Search results

This paper examines how staff at a Finnish hospital develop a new medical identity amidst other already-established professions. This study was conducted during the merger of two surgical departments at a public Finnish university hospital, and concerned the identity development process of a hospitalist which was, at the time, an entirely new medical role at the hospital. Drawing on extensive videos of authentic team meetings and entries in various actors' reflective diaries, we find that the actors collectively developed the new medical identity during the change process by using the following reflexive strategies: (1) identity inquiry; (2) identity reflection; and (3) identity legitimacy. These strategies foster temporary identity claims while the new medical identity is developed through experimentation and discourse, culminating in an identity that acquires stability within the ward environment. We found that an environment allowing transparent and open dialogue, in this case through periodic change facilitation meetings, was conducive to the development of a new identity.

Prior research on professional boundary work emphasises the importance of subtle interactions among affected individuals when a new role is inserted into an established professional setting, which inevitably changes the prevalent division of labour. Thus, managers may set reflective spaces for professionals to collaboratively arrange their boundaries and make room for the new professional. This ethnomethodologically oriented study examines boundary arrangements in work development meetings in a university hospital, while professionals made room for a new role, a hospitalist. Examining professionals' naturally occurring interactions in reflective spaces, the findings depict seven categorisations for the hospitalist. Elaborating on the dynamics of these categorisations, we propose that technically based categorisations sustain stability, and context-bound categorisations allow change in work practices, whereas their combination enables transformation within the institutional context. Accordingly, the study adds to the literature on the transformative potential of reflective spaces by illuminating the intertwining of engaged professionals' boundary talk in interaction with the consequences of configurational boundary work in relation to a new professional role.

Health care professionals need continuous education to maintain the competencies required to provide high-quality care; in today's world, this means an understanding of digital health services. Insight into health care professionals' experiences of which aspects influence their digital health competence development is therefore highly relevant.
The objective of the study was to examine which aspects influence the digital health competence development of health care professionals (nursing workforce and allied health professionals).
In-depth, semi-structured interviews were conducted with 20 health care professionals (Finland n=15, Sweden n=5) from various health care settings between May 2019 and July 2020. Interviews were audio-recorded, translated verbatim and analysed with inductive content analysis.
Health care professionals perceive that digital health competence development is influenced by aspects related to digital health adoption, co-workers and the work community, their manager, and opportunities for continuous education and orientation.
The participants agreed that digital health competence is an important part of a health care professional's overall clinical competence. Continuous education geared towards digital health competence should be systematically designed, and potentially integrate the resources available on social media platforms. Additionally, managers and supervisors should take a stronger stance towards learning about digital health services so they can serve as role models to their employees and genuinely promote digital health competence development.