Rebuilding Nursing Culture Through Application of Social Identity Theory and Inclusivity in Health Care Systems: An Exemplar.

This article explores leader practices for rebuilding health system nursing culture by leveraging feedback from clinical nurses and applying Social Identity Theory (SIT) and inclusivity frameworks. An enriched nursing culture is the foundation of quality patient care, and as healthcare systems evolve, it becomes increasingly essential to foster a cohesive and inclusive environment in every aspect of employment practices. Social Identity Theory, which emphasizes how individuals define their self-concept through group affiliations, offers a lens to understand the interplay of identity, values, and behavior within nursing teams. Inclusivity practices are pivotal in creating a welcoming and diverse health care workplace. By employing these approaches, health care systems can rebuild and strengthen their nursing culture, improving retention, onboarding, job satisfaction, teamwork, and enhancing the quality of care provided to patients. This article delves into practical strategies and application of SIT and inclusivity practices to restructure and revitalize nursing culture, emphasizing the positive impact on health care outcomes. An exemplar demonstrating the impact of the voice of the clinician in program development highlights the application of SIT and inclusivity to create culture. It concludes with leader practices for rebuilding nursing culture to include contingent labor as part of the care team.

The mobilisation of professional identity: A scoping and lexical review.

Interprofessional care obliges different healthcare professions to share decision-making and sometimes, practices. Given established hierarchies, it can be difficult to promote interprofessional care, partly because of the need to reshape professional identities. Despite interest in effective interprofessional care, there is limited research on how professional identity can be mobilised to promote it. A scoping review as well as lexical review of academic publications was conducted to address this void. After searching seven academic databases and screening the identified publications, 22 publications met the inclusion criteria. They collectively reported on 22 interventions, most of which were used in healthcare. The scoping review suggested there is some evidence that professional identities can be mobilised. Yet, of the 22 interventions, only ten explicitly targeted professional identity. The most common intervention was a training or development program, followed by workplace redesign. The need for internal motivation to mobilise professional identity was reported as was the impact of external drivers, like extending the scope of practice. Extending these findings, the lexical review demonstrated that, among the 22 publications, the relationship between professional identity and mobilisation did not feature prominently within the discourse. Furthermore, it seems that geography matters-that is, while all the publications spoke of professional identity, they differed by region on how they did this. Given these findings, concentrated scholarship is needed on the relationship between professional identity and interprofessional care, lest interprofessional care programs have limited, sustained effect. Implications for scholars and practitioners are explicated.

Storylines of family medicine XI: professional identity formation-nurturing one's own story.

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'XI: professional identity formation-nurturing one's own story', authors address the following themes: 'The social construction of professional identity', 'On becoming a family physician', 'What's on the test?-professionalism for family physicians', 'The ugly doc-ling', 'Teachers-the essence of who we are', 'Family medicine research-it starts in the clinic', 'Socially accountability in medical education', 'Personal philosophy and how to find it' and 'Teaching and learning with Storylines of Family Medicine'. May these essays encourage readers to find their own creative spark in medicine.

Celebrating organizational history triggers social identity threat among Black Americans.

Many mainstream organizations celebrate their historical successes. In their history, however, they often marginalized racial minorities, women, and other underrepresented groups. We suggest that when organizations celebrate their histories, even without mentioning historical marginalization, they can undermine belonging and intentions to join the organization among historically marginalized groups. Four experiments demonstrate that Black participants who were exposed to an organization that celebrated their history versus the present showed reduced belonging and intentions to participate in the organization. These effects were mediated by expectations of biased treatment in the organization. Further, when organizations had a history of Black people in power, celebrating history was no longer threatening, highlighting that the negative effects of celebrating history are most likely when organizations are or are assumed to be majority-White and have treated Black Americans poorly. Taken together, these findings suggest that emphasizing organizational history can be a source of social identity threat among Black Americans.

Alienation in the Teaching Hospital: How Physician Non-Greeting Behaviour Impacts Medical Students' Learning and Professional Identity Formation.

