Category: Professionalism

Reflection is very significant for effective practice and the development of professional knowledge. According to John (2010), reflection is a way to reach an awareness of how and why things have occurred. Ghaye and Lillyman (2010), said it’s’ ‘a transformative process that changes individuals and their actions’. Reflection may be a way of examining your experience to appear for possibility of the opposite explanations and alternative approaches to doing things. Howatson-Jones (2013), said reflection is not unusual as we can reflect anywhere, for example in a train, car, in a bath, when exercising, cooking, or when we have any chance or time to ourselves to think. When reflecting, I put 6c into consideration knowing that reflective practice is very important in continuously improving the standard of service provided because it helps you keep a check on yourself by evaluating your performance, recording and tracking your progress, and seeking people’s feedback.

Self-awareness: Seager (2012), said it is the power to look at one’s thoughts and motivations. Having knowledge of our mind which helps in growing emotional resilience. It’s vital that we learn the way and become conscious of how we react when stressed or under pressure as this helps us to achieve better control over those reactions. (www.mentalhelp.net)

Emotional resilience: Dr. Harry (2018), in his book defined Emotional Resilience “as our individual capacity to deal with adversity in life”. The word resilience comes from the Latin word resilient, which suggests to ‘bounce back’ or ‘recoil’.

To reflect on my very own learning and development in relation to the module by considering my very own self-awareness and emotional resilience as part of this discussion, I will be able to use the Gibbs Reflective Cycle (1988), as a framework for caring conversation and therefore the outcome of my learning since Gibbs cycle is tailored from a framework for experimental learning with inquiries to provide structure for caring encounters experience to be reflected on. In other to preserve the patient’s confidentiality, I will address the patient in my scenario as Tim.

Situation: I went with my assessor to have a caring conversation with a patient who self-harms and is suicidal. Self-harm is an act of self-poisoning or self-injury applied by an individual regardless of motivation NICE (2011).

Analysis of feelings: I was excited, happy, and nervous at the same time even though it felt so great to be asked to assist and observe in the health promotion of a patient with a mental health problem. The conversation started out well and good enough is the fact that we have fewer people to see for the day.

Evaluation: The good thing about the meeting is I was able to observe and speak to the patient and ask a few questions about safe harm, and the bad thing is I was too emotional and not very confident.

Analysis: My assessor spent time talking to Tim and that made him more relaxed and able to express his concerns, fears, anxieties, and worries. Communication impacts the way care is delivered because it is as essential as the care itself Arnold and Boggs (2019). Showing empathy enabled trust and rapport. She was understanding, non-judgemental, and acknowledged how scared and fearful it may be for him maybe his failure to commit suicide. Effective communication reduces complaints and increases self-confidence as well as enhances patient experience Ali (2017). By active listening, I and my assessor showed we were willing and ready to talk and listen. I am fully aware of the communication techniques and their effectiveness and so we sat near Tim. I learned how important it is to sit on the same level rather than standing on patients because if you are sitting in a higher position than the patient, you make them feel inferior or they feel that they are being told off.

Evan et al (2014), noted talking about health issues with little knowledge limits the depth and nature of the conversation. Evans states that when talking to a patient about health issues, you wish to consider how you will interpret technical language or jargon into language that is easily understandable and clear. My assessor is confident and knowledgeable about the issue at hand which made it easier for us to provide complete information and advice to him. She checked if there were risks to Tim’s safety or the public and was fully aware of the duty of candor. NMC (2015). As Tim wants help and advice, I with the assistance of my assessor using a person-centered plan agreed with Tim on ways to come back up with a safety plan for him. According to Professor Gillian (2016), ‘it is important that a culture of shared higher cognitive process is embedded into clinical practice’. We displayed professionalism all through and accountability which is open to challenge and able to show how we were able to make clinical decisions and care provided Reed and Dix (2018). “What strengthens trust between patients and health care professionals is the principle of confidentiality” RCN (2016).

At the end of the interaction, I recorded in detail our conversations from start to end and my observations bearing in mind the NMC code on record keeping which highlights that inadequate and inappropriate record keeping negatively affects the general well-being of care.

Conclusion: I and my assessor were able to carry out an effective assessment check and caring conversation. we prioritized our workload and were able to spend enough time with Tim, being aware that lack of time, workloads, and busy schedules can influence communication.

Action plan: In other to enhance the standard of future communication, I should continue with the standard of communication strategy I displayed and develop my confidence. Observing my assessor inspired me and in the future, I want to be confident and knowledgeable like her. I would need assessor feedback, tutor feedback, and self-assessment to checkmate my progress.

Through reflection, I now feel very confident and can now appreciate and value the importance of my past experience. Working to improve myself and involving in-patient care to help me achieve my goal of becoming a nurse.

Professionalism is widely regarded as a key concept in all aspects of working society not only in the dental sector. Its meaning is well known but broad, each individual will have their own interpretation of what they see as a professional person. Most will agree with the attributes described by Mason (2016) that will qualify someone to be considered professional; neat appearance, confident demeanor, be reliable, ethics, and organization amongst other attributes.

Professional integrity on the other hand is a more narrowed concept. It is a person who bases their decisions on moral and ethical values and in turn, is always honest and accountable even when no one is around.

“Professional integrity thus defines the professional who consistently and willingly practices within the guidelines of the mission of a chosen profession under the obligation of a Code of Ethics.” (Catalog-ngcsu.ung.edu, 2012).

