPAs is feasible, and can be applied to future marine spatial planning practices globally.