Introduction: Clinical workplaces offer unrivalled learning opportunities if students get pedagogic and affective support that enables them to confidently participate and learn from clinical activities. If physicians do not greet new students, the learners are deprived of signals of social respect and inclusion. This study explored how physicians' non-greeting behaviour may impact medical students' participation, learning, and professional identity formation in clinical placements. Methods: We analysed 16 senior Norwegian medical students' accounts of non-greeting behaviours among their physician supervisors in a reflexive thematic analysis of focus group interview data. Results: The main themes were: A) Descriptions of non-greeting. Not being met with conduct signalling rapport, such as eye contact, saying hello, using names, or introducing students at the workplace, was perceived as non-greeting, and occurred across clinical learning contexts. B) Effects on workplace integration. Non-greeting was experienced as a rejection that hurt students' social confidence, created distance from the physician group, and could cause avoidance of certain workplace activities or specific medical specialties. C) Impact on learning. Non-greeting triggered avoidance and passivity, reluctance to ask questions or seek help or feedback, and doubts about their suitability for a medical career. Conclusion: Medical students' accounts of being ignored or treated with disdain by physician superiors upon entering the workplace suggest that unintended depersonalising behaviour is ingrained in medical culture. Interaction rituals like brief eye contact, a nod, a "hello", or use of the student's name, can provide essential affective support that helps medical students thrive and learn in the clinic.

Perceived discrimination and multiple indicators of positive development among second-generation Chinese-American youth: The moderating role of ethnic identity.

BACKGROUND: The present study examined the associations among ethnic identity, perceived discrimination and multiple indicators of positive youth development (PYD; i.e., intrapersonal-oriented competence, interpersonal-oriented competence, confidence, caring, character, family connection, peer connection, school and community connection, positive attitudes towards diversity and cultural pride) that were specifically identified among second-generation Chinese-American youth. METHODS: Participants were 196 second-generation Chinese-American youth (N girl = 93; M age = 14.56, SD age = 1.75) primarily from the greater Boston area in MA, United States. Multivariate regression models were estimated to examine the associations between ethnic identity, perceived discrimination, and each potential indicator of PYD, as well as the moderating role of ethnic identity, controlling for key demographics. RESULTS: (1) Ethnic identity was positively related to all PYD indicators, ßs = .32 to .72, ps < .01; (2) perceived discrimination was negatively associated with all indicators of PYD (ßs = -.15 to -.32, ps < .05), except for interpersonal-oriented competence and caring; and (3) ethnic identity significantly moderated the relationship between perceived discrimination and family connection (ß = .23, p < .01). CONCLUSIONS: Findings indicate that whereas discrimination has potential negative effects on the positive development of second-generation Chinese-American youth, ethnic identity may be a key strength that should be considered in PYD promotion practices for these youth.

The impact of epidemic infectious diseases on the relationship between subjective well-being and social class identity in older adults: The mediating role of Self-rated health.

BACKGROUND: The purpose of this paper is to explore the relationship between subjective well-being, social class identity, and Self-rated health among older persons,. Focusing on the mediating role of health and the impact of epidemic infectious diseases on these relationships. METHODS: Based on the 2018 and 2021 China General Social Survey (CGSS) databases, the data were screened, and processed. Using Stata17, we employed ordered probit regression to examine the relationships among variables and Bootstrap methods to assess mediation effects, and the CGSS data for 2018 and 2021 were compared and analyzed. RESULTS: Our results revealed that factors such as social class identity, health status, and personal income significantly positively impact older persons' subjective well-being (P<0.01). Notably, there was a partial mediating effect of health status between the subjective well-being of the elderly and social class identity. And findings showed that when older adults were affected by epidemic diseases, their subjective well-being, social class identity, and Self-rated health remained significantly positively correlated. Subjective well-being, social class identity. What is more noteworthy is that when affected by epidemic infectious diseases, older adults' subjective well-being, social class identity, and Self-rated health remained significantly positively correlated. The mediating role of self-rated health in older adults' subjective well-being and social class identity increased from 9.6% to 12.4%. CONCLUSIONS: In the face of epidemic infectious diseases, we need to pay more attention to the Self-rated health of the elderly, and the Chinese government should take effective measures to improve their health level, which will in turn improve the subjective well-being of the elderly and realize the goal of healthy aging.

A Qualitative Study of Adolescents from Refugee Backgrounds Living in Australia: Identity and Resettlement.

Identity formation among young people from refugee backgrounds is complex, as it occurs while they are both integrating into a novel cultural landscape and navigating the intricacies of adolescence. The present study explored sense of identity and experiences among refugee youth in the context of resettlement. Nineteen young people (15-18 years) from refugee backgrounds, settled in Brisbane, Australia, took part in the study. An individual semi-structured interview, drawing upon the Tree of Life method, was used. The thematic analysis (TA) methodology was adopted, and several themes emerged: experiencing changes in family roles; experience of belonging; experience of bonds with lost loved ones; dealing with emotions in a new context; experience of self in the context of change. There was one emergent overarching theme of meaning-making in the context of change. These themes were explicated within the framework of social identity and sociocultural theories, which emphasises the dynamic co-construction of identity through the interplay of belonging and meaning-making within specific contextual settings. This study highlights the fundamental role of social context, particularly the fostering of school belonging, in the multifaceted process of identity construction. The findings identify the importance of integrating multiple identities and experiences to develop a comprehensive and resilient sense of personal cohesion and selfhood.

