Misunderstood: Educator and Practitioner Perceptions of Respiratory Therapy Professional Identity
DOI:
https://doi.org/10.32674/q0k8c754Keywords:
health personnel, professional practice, respiratory therapy, social identity, self-concept, social perception, stakeholder participationAbstract
No current literature explores how respiratory therapists describe their professional identity. To address this gap, this descriptive phenomenological study used stakeholder theory (Freeman, 1994) as a framework to explore the perspectives of practitioners and educators through the use of semi-structured interviews. Participants were asked to share perspectives about professional identity, minimum degree requirements for entry-into-practice, and the clinical implications for identity and practice. The purpose of this study was to explore how increasing professional education expectations may change the professional identity and clinical practice. This exploratory study found a lack of cohesive identity often ascribed to therapists rather than determined by therapists and problematizes future research about respiratory care identity, teaching, and clinical care. Implications for practice include recommendations for focused reflective practice and increased socialization within the profession.
References
AARC’s Virtual Museum. (n.d.-a). Legends of respiratory care. http://museum.aarc.org/gallery/legends-of-respiratory-care/
AARC’s Virtual Museum. (n.d.-b). Milestones of the profession. http://museum.aarc.org/gallery/milestones/
Adams, M., Bell, L. A., Goodman, D., & Joshi, K. Y. (2016). Teaching for diversity and social justice. Routledge.
American Association for Respiratory Care. (n.d.-a). About us: Mission and goals. https://www.aarc.org/aarc/mission-statement/
American Association for Respiratory Care. (n.d.-b). States with RRT entry to licensure. http://www.aarc.org/advocacy/state-society-resources/states-rrt-entry-licensure/
American Association for Respiratory Care. (n.d.-c). Timeline and history. http://www.aarc.org/aarc/timeline-history/
American Association for Respiratory Care (2015a). Position statement: AARC statement of ethics and professional conduct. https://www.aarc.org/wp-content/uploads/2017/03/statement-of-ethics.pdf
American Association for Respiratory Care. (2015b). Position statement: Definition of respiratory care. https://www.aarc.org/wp-content/uploads/2017/03/statement-of-definition-of-respiratory-care.pdf
American Association for Respiratory Care. (2019a). Issue paper: Entry to respiratory therapy practice 2030. http://www.aarc.org/wp-content/uploads/2019/09/issue-paper-entry-to-respiratory-therapy-practice-2030.pdf
American Association for Respiratory Care. (2019b). Position statement: Entry requirements to respiratory therapy practice: 2030 and thereafter. http://www.aarc.org/wp-content/uploads/2019/09/statement-entry-requirements-to-respiratory-therapy-practice-2030-and-therafter.pdf
American Dental Hygienists’ Association. (2019). ADHA policy manual. https://www.adha.org/resources-docs/7614_Policy_Manual.pdf
American Occupational Therapy Association, Inc. (2014). AOTA board of directors position statement on entry-level degree for occupational therapist. https://www.aota.org/aboutaota/get-involved/bod/otd-statement.aspx
American Occupational Therapy Association-Accreditation Council for Occupational Therapy Education. (2019). Joint AOTA-ACOTE statement on entry-level education. https://www.aota.org/AboutAOTA/Get-Involved/BOD/News/2019/Joint-AOTA-ACOTE-Statement-Entry-Level-Education-April-2019.aspx
American Physical Therapy Association. (n.d.). Positions, standards, guidelines, policies & procedures. https://www.apta.org/Policies/FullPacket/
Anderson, P. J. (2005). History of aerosol therapy: Liquid nebulization to MDIs to DPIs. Respiratory Care, 50(9), 1139-1150.
Barnes, T. A., Kacmarek, R. M., & Durbin, C. G. (2011). Survey of respiratory therapy education program directors in the United States. Respiratory Care, 56(12), 1906-1915.
Barnett, K. (2011). System members at odds: Managing divergent perspectives in the higher education change process. Journal of Higher Education Policy and Management, 33(2), 131-140.
Battrell, A., Lynch, A., & Steinbach, P. (2016). The American dental hygienists' association leads the profession into 21st century workforce opportunities. Journal of Evidence Based Dental Practice, 16, 4-10.
Bureau of Labor Statistics, U.S. Department of Labor (2019). Occupational employment statistics, Occupational employment and wages, May 2018, Respiratory therapists. https://www.bls.gov/oes/current/oes291126.htm#(1)
Becker, E. A. (2003). Respiratory care managers' preferences regarding baccalaureate and master's degree education for respiratory therapists. Respiratory care, 48(9), 840-858.
Becker, E. A., & Nguyen, X. T. (2014). The current impact of entry-level associate and baccalaureate degree education on the diversity of respiratory therapists. Respiratory Care, 59(12), 1817-1824.
Benbow, P., & Kanji, Z. (2019). Dental hygiene baccalaureate education: A national study of students’ perceived value and intentions. Canadian Journal of Dental Hygiene, 53(2), 89.