Within dentistry, the ethical standards of professionalism are set out by the General Dental Council (GDC) and are a core part of education for any role within dentistry from dental nurse to dentist. The 9 ethical principles written in the GDC Standards for the Dental Team (2013) are instilled into students when training and is expected that individuals nurture these concepts and develop them throughout their careers. Following these principles ensures the general public has continued faith in the dental sector and is utilized to provide successful treatment that is in the patient’s best interest. Following the guidance set out in these standards at all times will ensure a high level of professional integrity. This seems easy in theory, but practically there are hurdles that most individuals will come up against within their dental career. How individuals behave and react in these situations is a reflection of their professional integrity and will influence how they are seen by other members of staff and patients.

The ideals of professional integrity, its growth, as well as situations that can erode this ideal over time will be examined in this essay. It will include a discussion of how professional integrity can be maintained and how it affects the dental sector as a whole.

The Role of Professional Integrity

• Maintain faith – people coming for appointments – ensure overall dental health and wellbeing
• Ensure confidentiality – sensitive subject – invasive area – GDPR

Having a consistent level of professional integrity will provide patients with a sense of safety and a lack of judgment. This is particularly important when providing care to those patients who are anxious/phobic. These integral attributes will encourage these individuals to return for dental treatment. This is not only imperative to maintain good oral health but can lead to a better overall quality of life.

Growth of Professional Integrity

Echoed throughout university learning is the importance of professionalism within the dental sector. Masella (2007) believes that the development of a student’s professionalism should be the most important mission of dental education. One of the first literary documents given to students is the ‘Student Professionalism and Fitness to Practice’, written by the General Dental Council (2016). This guidance aims to set out the standards of conduct that are expected of an individual in study to become a registered dental professional. This document ensures that students are aware of the high expectations placed upon them due to the very high degree of responsibility that comes with this career path. As mentioned, the public place their trust in dental registrants, and thus must retain integrity.

So what happens when you come up against barriers in dentistry where you are asked to compromise your professional integrity?

The Fall of Professional Integrity

• Implications of complacency – no room in the dental sector
• Slowly erode own personal standing over time
• Is some erosion expected?
• Time restraints/staff issues
• Hawthorn theory

It is difficult to comprehend that an individual who does not place high importance on professionalism would choose this profession, understanding the career-long expectations that are expected of them.

Despite this, there are numerous barriers workers are up against that may erode their professional integrity over time.

One such instance is working in an environment where the standard of working is lower than your own. It is argued that the most dangerous phrase in business is ‘We have always done it this way.’ It is the attitude of someone who is comfortable with how they do things and may not know or want to change.

“We know that past success is no guarantee for the future, especially when the only constant is change.” (Boogaard, n.d).

And this could not be truer in the dental industry, with new regulations and techniques being implemented on a regular basis, there is no place in the dental sector for complacency and this kind of attitude. But it does happen. And this mindset will fester and worsen over time and potentially be adopted by other members of the team until this old way of thinking is the habit of the whole practice. This erosion of professional integrity can lead to substandard work and patients not receiving a high standard of care.

As well as being mindful of other team members working ethics, one must ensure our own attitude does not slip. It could be argued that with experience come complacency and individuals feeling they do not need to continue their professional development.

Provisions to Maintain Professional Integrity

Teamwork, according to Englehardt-Nash (2013) can have a direct impact on the success of the practice. If a workplace can have authentic and open communication with each other, then the practice as a whole will have a better professional relationship, and subsequently, the patients will receive a consistently high standard of care.

This opinion is reflected by the General Dental Council, as it is one of its nine ethical principles. They state that individuals should ‘work with colleagues that are in the patient’s best interest.’ Dental professionals working in sync with each other and helping one another to be the best clinicians will help maintain good working morale and professional integrity.

It is easy to assume all individuals who choose this profession would work in this way, but if there is a member of the dental team who is not acting within their scope or providing continuous substandard care, it is the ethical duty of others in the dental team to whistleblow. As mentioned above, the actions and habits of one individual can cause other staff members to copy the behavior and lower standards. Therefore it is important to have clear communication to either bring up issues in-house or follow protocols in the whistle-blowing policy.

To work in the dental sector, registrants are required to fulfill a certain amount of post-qualification development called CPD (continuing professional development).

“It refers to the process of tracking and documenting the skills, knowledge, and experience that you gain both formally and informally as you work, beyond any initial training.” (Johnston, n.d).

Each CPD cycle lasts 5 years and at which time you must complete a certain amount of hours of verifiable learning. It is a process where you expand on current knowledge and reflect on what you have learned and how it will affect your future practice. The GDC place the utmost importance on CPD as they believe it is “at the heart of what it means to be a professional”. As a result, the General Dental Council has included the need for the maintenance and development of skills as one of the 9 principles. As well as CPD, registrants also must construct a personal development plan (PDP) to map out their learning and undergo regular appraisals.

The author believes this is due to the ever-changing nature of the dental field. Because of this, dental professional knowledge needs to be ever-changing. This ensures knowledge is up to date and subsequently patients will receive a high standard of care.

Conclusion

Upholding every rule and guideline can be unreasonable, and in some cases impossible due to time and staffing constraints. But it is important that dental professionals strive to work to best practice standards where possible. It is imperative to recognize when we fall short and put provisions in place to ensure that we do not get repeat incidents. This quote from Cooley sums it up nicely;

“…professionalism does not mean perfectionism. We all fall short at times; we are human. When we fall, we pick ourselves up and get back in the game.” (Cooley, 2016).

Being supported by a dental team who is able to provide knowledge and encouragement is the main asset to maintaining professional integrity. Being surrounded by like-minded professionals who work to the best standard even when no one is around can only provide the patients with the highest quality of care. It is imperative for dental professionals to be mindful of their integrity as they gain experience, as this can lead to complacency. “The truth of the matter is, being a professional and acting as such is timeless.”