From a humble identity to an identity of respect: lifetime abuse among Arab Israeli older women.

This study addresses the retrospective experiences of older Arab Israeli women after a lifetime of living in the shadow of intimate partner violence. Qualitative research was conducted, using in-depth, semi-structured interviews of 15 Arab Israeli older women. Underlying this study is a feminist perspective and a life course perspective. Two main themes emerged: (1) socially endorsed violence against Arab Israeli women. This took several forms: men's dominant position and women's dependence, sources of violence used against women before and after marriage, and the social education of women to accept their fate. (2) The construction of a multifaceted survival identity throughout Arab Israeli women's life and old age. This identity has a variety of dimensions, including: a submissive victim identity, a rehabilitative identity of respect in old age, and a form of split identity that combines both the rehabilitative social identity and the marginal identity still experienced within the home.

Team players and helpers - describing professional identity among finnish physicians in a cross-sectional study.

BACKGROUND: Every physician has a unique professional identity. However, little is known about the diversity of identities among physicians. This study aimed to quantitatively assess the professional identity of physicians in Finland using descriptions of professional identity. METHODS: This study was part of a larger cross-sectional Finnish Physician 2018 Study. The target population consisted of all Finnish physicians under the age of 70 (N = 24,827) in 2018. The sample was drawn from physicians born on even numbered days (N = 11,336) using the Finnish Medical Association register. A total of 5,187 (46%) physicians responded. Professional identity was examined by 27 given characterisations using a five-point Likert scale. Multivariate logistic regression was used in assessing how place of work, graduation year and gender were associated with identity descriptions. RESULTS: The descriptions which most physicians identified with were "member of a working group/team" (82%), "helper" (82%), and "health expert" (79%); the majority reported these as describing them very or quite well. Identity descriptions such as "prescriber of medications" (68% vs. 45%), "prioritiser" (57% vs. 35%) and "someone issuing certificates" (52% vs. 32%) were more popular among junior than senior physicians. The biggest differences between the genders were found in the descriptions "provider of comfort" (62% vs. 40%) and "someone engaged in social work" (45% vs. 25%), with which women identified more frequently than men. CONCLUSIONS: Strong identification as a member of a team is an important finding in the increasingly multiprofessional world of health care. Importantly, most physicians shared several core professional identity descriptions (i.e., helper, health expert) that reflect the traditional image of an exemplary doctor.

Quarantining From Professional Identity: How Did COVID-19 Impact Professional Identity Formation in Undergraduate Medical Education?

Introduction: Professional Identity Formation (PIF) entails the integration of a profession's core values and beliefs with an individual's existing identity and values. Within undergraduate medical education (UGME), the cultivation of PIF is a key objective. The COVID-19 pandemic brought about substantial sociocultural challenges to UGME. Existing explorations into the repercussions of COVID-19 on PIF in UGME have predominantly adopted an individualistic approach. We sought to examine how the COVID-19 pandemic influenced PIF in UGME from a sociocultural perspective. This study aims to provide valuable insights for effectively nurturing PIF in future disruptive scenarios. Methods: Semi structured interviews were conducted with medical students from the graduating class of 2022 (n = 7) and class of 2023 (n = 13) on their medical education experiences during the pandemic and its impact on their PIF. We used the Transformation in Medical Education (TIME) framework to develop the interview guide. Direct content analysis was used for data analysis. Results: The COVID-19 pandemic significantly impacted the UGME experience, causing disruptions such as an abrupt shift to online learning, increased social isolation, and limited in-person opportunities. Medical students felt disconnected from peers, educators, and the clinical setting. In the clerkship stage, students recognized knowledge gaps, producing a "late blooming" effect. There was increased awareness for self-care and burnout prevention. Discussion: Our study suggests that pandemic disruptors delayed PIF owing largely to slower acquisition of skills/knowledge and impaired socialization with the medical community. This highlights the crucial role of sociocultural experiences in developing PIF in UGME. PIF is a dynamic and adaptable process that was preserved during the COVID-19 pandemic.