Benneworth, P., & Jongbloed, B. W. (2010). Who matters to universities? A stakeholder perspective on humanities, arts and social sciences valorization. Higher Education, 59, 567-588.
Bransberger, P., Falkenstern, C., & Lane, P. (2020). Knocking at the college door: Projections of high school graduates. Western Interstate Commission for Higher Education.
Caffrey, S. M., Barnes, L. C., & Olvera, D. J. (2019). Joint position statement on degree requirements for paramedics. Prehospital Emergency Care, 23(3), 434-437.
Caplin, M. S. (2016). Professional identity development in nurses returning for a BSN: A naturalistic inquiry [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1479746734449734
Chen, L. Y., & Hubinette, M. M. (2017). Exploring the role of classroom-based learning in professional identity formation of family practice residents using the experiences, trajectories, and reifications framework. Medical Teacher, 39(8), 876-882.
Clarkson, M. E. (1995). A stakeholder framework for analyzing and evaluating corporate social performance. Academy of Management Review, 20(1), 92-117.
Commission on Accreditation for Respiratory Care (2018). 2017 report on accreditation in respiratory care education. https://coarc.com/CoARC/media/images/2017-CoARC-Report-on-Accreditation-4-3-18.pdf
Commission on Accreditation for Respiratory Care (2019). Entry into practice standards: Accreditation standards for entry into respiratory care professional practice. https://coarc.com/Accreditation/Entry-into-Practice-Standards.aspx
Colesso, W., Cusinato, M., & L'Abate, L. (2013). Self-identity differentiation: A supermodel expanded into two other models. In E. L. Anderson & S. Thomas (Eds.), Socialization theories, processes, and impact (pp. 79–100). Nova Science Publishers.
Creswell, J. W., & Poth, C. N. (2016). Qualitative inquiry and research design: Choosing among five approaches. Sage Publications.
Cruess, R. L., Cruess, S. R., Boudreau, J. D., Snell, L., & Steinert, Y. (2014). Reframing medical education to support professional identity formation. Academic Medicine, 89(11), 1446-1451.
Cruess, R. L., Cruess, S. R., Boudreau, J. D., Snell, L., & Steinert, Y. (2015). A schematic representation of the professional identity formation and socialization of medical students and residents: a guide for medical educators. Academic Medicine, 90(6), 718-725.
Druse, T. L. (2012). Educator, supervisor, and graduate recommendations of a bachelor degree for physical therapist assistants. Northcentral University.
Farach, L. (2018). Professional impact of advanced education for practicing respiratory therapists. Respiratory Care Journal, 63(suppl 10).
Farmer, T., Robinson, K., Elliott, S. J., & Eyles, J. (2006). Developing and implementing a triangulation protocol for qualitative health research. Qualitative Health Research, 16(3), 377-394.
Fisher, M. (2014). A comparison of professional value development among pre-licensure nursing students in associate degree, diploma, and Bachelor of Science in Nursing programs. Nursing Education Perspectives, 35(1), 37-42.
Freeman, R. E. (1984). Strategic management: A stakeholder approach. Pitman Publishing.
Freeman, R. E. (1994). The politics of stakeholder theory: Some future directions. Business Ethics Quarterly, 4(4), 409-421.
Freeman, R. E., Rusconi, G., Signori, S., & Strudler, A. (2012). Stakeholder theory (ies): Ethical ideas and managerial action. Journal of Business Ethics, 109, 1-2.
Fulton, M. (2020). Community college bachelor's degrees: An update on state activity and policy considerations policy brief. Education Commission of the States.
Gigli, K. H., Davis, B. S., Ervin, J., & Kahn, J. M. (2020). Factors associated with nurses’ knowledge of and perceived value in evidence-based practices. American Journal of Critical Care, 29(1), e1-e8.
Goldie, J. (2012). The formation of professional identity in medical students: Considerations for educators. Medical Teacher, 34(9), e641-e648.
Gresham-Anderson, J. L., Kurszewski, T., Davenport, E., Flagg, S., & Coonce-Smith, M. (2019). Exploring death coping strategies of respiratory therapists who work in neonatal intensive care units: A pilot study. Respiratory Care Education Annual, 28, 36-42.
Han, M. K., Martinez, C. H., Au, D. H., Bourbeau, J., Boyd, C. M., Branson, R., Criner, G. J., Kalhan, R., Kallstrom, T. J., King, A., Krishnan, J. A., Lareau, S. C., Lee, T. A., Lindell, K., Mannino, D. M., Martinez, F. J., Meldrum, C., Press, V. G., Thomashow, B., ... & Dransfield, M. T. (2016). Meeting the challenge of COPD care delivery in the USA: A multiprovider perspective. The Lancet Respiratory Medicine, 4(6), 473-526.
Kacmarek, R. M., Barnes, T. A., & Durbin, C. G. (2012). Survey of directors of respiratory therapy departments regarding the future education and credentialing of respiratory care students and staff. Respiratory Care, 57(5), 710-720.
