Barriers and facilitators to the formation of professional identity among nursing students: A four-year longitudinal qualitative study

Shuanglan Lin; Shucheng Chen; Qiang Tu; Xinyu Xu; Shiqi Xie; Bing Yang; Quanzhi Zhang; Liping Chen

doi:10.1016/j.nedt.2023.106087

Barriers and facilitators to the formation of professional identity among nursing students: A four-year longitudinal qualitative study

Nurse Educ Today. 2024 Mar:134:106087. doi: 10.1016/j.nedt.2023.106087. Epub 2023 Dec 29.

Authors

Shuanglan Lin¹, Shucheng Chen², Qiang Tu³, Xinyu Xu¹, Shiqi Xie⁴, Bing Yang⁵, Quanzhi Zhang⁶, Liping Chen⁷

Affiliations

¹ Nursing College of Chongqing Medical University, Chongqing, China.
² School of Nursing, The Hong Kong Polytechnic University, Hong Kong. Electronic address: cara-sc.chen@polyu.edu.hk.
³ Faculty of Medicine and Health, The University of Sydney, Australia. Electronic address: qiang.tu@sydney.edu.au.
⁴ Nursing College of Chongqing Medical University, Chongqing, China. Electronic address: 102835@cqmu.edu.cn.
⁵ Department of Nursing, Stomatological Hospital of Chongqing Medical University, Chongqing, China. Electronic address: yangb@hospital.cqmu.edu.cn.
⁶ School of Nursing, Harbin Medical University, Heilongjiang Province, China.
⁷ Nursing College of Chongqing Medical University, Chongqing, China. Electronic address: lipingchen.cqmu@hotmail.com.

PMID: 38232627
DOI: 10.1016/j.nedt.2023.106087

Abstract

Background: Nursing professional identity (NPI) is essential for nurses to develop their nursing profession. It reflects the competencies consistent with the professional practices of nurses and contributes to them providing better healthcare and public health. The formation process of NPI started with undergraduate nursing education and continued throughout the nursing career.

Objective: To explore nursing students' perceptions of facilitators and barriers to the formation of NPI during their study.

Methods: A 4-year longitudinal, qualitative research design with yearly semi-structured interviews undertaken from 2019 to 2022. The reflexive thematic analysis methodology was applied for the data analysis.

Results: Ninety-three nursing students were recruited, joining a group or individual interview. The four-year nursing baccalaureate program revealed a dynamic formation process of NPI: "Outsider of nursing", "Entering the nursing courses", "Building nursing competence", and "Thinking and acting like a nurse". A total of 12 themes were identified to present the barriers and facilitators to the NPI formation at different stages. Specifically, the six barriers include conflict between their ideals and reality, sociocultural stereotypes about nursing, the negative impact of COVID-19, the pre-internship concerns, struggling to meet expectations, and potential danger and discrimination in the healthcare settings. The enablers were: self-motivation and inner belief towards the nursing profession, the power of role models, the improvement of nursing capacity, well integration into the healthcare professional teams, understanding of the clinical environment, and recognition and encouragement from others.

Conclusions: The formation of nursing students' NPI is an ever-changing process, with various intrinsic and extrinsic influences during their four-year study. Nursing educators are suggested to prepare and develop students' professional comportment in their theoretical and clinical practice to develop their professional identity as a nurse.

Keywords: Longitudinal qualitative study; Nursing formation; Nursing students; Professional identity.

MeSH terms

Delivery of Health Care
Education, Nursing, Baccalaureate* / methods
Humans
Qualitative Research
Social Identification
Students, Nursing*