It is clear that professional integrity plays a major role in the workings of a dental team and must be upheld throughout one’s career to maintain a good rapport with the general public and provide the best quality of care to patients.

Over the last decade, there has been a push for continuing education in the nursing profession. There are more options for registered nurses to pursue a career as advanced practice nurses (APNs). It is beneficial to the nurse to create a professional development plan (PDP) to assist in career growth. A professional development plan enables nurses to keep a record of their activities and show that they are keeping up with their competencies in practice (College of Registered Nurses of British Columbia, 2018). The PDP is essentially a tool used to guide the nurse through their career advancement. Career goals are established and a strategy to accomplish these goals is developed. The following paper is meant to outline the scope of practice for the APN in the state of Wisconsin, a personal assessment using Benner’s novice to the expert method, and the marketing/ networking strategies that will be used in achieving the professional development plan. The paper will conclude with an up-to-date curriculum vitae (CV). Having a plan is the first step in achieving a person’s goals.

APN Scope of Practice

Scope of practice laws is the guidelines that are set by the state that indicates the role of the APN. According to Mennella & Heering (2017), the scope of practice defines the nursing professional role and is legally determined by education, competencies, and nursing experiences. In the United States, the scope of practice is different for each state. The scope of practice may be full, reduced, or restricted. In the state of Wisconsin, the scope of practice is reduced, which means that the nurse practitioner has a reduced ability to engage in at least one component of their practice (AANP, 2018). This means that NPs are not recognized in the state of Wisconsin as primary care providers. NPs must work in collaboration with a physician. This is limiting to patient care in Wisconsin, particularly in rural areas. A full practice state allows for APNs to practice to the full extent of their education. According to Martin & Alexander (2019), full-practice states tend to have better access to care in rural communities as well as underserved and minority populations.

To practice in Wisconsin, the APN is required to have a current license. The APN is responsible for but not limited to thorough interviewing, history taking, physical assessment, test selection and interpretation, pathophysiology, epidemiology, diagnostic reasoning, differentiation of conditions, treatment decisions, case evaluation, and non-pharmacologic interventions (Wisconsin Scope of Practice, 2019). To be a certified advanced practice nurse prescriber the nurse must submit a fee and application, hold a current license in the state, have evidence of a master’s or doctoral degree in nursing, provide evidence of completion of 45 contact hours in clinical pharmacology or therapeutics within 5 years of the application for a certificate, and provide proof of passing the exam for advanced practice nurse prescribers (Wisconsin Scope of Practice, 2019).

Obtaining licensure in the state of Wisconsin requires that the registered nurse must submit a fee and application to the Wisconsin Board of Nursing. It is also a requirement to have a master’s or doctoral degree in nursing or a related health field granted by a college or university accredited by a regional accrediting organization approved by the Council for Higher Education Accreditation. The nurse must also have 45 contact hours in clinical pharmacology in order to have prescribing rights. Lastly, the nurse must have passed the examination for advanced practice nurses (Wisconsin Scope of Practice, 2019).

Personal Assessment Using Benner’s Self-Assessment Tool

A comprehensive assessment enables an individual to evaluate their own strengths and weaknesses and the areas that need improvement. This allows one to set goals and objectives that can help in prioritizing and organizing career goals. Employers are looking for nurses who are qualified, have leadership skills, someone who can prioritize, and multitask.

I will be using Benner’s novice to expert model (2011), in completing my personal assessment. This will help me to identify areas of strength and areas needed for improvement. Benner’s model is divided into five levels of professional stages. The first stage is the novice nurse; this nurse has little to no experience and lacks the confidence to carry out safe practice without supervision (Benner, 2011). The advanced beginner has some experience and works with the support of others (Benner, 2011). The competent nurse is independent and uses critical thinking based off of past experiences (Benner, 2011). The proficient nurse has many years of experience and approaches patient care with a holistic approach by seeing the situation in its entirety (Benner, 2011). The expert nurse is considered highly proficient and flexible and able to approach all situations with a deep understanding (Benner, 2011).

I am currently working as a registered nurse on an inpatient oncology unit. I consider myself to be somewhere between a competent and a proficient nurse. I have been working on my unit for nearly seven years, three of which I have been a nurse. I can anticipate patients’ needs and plan accordingly. I can base my decisions on my education and my past experiences by using an analytical thought process. I would say that I am becoming more proficient with more experience. I can see most situations as the bigger picture. I can look toward what might happen next when making decisions.

I am studying to become an advanced practice nurse. In this role, I would consider myself a novice. I have not yet started my practicum, meaning I have no clinical experience in this role. The decisions that I am making at this point are based on the text and what I am learning from my coursework. With that said, I am still strengthening my decision-making skills as a registered nurse. The preparation in my current role will continue to help me through my transition into the APN role. I will continue in my new role building my confidence, but I will need support before I can practice independently.

What areas of your career do you most want to focus on and further develop?

I have worked for close to seven years with the same patient population. I would like to focus my career on working with underserved populations, specifically in public health. I am also considering a career in family planning. I would like to focus on learning more about women’s health.

What do you look forward to most about your new role?

I look forward to working with different populations as a family nurse practitioner. I want to have an active role in holistic care and establishing treatment plans for my patients. I am also excited to learn new things. I hope to be able to work in a practice where I have some autonomy and where my voice and opinions make a change for the better in patient care.

What do you fear the most about your new job?