Kay, D., Berry, A., & Coles, N. A. (2019). What experiences in medical school trigger professional identity development? Teaching and Learning in Medicine, 31(1), 17-25.
King, J., Freburger, J. K., & Slifkin, R. T. (2010). What does the clinical doctorate in physical therapy mean for rural communities? Physiotherapy Research International, 15(1), 24-34.
Leider, J. P., Coronado, F., Beck, A. J., & Harper, E. (2018). Reconciling supply and demand for state and local public health staff in an era of retiring baby boomers. American Journal of Preventive Medicine, 54(3), 334-340.
McCombie, R. P. (2016a). Attitudes of occupational therapists and occupational therapy assistants toward the entry-level bachelor’s degree for OTAs. Open Journal of Occupational Therapy, 4(1), 1-11.
McCombie, R. P. (2016b). Entry-level doctorate for occupational therapists: An assessment of attitudes of occupational therapists and occupational therapy assistants. Rehabilitation Research, Policy, and Education, 30(4), 389-403.
Miller, D. P., & Levere, T. H. (2008). “Inhale it and see?” The collaboration between Thomas Beddoes and James Watt in pneumatic medicine. Ambix, 55(1), 5-28.
Mishoe, S. C. (2003). Critical thinking in respiratory care practice: A qualitative research study. Respiratory Care, 48(5), 500-516.
Mishoe, S. C. (2007). Problem-based learning: Any influence in respiratory care?. Respiratory Care, 52(11), 1457-1459.
Mitchell, R. K., Agle, B. R., & Wood, D. J. (1997). Toward a theory of stakeholder identification and salience: Defining the principle of who and what really counts. Academy of Management Review, 22(4), 853-886.
Molitor, W. M. L., & Nissen, R. (2018). Clinician, educator, and student perceptions of entry-level academic degree requirements in occupational therapy education. Journal of Occupational Therapy Education, 2(1). Article 2.
Myers, T. (2019, Fall). AARC executive office board activities report. Fall House of Delegates Meeting. Talk presented at 2019 Fall House of Delegates Meeting, New Orleans, LA.
Nagendrappa, G. (2012). Antoine-Laurent Lavoisier. Resonance, 17(1), 11–22. https://doi.org/10.1007/s12045-012-0002-2
National Board for Respiratory Care. (2020). About us. https://www.nbrc.org/about/
Organization for Associate Degree Nursing and American Nurses Association. (2015). Position statement: Academic progression to meet the needs of the registered nurse, the health care consumer, and the U.S. health care system [PDF File]. https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/academic-progression-to-meet-the-needs-of-the-health-care/
Privitera, G. J., & Ahlgrim-Delzell, L. (2019). Research methods for education. SAGE.
Rowley, T. (1998), A normative justification for stakeholder theory. Business & Society, 37(1), 105-107.
Rowley, L. J., & Stein, S. M. (2016). A baccalaureate education curriculum to prepare dental hygienists for expanded public health practice. Journal of Evidence Based Dental Practice, 16, 122-128.
Sekhar, K., & Rao, S.S.C. (2014). John Scott Haldane: The father of oxygen therapy. Indian Journal of Anaesthesia, 58(3), 350-352.
Silveira, G. L., Campos, L. K., Schweller, M., Turato, E. R., Helmich, E., & de Carvalho-Filho, M. A. (2019). “Speed up”! The influences of the hidden curriculum on the professional identity development of medical students. Health Professions Education, 5(3), 198-209.
Smith, S. G., Endee, L. M., Scott, L. A. B., & Linden, P. L. (2017). The future of respiratory care: results of a New York state survey of respiratory therapists. Respiratory Care, 62(3), 279-287.
Sperle, C. K. (2017). A comparative analysis of associate and baccalaureate degree respiratory therapy programs preparation of graduates for entry into the profession (Doctoral dissertation). ProQuest. (10125585)
Stolberg, R. L., & Tilliss, T. (2016). The baccalaureate-educated dental hygienist. Journal of Evidence Based Dental Practice, 16, 136-143.
The National Academic Press. (2011). The future of nursing: Leading change, advancing health. Author.
Turkestani, F. A. (2022). Mind mapping: A learning strategy to promote critical thinking skills for respiratory therapy students (Doctoral dissertation, Seton Hall University). ProQuest Dissertations & Theses.
Vukojević, B. (2016). Creswell JW: Research design: Qualitative, quantitative, and mixed methods approaches, London: Sage Publications, 2009. Politeia, 6(12), 191-194.
Wagner Mainardes, E., Alves, H., & Raposo, M. (2012). A model for stakeholder classification and stakeholder relationships. Management Decision, 50(10), 1861-1879.
Wong, A., & Trollope‐Kumar, K. (2014). Reflections: an inquiry into medical students’ professional identity formation. Medical Education, 48(5), 489-501.
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