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      Professional identity in clinician‐scientists: brokers between care and science

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          Abstract

          Context

          Despite increasing numbers of publications, science often fails to significantly improve patient care. Clinician‐scientists, professionals who combine care and research activities, play an important role in helping to solve this problem. However, despite the ascribed advantages of connecting scientific knowledge and inquiry with health care, clinician‐scientists are scarce, especially amongst non‐physicians. The education of clinician‐scientists can be complex because they must form professional identities at the intersection of care and research. The successful education of clinician‐scientists requires insight into how these professionals view their professional identity and how they combine distinct practices.

          Objectives

          This study sought to investigate how recently trained nurse‐ and physiotherapist‐scientists perceive their professional identities and experience the crossing of boundaries between care and research.

          Methods

          Semi‐structured interviews were conducted with 14 nurse‐ and physiotherapist‐scientists at 1 year after they had completed MSc research training. Interviews were thematically analysed using insights from the theoretical frameworks of dialogical self theory and boundary crossing.

          Results

          After research training, the initial professional identity, of clinician, remained important for novice clinician‐scientists, whereas the scientist identity was experienced as additional and complementary. A meta‐identity as broker, referred to as a ‘bridge builder’, seemed to mediate competing demands or tensions between the two positions. Obtaining and maintaining a dual work position were experienced as logistically demanding; nevertheless, it was considered beneficial for crossing the boundaries between care and research because it led to reflection on the health profession, knowledge integration, inquiry and innovation in care, improved data collection, and research with a focus on clinical applicability.

          Conclusions

          Novice clinician‐scientists experience dual professional identities as care providers and scientists. The meta‐position of being a broker who connects care and research is seen as core to the unique clinician‐scientist identity. To develop this role, identity formation and boundary‐crossing competencies merit explicit attention within clinician‐scientist programmes.

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          Most cited references37

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          Provisional Selves: Experimenting with Image and Identity in Professional Adaptation

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            Official statistics and claims data records indicate non-response and recall bias within survey-based estimates of health care utilization in the older population

            Background The validity of survey-based health care utilization estimates in the older population has been poorly researched. Owing to data protection legislation and a great number of different health care insurance providers, the assessment of recall and non-response bias is challenging to impossible in many countries. The objective of our study was to compare estimates from a population-based study in older German adults with external secondary data. Methods We used data from the German KORA-Age study, which included 4,127 people aged 65–94 years. Self-report questions covered the utilization of long-term care services, inpatient services, outpatient services, and pharmaceuticals. We calculated age- and sex-standardized mean utilization rates in each domain and compared them with the corresponding estimates derived from official statistics and independent statutory health insurance data. Results The KORA-Age study underestimated the use of long-term care services (−52%), in-hospital days (−21%) and physician visits (−70%). In contrast, the assessment of drug consumption by postal self-report questionnaires yielded similar estimates to the analysis of insurance claims data (−9%). Conclusion Survey estimates based on self-report tend to underestimate true health care utilization in the older population. Direct validation studies are needed to disentangle the impact of recall and non-response bias.
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              Boundary Crossing and Boundary Objects

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                Author and article information

                Contributors
                m.kluijtmans@umcutrecht.nl
                Journal
                Med Educ
                Med Educ
                10.1111/(ISSN)1365-2923
                MEDU
                Medical Education
                John Wiley and Sons Inc. (Hoboken )
                0308-0110
                1365-2923
                28 February 2017
                June 2017
                : 51
                : 6 ( doiID: 10.1111/medu.2017.51.issue-6 )
                : 645-655
                Affiliations
                [ 1 ] Center for Education and TrainingUniversity Medical Center Utrecht Utrechtthe Netherlands
                [ 2 ] Institute for Paramedical StudiesHU University of Applied Sciences Utrecht Utrechtthe Netherlands
                [ 3 ] Leiden University Graduate School of TeachingLeiden University Leidenthe Netherlands
                [ 4 ] Department of EducationUtrecht University Utrechtthe Netherlands
                Author notes
                [*] [* ] Correspondence: Manon Kluijtmans, Center for Education and Training, University Medical Center Utrecht, HB4.05, PO Box 85500, 3508 GA Utrecht the Netherlands. Tel: 00 31 8875 53460; E‐mail: m.kluijtmans@ 123456umcutrecht.nl
                Article
                MEDU13241
                10.1111/medu.13241
                5434929
                28247420
                ee2fa4db-4362-4b25-9300-7e3b226b6ca5
                © 2017 The Authors Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 01 June 2016
                : 16 August 2016
                : 30 September 2016
                : 04 October 2016
                : 25 October 2016
                Page count
                Figures: 1, Tables: 1, Pages: 11, Words: 7043
                Categories
                Professional Identity
                Professional Identity
                Custom metadata
                2.0
                medu13241
                June 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.0.9 mode:remove_FC converted:17.05.2017

                Education
                Education

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