I know that I do fear the unknown and I have some hesitation about change. I have been a registered nurse for almost three years, and I can remember a time as a novice nurse when I often questioned my judgment. My new role will be another adjustment period which scares me.

What do you most hope to gain from your new experience?

As I stated earlier, I am looking forward to an opportunity to work with new patient populations. My current role is all I have known in healthcare. I also hope to become more knowledgeable in primary care and become confident in my abilities to be an FNP.

Adapting to a new position/work setting is stressful and overwhelming. List three ways in which you cope with excessive stress.

Early on in my education, I decided that I would continue going to school for my MSN. School has not always come easy to me but every time I successfully complete a milestone in my education and career, I am reassured that I can do this. I do struggle with anxiety and I must find ways to cope with that additional barrier. Going into a new position is another transition in my life that will potentially be stressful. I have established a great support system with family and colleagues. I make sure to talk about the things that are overwhelming me. I also make time for myself so that I can recharge so to speak. One of the things that I hope to work on is to exercise more so that I can stay healthy through the transition. It is important to me that I take care of myself too.

What are your goals and objectives for your first, second, and third months in your new position as well as the remainder of your first year?

My goal is to complete my post-graduate degree and obtain my APN registration and certification. I also hope to donate some of my time to a community clinic to better understand the patient population I wish to work with. I would like to join an APN organization, such as the American Association of Nurse Practitioners. My objective as a new FNP would be to learn as much as I can and keep an open mind to new opportunities. My professional goal is to be able to collaborate with new team members that I will be working with. In order to deliver high-quality, patient-centered care, manage chronic illness and improve team capacity among providers, the current healthcare system will need to use team collaboration (Farrell, Payne, & Heye, 2015).

Networking and Marketing Strategies

Understanding how to use marketing tools and how to network within the profession are important for new APNs to move forward in their career. When beginning the process of looking for a new job it is important to assess the healthcare organizations around the local area, the state, and other places where the APN would like to practice. The job market assessment begins by researching; this gives the APN a better idea of the available employment opportunities, as well as the culture and structure of different organizations.

There are multiple ways to do marketing and networking as an APN, such as national exposure, regional participation, and online networking. Networking is a shared interaction between a group of people or individuals which is usually beneficial to both sides; it can be done by meeting face-to-face or electronically (Goolsby & Knestrick, 2017). Networking is used to assess the job market in both local and state areas. Joining professional organizations is a great way for the new APN to network. In Wisconsin, jobs are advertised through local newspapers, clinic and hospital websites, Facebook and LinkedIn, and professional organizations like Wisconsin Nurses Association (WNA). For national exposure, joining a national organization such as the American Association of Nurse Practitioners (AANP) is a good place to start. National groups help gain access to benefits such as insurance and free continuing education courses. They will also put you in contact with nurse practitioners nationwide. There is also an opportunity to network regionally or in your home state. In Wisconsin, there is the Wisconsin Nurses Association (WNA) that is open to all APRNs certified in the state. They provide a discussion place for education, professional and legislative issues. Social media is another popular resource for networking and is gaining popularity among healthcare professionals (Khanum et al., 2016). Networking is a great method to create personal connections and form a rapport with other nursing professionals to seek career opportunities.

Conclusion

A professional development plan is to be used as a guide to develop a person’s career. Advanced practice nurses are on the frontlines of patient care. It is a growing profession with the advancement of nursing education. APNs are leaders in the nursing profession, and it is crucial for the new APN to have a career development plan. This plan will help identify areas of weakness as well as the strengths of the individual. The plan will also be used as a guide for the individual’s career path. It is important for this plan to evolve along with the nurse. This plan can also assist in developing a CV and be used as a tool for networking.

References

1. Benner, P. (2001). From novice to expert: Excellence and power in the clinical nursing practice. Upper Saddle River, NJ: Prentice Hall Health.
2. Certification of advanced practice nurse prescribers. (2016, September). Retrieved from
3. http://docs.legis.wisconsin.gov/code/admin_code/n/8/06
4. Farrell, K., Payne, C., & Heye, M. (2015). Integrating inter-professional collaboration skills into the advanced practice registered nurse socialization process. Journal of Professional Nursing, 31(1), 5-10. https://doi.org/https://doi.org/10.1016/j.profnurs.2014.05.006
5. Khanum, S., Souza, M. D. L. D., Naz, N., Sasso, G. T. M. D., Brüggemann, O. M., & Heideman, I. T. S. B. (2016). The Use of Networking in Nursing Practice—An Integrative Review. Societies, 6(3), 22.
6. Goolsby, M., & Knestrick, J. (2017, August). Effective professional networking. Journal of American Association of Nurse Practitioners, 29(8), 441-445. https://doi.org/DOI: 10.1002/2327-6924.12484
7. Martin, B., & Alexander, M. (2019). The Economic Burden and Practice Restrictions Associated With Collaborative Practice Agreements: A National Survey of Advanced Practice Registered Nurses. Journal of Nursing Regulation, 9(4), 22–30. https://doi.org/10.1016/S2155-8256(19)30012-2
8. Mennella, H. D. A.-B., & Heering, H. R. C. (2017). Professional Autonomy and Advanced Nursing Practice. CINAHL Nursing Guide. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=nup&AN=T904768&site=eds-live&scope=site
9. Wisconsin scope of practice. (2019). Retrieved from http://scopeofpracticepolicy.org/states/wi/

Reflective learning is associated with looking back on experiences and understanding what actions could be taken in the future (Schon, 1983).