Social identity and health-related behavior: A systematic review and meta-analysis.

This paper examined the relationship between social identity and health-related behavior, exploring whether social identities are associated with multiple health-related behaviors or only specific ones, and whether this association varies on the type of social identity, the type of social identity measures or the expected relationship between identity and behavior. In a systematic review and meta-analysis we assessed whether the pattern of findings can be explained by the social identity approach. An extensive literature search was conducted in several databases including EBSCO-host and PubMed, using elaborate search terms related to social identity and health-related behavior. This resulted in 10728 potential articles, with 115 articles (with 248 effect sizes from 133 independent samples, N = 112.112) included in the meta-analysis. We found a small but positive overall association between social identification and health-related behavior, which was present for actual behavior, as well as for intention and attitudes. This association was stronger for health-related social identities, positive health-related behaviors, when the expected relationship was positive and when indirect social identity measures were used. However, not all findings could be explained by the social identity approach, indicating a need for further research to better understand the relationship between social identity and health-related behavior, in order to more effectively incorporate social identity into health interventions.

"Honestly, they are just like us": U.S. parents choose middle-class gender and racial ingroup peers for their children.

Children and adolescents benefit from positive intergroup peer interactions, but they are unlikely to have many opportunities for these interactions if their parents are uncomfortable with them. Drawing primarily on social identity theory (SIT), this study investigated how U.S. parents' (N = 569) comfort with their children's potential intergroup peer interactions (a) differed by child and peer group gender (boy, girl), race (Black, White), and social class (higher-, middle-, or lower-subjective social status), (b) changed over the transition from childhood to adolescence (8-10, 11-13, and 14-16 years), and (c) varied by context intimacy (hanging out vs. sleeping over). The sample was equally balanced between parents of children reflecting those same group memberships. Consistent with SIT, when asked to choose, parents were typically most comfortable with their child spending time with middle-class peers who shared their child's gender and racial ingroup membership. Moreover, parents often explained their decisions with reference to similarities between these peers and their own child or family. Parents' comfort did not differ systematically by child age, but many parents were less comfortable with cross-gender peer interactions in the more intimate sleepover context than the less intimate hangout context. All groups of parents also exhibited at least some openness to cross-group interactions. These findings advance developmental scientists' understanding of parents' roles as potential facilitators or gatekeepers of their children's intergroup peer interactions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Online racial discrimination, centrality, and academic outcomes among Black youth.

Online racial discrimination (ORD) has been found to have deleterious effects on the psychological and academic outcomes of youth of color. Racial centrality (i.e., the extent to which one regards their racial group membership as important to their identity) may be a powerful buffer of these effects and has been identified as an important sociocultural asset for Black youth in particular. This study examined the relations among ORD, racial centrality, academic self-efficacy (ASE), and academic achievement among Black children and adolescents (ages 8-17). Results indicated that ORD and centrality increased with age, and the majority (76%) of youth reported at least one incident of ORD in the last year. Racial centrality moderated ORD's relationship with ASE but not with achievement; specifically, ORD and ASE were more strongly related at higher levels of centrality. Centrality was not significantly related to achievement; however, it was indirectly related to achievement via ASE. These findings underscore the importance of disrupting ORD as well as providing support for children and adolescents who experience it. This study also highlights racial centrality as an important mechanism for promoting academic achievement among Black youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Belonging matters: The impact of social identification with classmates, friends, and family on interpersonal distance and bullying/cyberbullying in adolescence.

In adolescence individuals enlarge their social relationships and peer groups acquire a strong importance for their identity. Moreover, adolescents can experiment negative relationships with peers, i.e., bullying/cyberbullying. The present study aims to investigate the relationship between the feeling of belonging to a specific group, social identification, the distance that adolescents maintain interacting with others, interpersonal distance, and bullying/cyberbullying behaviors. Adolescents (age range 10-15 years) completed online measures of group identification (social identification with classmates, friends and family), interpersonal distance, and bullying and cyberbullying (perpetration and victimization). Results showed that adolescents with low social identification with classmates and friends chose larger interpersonal distance. Additionally, low scores in social identification with classmates were associated with higher victimization in cyberbullying. In contrast, adolescents with low scores in social identification with family were more involved as bullies in bullying and as victims in cyberbullying. Male adolescents were more likely to be victimized in bullying than females. This study underlines how social identification with peers and family works as a buffer in interfacing strangers, adjusting the distance maintained with them, and as a protective factor against aggressive relationships in adolescence. This study provides new opportunities for psychologists in understanding the psychological dynamics that shape social interactions among adolescents.

