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

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.

Figure 1

Timeline drawing by Gaby depicting the changes in her professional identity and in her affinity with care. Self‐indicated time‐points: 2005, starts Bachelor's training in nursing; 2009, graduates and starts working as nurse; 2010, enters the Clinical Health Sciences (CHS) pre‐Master's programme; 2011, begins CHS Master's programme (specialising in nursing science); 2013, graduates from CHS and starts working 50/50 as a senior nurse and nursing scientist in an academic hospital