Atwal & Jones, (2009) states that ‘reflective practice is a fundamental component of continuing professional development and is required by all regulatory bodies, in order to revalidate registration’; erasing complacency within healthcare. Reflection enables health professionals to share knowledge with others, to make sense of challenging situations (Chapman et al, 2009). Gibbs’ reflective cycle (1988) encourages a description of the situation, analysis of feelings, evaluation, and analysis to make sense of the experience; however, this reflection will focus on free-form reflection (The University of Edinburgh 2018). as I found it more productive to think freely in regards to learning British sign language (BSL). I find some reflective models to be quite restrictive in regards to fully expressing the event or experience; such as Johns (1995) or Schon (1983); therefore whilst my original note-taking in my action plan followed a reflective model, I chose to not to follow one for my reflection. Hand, (1995) explains that reflection enhances personal development by leading to self-awareness; which ultimately leads to empowerment. The reflection will cover the identification of my own occupational identity, occupational performance, and what influences my own culture, morals, values, and ethics. The term professionalism will be examined; and how I define it personally. According to Christiansen and Townsend (2004) occupational science was established in the 1980s with the goal of ‘understanding and exploring the nature and meaning of occupation; and the correlations to health and wellbeing’. Key themes of occupational science that I will cover in this reflection are ‘Doing, Being, Becoming and Belonging’ (Wilcock 2006), ‘Occupational performance’, ‘Occupational flow’ ‘Professionalism and professional behavior’, ‘Culture, Ethics, values and morals’, and ‘Occupational identity’. BSL has been at the forefront of my mind since meeting my friend Abigail; whose son is deaf due to cytomegalovirus during pregnancy. He has a cochlear implant and uses sign language to communicate. Within my healthcare background, I have used Makaton and semiotics surrounding Dementia care; however, I feel sign language is a different concept and requires focus and time to learn; this is why I chose BSL for my occupational learning experience (OLE). By dedicating 4 hours a week to my OLE, I have been able to learn a new skill that will benefit my future occupational performance and identity. In order to link the occupational science concepts to my occupational learning experience; objectives were used to distinguish focus.

Occupational performance is defined as ‘the result of a dynamic, interwoven relationship between person, environment and occupational over a person’s life span’ (Law et al 1996).

Within my research, I encountered facts about Wolverhampton having a strong and supportive Deaf community; which is progressive at changing the environment to ensure the needs of others were being met; making me question my own identity. ‘The “representation of the self” is the classical way of describing identity’ (McIlroy and Storbeck 2011). Before my OLE, I assumed the occupations of my identity as a mother and a student, were in balance within the PEO model (Kielhofner 2004); enabling enhanced occupational performance. I became aware that my occupational performance in learning sign language was diminished due to my environment; and needed adapting. I established a formal study space and utilized a timetable. I became aware of my own body language, and gestures. Hand movements are vital in communication as well as pronouncing words correctly in order for clear lip reading translation. Lieu et al (2007) state ‘individuals who are effective in lip reading, are able to understand around 30-45% of spoken English’.

‘The sense of belonging is a human need’ (Hall, 2019). Belonging to a group, or culture in society enables individuals to see value in their lives and gives a sense of direction. According to the National Registers of Communication Professionals working with Deaf and Deafblind People, there are only 908 registered sign language interpreters (Signature, 2015). Improving my own communication and increasing my occupational identity, has enabled me to belong to the sign language and Deaf community combined. Recently on Strictly come dancing, the presenters have been using sign language whilst on television, in order to promote and teach simple sign language to viewers; which I thought was a wonderful act of consideration and respect for the Deaf community.

My self-actualization in regard to my culture was realized halfway through my OLE. I no longer deemed my own culture to be primarily focused on being a mother, and a student. I found myself being drawn to the sign language culture when I realized I could simply finger-sign the alphabet. Through research, I learned that the term ‘Deaf culture’ is relatively new, in terms of definition for the UK Deaf community. The culture surrounding the grammar of the term ‘Deaf’ is dependent on the individual’s identity or perception of their self. ‘Deaf’ refers to an individual who identifies with and is an active participant in the culture and language (Berke, 2019). However ‘the term ‘deaf’ refers to someone with hearing loss but does not consider themselves participants in the deaf community’ (Inclusion London, 2019). I feel this classification will impact my future practice as the simple pronunciation surrounding the word ‘Deaf’ could be deemed as a risk factor for patients and professionals; this is due to preconceptions that support may be in place, or recommendations may be given without truly understanding ones’ occupational culture.

I have always thought of myself to have quite traditional values and morals in regard to my work ethic and my home life. I feel that my values and morals within my current and professional role can be adjusted, in accordance with my professional standing with the Royal College of Occupational Therapists code of conduct; to promote equality and diversity (College of Occupational Therapists 2015). Lesch et al (2019: 237-244.) state the importance of health professionals knowing basic BSL, in order to reduce cultural incompetence among health providers. Research into ethics surrounding the Deaf community identified the question of bypassing a child’s consent in order to fit cochlear implants; based on the parent’s wishes and perceived perception of being Deaf. ‘The Deaf culture identifies this dilemma as an attempt to change the infant’s birthright cultural group’ (Hladek, 2009).

According to Hitch et al (2014: 231- 246) the term ‘doing’ is central to human life; and ‘serves as a socializing agent, and verifying one’s efficacy as a competent contributing member of one’s society’ (Fidler and Fidler 1978: 305-310). The classification of ‘doing’ stems from the purpose occupations serve; whether that be self-care, contribution to community, family and culture, or leisure. The act of learning sign language was met with enthusiasm and willingness; however, it became apparent fairly quickly that Makaton and finger signing are very different concepts. Instead, I focused entirely on learning the finger-signing alphabet; understanding it would be the basis of my new form of communication.