A Common Trajectory Toward a Professional Identity as a Faculty Developer.

BACKGROUND AND OBJECTIVES: Professional identity formation is a complex construct that continually evolves in relation to an individual's experiences. The literature on educators identifying as faculty developers is limited and incompletely addresses how that identify affects other identities, careers, and influences on teaching. Twenty-six health professionals were trained to serve as faculty developers within our educational system. We sought to examine the factors that influence the professional identity of these faculty developers and to determine whether a common trajectory existed. METHODS: We employed a constructivist thematic analysis methodology using an inductive approach to understand the experiences of faculty developers. We conducted semistructured recorded interviews. Coding and thematic analysis were completed iteratively. RESULTS: We identified eight primary themes: (1) initial invitation, (2) discovery of faculty development as a professional activity, (3) discovery of educational theory, skills, and need for more education, (4) process of time and experience, (5) fostering relationships and community, (6) transfer of skills to professional and personal roles, (7) experiences that lead to credibility, and (8) sense of greater impact. CONCLUSIONS: An individual's journey to a faculty developer identity is variable, with several shared pivotal experiences that help foster the emergence of this identity. Consideration of specific programmatic elements to support the themes identified might allow for a strategic approach to faculty development efforts in health professions education.

The impact of online education during the Covid-19 pandemic on the professional identity formation of medical students: A systematic scoping review.

Evolving individual, contextual, organizational, interactional and sociocultural factors have complicated efforts to shape the professional identity formation (PIF) of medical students or how they feel, act and think as professionals. However, an almost exclusive reliance on online learning during the COVID-19 pandemic offers a unique opportunity to study the elemental structures that shape PIF and the environmental factors nurturing it. We propose two independent Systematic Evidence-Based Approach guided systematic scoping reviews (SSR in SEBA)s to map accounts of online learning environment and netiquette that structure online programs. The data accrued was analysed using the clinically evidenced Krishna-Pisupati Model of Professional Identity Formation (KPM) to study the evolving concepts of professional identity. The results of each SSR in SEBA were evaluated separately with the themes and categories identified in the Split Approach combined to create richer and deeper 'themes/categories' using the Jigsaw Perspective. The 'themes/categories' from each review were combined using the Funnelling Process to create domains that guide the discussion. The 'themes/categories' identified from the 141 included full-text articles in the SSR in SEBA of online programs were the content and effects of online programs. The themes/categories identified from the 26 included articles in the SSR in SEBA of netiquette were guidelines, contributing factors, and implications. The Funnelling Process identified online programs (encapsulating the content, approach, structures and the support mechanisms); their effects; and PIF development that framed the domains guiding the discussion. This SSR in SEBA identifies the fundamental elements behind developing PIF including a structured program within a nurturing environment confined with netiquette-guided boundaries akin to a Community of Practice and the elemental aspect of a socialisation process within online programs. These findings ought to be applicable beyond online training and guide the design, support and assessment of efforts to nurture PIF.

Impact of Pharmacy-Related Memes on Students' Professional Identity Formation.

OBJECTIVE: Professional identity formation (PIF) is the process which one internalizes the values and norms of a profession, ultimately becoming a member of that profession. The objective of this study was to determine the perceived professional identities of pharmacists in memes and how pharmacy-related memes affect students' PIF. METHODS: Student pharmacists from a single academic institution participated in focus groups to discuss the concept of professional identity, view self-submitted pharmacy-related memes, and reflect on the memes' impact on their PIF. An inductive, thematic content analysis was performed, and a theoretical model was developed to illustrate the themes observed. RESULTS: Twenty-six student pharmacists participated in the study. Before exposure to the self-submitted memes, the participants described the professional identity of a pharmacist in a more idealistic way, noting pharmacist roles such as medication expert, educator, and patient care provider. After exposure to the memes, the participants' responses reflected a pharmacist identity based on feelings of being antagonized, overwhelmed, and misperceived. Despite these challenges, the participants noted the importance of remaining professional. CONCLUSION: When exposed to pharmacy-related memes, the students' perceptions of the pharmacist identity changed from one based on idealistic roles to an identity based on negative feelings and interactions. Owing to memes' ability to reflect one's experiences, it is important to recognize the impact memes may have on PIF. Further research is needed to determine how pharmacy educators can help students navigate identity dissonances that arise from the students' pharmacy experiences.