Interprofessional identity in health and social care : a concept analysis

Background: Professional identity formation is regarded as one of the fundamental goals of education, leading to professionals that are equipped to function within an interprofessional healthcare environment. However, current education is predominantly organized in an uniprofessional way, with little opportunity for interprofessional interactions. As a result, students learn profession-specific competencies and pursue distinct goals, while they remain largely unfamiliar with the roles, goals, and perspectives of other professions. This uniprofessional education may give rise to false beliefs and stereotypes about a profession that can hinder one to see others’ capabilities and unique contributions, thereby hampering interprofessional collaboration and affecting quality of care. Therefore, an investment in interprofessional education, where students from different professions learn with, from, and about each other, is needed. Evidently, the implications of interprofessional education on the professional identity formation of students are increasingly being investigated and has led researchers to presume the existence of an interprofessional identity (IPI). Nonetheless, there are noticeable differences in how this concept is operationalized. An analysis of the characteristics and components of IPI could reduce this ambiguity and aid in the development of educational interventions. Therefore, the literature pertaining IPI was reviewed and the concept was analyzed with the goal of providing a clear and measurable definition. Methods: Walker and Avant’s model was adhered throughout this study. Firstly, the possible uses of the concept were investigated and the attributes (key characteristics) were determined by conducting an integrative review of studies mentioning and describing IPI or a synonym. Seven academic databases and Google Scholar were searched until July 2020, in addition to relevant journals, reference lists and citations. This has led to the full-text screening of 75 out of 1334 records and subsequent inclusion of 39 articles. Secondly, the attributes and associated antecedents (conditions) and consequences (outcomes) of IPI were data-extracted and analyzed independently by two authors by use of a coding frame which was developed after a pilot analysis of ten articles. The remainder of the articles were then analyzed deductively and were regularly discussed to facilitate triangulation. The constant comparison method was used to iteratively refine and establish a final list of attributes, antecedents and consequences. An additional concept derivation of ‘intergroup relational identity’ was required to create a definition. Lastly, illustrative cases were developed and the concept was defined in term of its empirical referents by discussing the measurability of each specific attribute. Results: Three overarching perspectives were identified that define IPI as either; (1) a social identity, (2) a team identity, or as (3) a role identity. The majority (n=26) of the articles referred to social identity theory when describing IPI, and mostly as a dual identity (n=12). Qualitative analysis led to four categories reflecting (1) the characteristics of IPI, (2) values, (3) attitudes and beliefs, and (4) knowledge and skills. Firstly, the identity is thought to be fluid and dynamic (n=19), context-dependent (n=14), and a reconstruction of the professional identity (n=11) in which professionals share a mental model of teamwork (n=9) and a commitment to a superordinate collective (n=25). Secondly, professionals in collaborative practice are guided by a set of shared values such as respect (n=11), interdependence (=17), equality (n=16), trust (n=7), togetherness (n=4) and patient-centeredness (n=2). Thirdly, interprofessional attitudes and beliefs are fostered, comprising positive attitudes towards team members (n=12), interprofessional openness and readiness for interprofessional collaboration (n=13), and an awareness of the value of a collaborative team approach (n=6). Lastly, professionals possess a shared repertoire of knowledge and skills pertaining roles and responsibilities (n=18, a mutual understanding of perspectives and the ability to use this knowledge), teamwork and collaboration (n=28, an understanding of leadership, mutual engagement and consensus building, and an ability to apply relationship-building values) and interprofessional communication (n=22, an ability to communicate with different health professionals in a way that supports a team approach). The integration of these categories led to following definition; an interprofessional identity is a fluid and dynamic identity embedded within an individual’s professional identity comprising the internalized values, attitudes and beliefs, knowledge and skills shared across different professionals, consequently resulting in the thinking, acting and feeling as an interprofessional. Conclusions: This study has shed light on the different takes o...