The most effective form of learning for me was to meet with my close friend Abigail, who has over 7 years of knowledge of sign language and is a level 2 qualified interpreter. With her, I honed my signing skills and understanding. ‘Doing’ the actions, I became aware of occupational flow (Csikszentmihalyi, 1990); a need to ‘do more’ and fully engrossed in learning.

‘There is a strong correlation between becoming and the growth or development of an individual in order for fulfillment’; which involves competency and socialization (Kielhofner 2004). The identification of why I wanted to be able to use sign language was made clear after conversations with Abigail surrounding her communication with health professionals. Professionalism can be defined in a multitude of ways. ‘It is deemed that professional behavior is a form of etiquette in the workplace that is linked primarily to respectful and courteous conduct’ (Fuller n.d.). Differences between being professional, and professional behavior can impact building relationships between health professionals and patients. Due to having previous healthcare experience; I feel I have been able to adapt and improve my professional behavior to extend to being an active listener. Legislation, policies, and procedures are important in healthcare in order to ensure professionals follow standards of care; which are fundamental guidelines that maintain the integrity of the industry. The Royal College of Occupational Therapists and Health and care professionals council state that occupational therapists are to maintain the code of ethics and standards of proficiency, in order to validate and practice effectively (College of Occupational Therapists 2011)

The correlation between occupational science concepts and my OLE has enhanced my occupational being. Adapting my identity as a mother and student into a professional being; gave me a sense of belonging to the occupational therapy and sign language culture. Being a true advocate for person-centered care; I feel that BSL will enhance my occupational performance by being able to prevent miscommunication within the deaf culture in my practice; further enhancing my professional behavior. I feel that Abigail and her son are my purposive view of motivation; highlighting why learning BSL has become a meaningful occupation for me.

Being a part of the field of education, I am tasked with making decisions based on my ethical beliefs daily. I have always thought about my ethical framework and how it is comprised. Until I received this assignment, I had never considered taking the time to compose my thoughts in writing as a way of defining the diverse components that culminate to build my ethical character, whether personally or professionally. Often, life runs together, causing us to mix personal and professional ideas regularly. There very well is a difference in some instances. I am assured that some decisions that I make in my personal life are drawn from different values than when I make decisions in my professional life, as often the decisions affect me differently for varying reasons. As Calder (2012) states, there is a difference between knowing the right thing to say in comparison to being confident in one’s self to do the right thing.

Considering the ideas that steer my thinking in all situations, my ethical foundation is composed of various influences. Some thoughts that come to mind include family, friends, religion, co-workers, personal beliefs, culture, workplace agendas, and health, to name a few. There are times when I must consider if I am being true to myself or dividing and conquering to please others through my decision-making. “We end up living divided lives, so far removed from the truth that we hold within that we cannot know the integrity that comes from being what you are” (Palmer, 2004, p. 4).

In deciding on the framework that currently closely aligns with my personal and professional values, I would have to note the Blanchard-Peale Framework. The framework addresses three thoughts: legality, fairness, and personal feelings. As Palmer (2004) shares, when we move beyond focusing on codes of conduct, then we can have a better understanding of integrity. I must not only feel right about the decision but also be aware of the ramifications that may follow. If it will affect me negatively, in the long run, then it is probably not the best decision for me to make.

According to Sah (2015), ethics is a discussion throughout society focused on addressing the overall well-being of humans. As much as I hate to admit it, society’s ideas play a part in my decision-making as well. Though I work hard within myself to make the best decision, I often think about whether the decision is socially acceptable.

I rationalize daily in both my personal and professional lives. “The difference between rational decisions and rationalization is when reasoning takes place” (Josephson, 2010, 2:19). I work to avoid situations that are unethical, but it is inevitable, as we all must deal with the world every day. “Organizational culture does not always support the right thing” (Josephson, 2010, (0:24). It is up to individuals to find the happy medium in doing what they know, and feel is right while battling the identified wrong. “Rationalization allows us to convince ourselves to do what we know we shouldn’t do” (Josephson, 2010, 3:27).

I, like so many others, go back and forth in my thought process before making decisions. Filling my current role at work, I have been placed into many more situations where I must make decisions, that in some instances can be detrimental. My goal is to ensure that I am strongly aligning my decisions with the ethical practices that balance the perspectives of my principled basis, while also considering others involved in the processes.

Having a job or a carrier doesn’t mean that someone is professionally qualified. As David Maister said Professional is not a label you give yourself, it’s a description you hope that others will apply to you. In recent decades, Professionalism has become an essential term among different occupations and it is supposed to be as positive. So, acting professionally tends to win the trust of many parties within the different professions. However, the meaning of professionalism tends to differ from one person to another. To be professional one should have different skills like communication skills, leadership skills, and time management but it is very important to have reflective practices in the relevant field. The theme of reflection suggests many aspects as we reflect on something to consider it in more detail or re-present it in an oral or written way, and also involves the complicated mental processing of issues (Moon, 1999). Sometimes people use reflection practices for making plans by looking at past experiences.

Historical views of professionalism make arguments about whether particular occupations are professions or not, and these arguments come up with the terms of profession, professionalism, and professionality. It is very hard to define these terms because of their semantic confusion, the limitation of identifying essential characteristics, and the dynamic process involved in professionalism.

Profession simply means any vocation or business (www.dictionary.com). So the term is generally associated with any, and every type of ‘black-coated ‘and’ white-collar ‘occupation (Millerson 1998). The professional concept came from the middle ages from the perspectives of churchmen who were considered the most prominent group educated in the cathedral schools (Crook 2008). To give a definition and a clear picture of the professions many writers tried to describe the characteristics of professions but most of the definitions are biased with their occupational ideas. The profession’s legal definition is described as a self-selected, self-disciplined group of individuals who hold themselves out to the public as possessing a special skill derived from education and training and who are prepared to exercise that skill primarily in the interest of others (Klass 1961). So, it is more likely public service which is not what you do to earn money, it is something more valuable than a job and it is combined with ethics and guidelines. The accountant may stress about professions as control over competence and reliability in an organized way and the value of practical experience (Millerson 1998).

The professional culture determines the nature of professionalism (Evans 2010). Professionalism, in its essence, is an attitude whereby you assume a particular role (Collier R 2017). Sometimes, Many Interpretations and definitions come under a broader sense of collective responsibilities and a range of activities. The profession’s actual and potential authority, power, and influence, external agencies are subjective to designing and defining professions (Evans 2008). In his book ‘The Rise of Professionalism’ Larson stated that Researches argued about professions and professionalism as discourses of occupational change and social control (Larson 1977). In the introduction part of the book, the author argued that professionalism could be free from the difficult task of directly controlling a skilled task force but without much empirical confirmation.

Professional regulation is arguably perfectly defined by (Black, J. 2002) as ‘the steady and targeted attempt to change behavior according to standards in order to achieve identified outcomes, through techniques of standard-setting, information-gathering, and behavior modification. Professional regulation is set out as part of four elements of regulation the others being personal regulation, team-based regulation, and workplace regulation each of which I will discuss (General Medical Council, 2005). Professional regulation is essential in protecting the safety of those following it and those it impacts through practice, it covers areas such as fitness to practice, conduct, education as well as power within healthcare (Law Commission, et al. (2014). Midwives are fundamentally regulated by the Nursing and Midwifery Council through documents like The Code (NMC, 2018) which highlights four key sections of practice which should be strived towards, additionally Practising as a midwife (NMC, 2020) which governs behavior of midwives.

The role of a midwife is defined globally by the International Confederation of Midwives (ICM) as a person who has completed a standardized midwifery program and is able to operate with clinical competency in midwifery (ICM, 2017). This broad definition of a midwife is specialised to each country in which midwives work by professional regulation for example the NMC Code which highlights that midwives should prioritise people, practice effectively, preserve safety, and promote professionalism and trust which influences the role of the midwife (NMC 2015). For example, advocacy is promoted through Code- 2.3 ‘encourage and empower others to collaborate in choices surrounding their care’ (NMC 2015) this encourages midwives to promote women’s choices above all else through advocacy however conflict arises in the scope of practice of midwives as in a midwife’s job contract it states they must follow hospital policy this may create tensions within the trust and challenges the proposed partnership with women which is promoted by the NMC, questioning how effectively scope of practice and role of a midwife can be fulfilled and may limit midwives autonomy. Midwives, the scope of practice can be argued to be restricted by professional regulation as the Royal College of Midwives has addressed the pressing issue of the need for increased autonomy and flexibility in the practice of midwives when working in partnership with women severe and multiple disadvantages (SMD) (RCM 2020) during pregnancy as they are likely to experience poor maternity care (McLeish, J. and Redshaw, M. 2019) this contradicts the purpose of professional regulation by the General Medical Council (2005) which states its purpose to preserve safety yet some women may be suffering as consequence, questioning the place and magnitude of which regulation should be involved with midwifery.

As professionals midwives have a position of power with access to sensitive information and additionally portraying a professional identity which could be argued to protect due to expectation of knowledge and understanding, this creates a need for professional boundaries as it is important women’s safety is protected due to vulnerability, therefore professional regulation is essential to uphold patient safety as promoted in section 13 of The Code (NMC 2015). An example where professional regulation upholds safety is the NMC Social Media Guidance, section 6 of The Code stresses the importance of practicing with the best available evidence in order to preserve safety (NMC 2015) this corresponds to the responsible use of social media as midwives should not be spreading false or misleading information which could harm others in order to remain inline with the NMC guidelines to ‘preserve safety’ and ‘practice effectively’; maintaining professional boundary in an online discussion about care can avoid incorrect or misleading comments being made.

Interprofessional collaboration is defined as when two or more professions work together to learn from each other in order to solve complex problems and achieve more as a team in improving care (Green, B.N. and Johnson, C.D. 2015) Interprofessional teamwork brings together professions and is important in maintaining patient safety as understanding others and being constructive instead of defensive helps to move toward solutions. Professional regulation through The Code such as 8.6 facilitates interprofessional working by requiring nurses and midwives to share patient information with necessary others in order to identify and reduce risks preserving patient safety (NMC, 2015). In the Morecambe Bay report, we can see where this guideline has been missed and interprofessional teamwork has broken down as maternity staff failed to raise concerns and escalate risks possibly due to beliefs surrounding normal birth at all costs, this resulted in the tragic loss of lives a stark reminder of the importance of interprofessional trust and communication (Kirkup, B. 2015), this tragic report also highlights how midwives may misunderstand their scope of practice as care was unsafe and so defining clearly midwives scope of practice and limits to autonomy through regulation can protect lives.

To conclude professional regulation is essential in 21st-century healthcare to protect service users through legislation however is also essential for practitioners to facilitate their safe practice so that the scope of practice is understood, and boundaries are upheld in order to avoid tragedies such as Morecambe Bay from ever repeating. However, it is vital to recognize challenges with professional regulation such as its lack of flexibility which may limit midwives’ autonomy which is central to their professional identity and may contribute to overmedicalization of maternity care. Finally, it’s important to recognize our personal regulation through our ethics, demographic background, and values which helps us to interpret professional regulation and informs practice, therefore, achieving balance is key to upholding effective practice.

Human service professionals play a big role in our community. Some people may not realize that certain professions are those of human service professionals. What are the duties of a human services professional in a correctional facility? Duties of human services include but are not limited to designing, administering, and monitoring services for clients (for facility units) immediate and long-range needs including some specialized living situations and treatment. Duties also include addressing the needs of victims and the community through restorative case planning.

Human service is a rigorous career that can offer great rewards but isn’t for everyone. Consider some of the personality traits needed to be successful. As a human services professional you must be compassionate, have excellent communication skills, be a problem solver, have a lot of patience, be organized with time management skills, be analytical, be a people person, and be responsible for the lives of many.

A probation officer acts as a community supervisor. Their main goal is to prevent new crimes from being committed. Their roles involve evaluating whether an offender is or is not a risk to the community and will assist in the development of each prisoner’s rehabilitation plan. They must ensure that once out on probation, each offender reports at the allotted and mandated time, proves them the necessary testing or program information, and ensures they are conducting health and welfare checkups in order to ensure each offender remains in compliance with their individual plans.

A victim advocate deals with crime prevention, legal rights, and safety planning. An average day for a victim advocate could include accompanying a victim to court, providing counseling, or ensuring the proper counseling or treatment is set up for their client. A victim advocate needs to be confident in order to support a victim in a challenging, and often scary situation.

Prison social worker has their hands full as well. The main responsibility for social work is rehabilitation and counseling. They perform assessments to determine inmates’ current level of functioning and to evaluate the presence of mental health or substance abuse counselors.

Police officers and corrections officers are similar but serve a little bit differently in the community. Police officers do more than fight crime and enforce laws. They assist in maintaining the welfare of citizens by monitoring community health and safety issues and intervening on a social level. Corrections officers seek to advise, support, console, refer or otherwise assist inmates with the problems and crisis of adjustment produced by imprisonment with people. The human services model holds the promise of more human environments in correctional institutions.

Many individuals forget about the importance of a substance abuse counselor. They play a huge role in the corrections world. They are typically responsible for evaluating inmates’ mental and physical health, helping inmates develop treatment plans, developing skills or behaviors needed to recover from the addiction, educating them on addiction to help foster strategies to cope with the problem, and referring offenders to community programs or support groups upon release.

As there are several other human service professionals in corrections one of the last ones that I choose to speak about that I feel plays an important role in corrections is a vocational career counselor. A vocational career counselor helps assist offenders with the process of making career decisions and developing social skills needed to pursue a career or educational program upon release.

Many individuals may think why do inmates get to go to school or earn a degree while in a correctional facility, while others outside the facility work hard daily and cannot afford an excellent education? The truth of the matter is yes, everyone deserves an excellent education to be successful in today’s society but let us help inmates mainstream and get ready to get back into society it is already cruel enough whether it’s a man or woman trying to better themselves after the prison/jail life.

Women have become the fastest-growing segment of the incarcerated population. Women’s prisons are normally a lower -level of security than a man’s prison. Oklahoma currently has the highest female incarcerated rate in the county.

The U.S. Bureau of Justice Statistics in 2013 shows that African American males accounted for 37% of the total male prison population, White males 32%, and Hispanic males 22%. White females are 49% and African American females are 22% of the total prison population.

In 2015, in the USA, women made up 10.4% of the incarcerated population in adult prisons and jails. Between 2000 & 2010 the number of males in prison grew by 1.4%, while females grew by 1.9% per year. In 35 states women’s population numbers have far worsened than men’s.

There are several institutional betterment programs that are offered to both female and male inmates. Some programs that they offer but are not limited to are Alcoholics Anonymous, Anger Management, Creative Writing, Life Skills, Money Management, Parenting, Wellness Education, Yoga, Worship Services, Faith and Character Based Programs, Religious Education, Adult Basic Education, GED, Special Education Screening and Volunteer Literacy Program.

What are some other things that are offered to help provide inmates with positivity while incarcerated? Healthcare and Mental Health for inmates are of high need while incarcerated. Healthcare for inmates wasn’t what I thought it was. Michelle Andrews (2015) While incarcerated Medicaid won’t pay for any of your medical. If you are enrolled in Medicaid while incarcerated, you may be able to get care more quickly after your release. The most common mental health issues in prison are depression, bipolar disorder, schizophrenia, and psychotic disorders. Treatment options available for those with mental health disorders while incarcerated are group counseling, individual counseling, and medication to help cope (which is prescribed and given to them by the correctional facility’s Registered Nurse on duty).

Matthew R. Durose, BJS Statistician (2005-2014) In order to reduce recidivism vocational counselors in corrections are responsible for helping inmates overcome behavioral or social problems through individual or group counseling, working with offenders to develop career skills, developing attainable career goals, evaluating aptitude testing and creating strategies to help inmates succeed as fully functional citizens for release back into society.

Matthew R. Durose, BJS Statistician (2005-2014) States were selected for the 2005 prisoner recidivism study based on their ability to provide prisoner records and the FBI or state identification numbers on persons released from state correctional facilities in 2005. This study estimated the recidivism patterns of more than 400,000 persons released in 2005 from state prisons in 30 states. In 2005, these 30 states were responsible for 77% of all persons released from state prisons nationwide. A representative sample of inmates released in 2005 was developed for each of the 30 states using data reported by state departments of corrections to BJS’s National Corrections Reporting Program (NCRP), yielding a final sample of approximately 68,000 persons. BJS used the state and FBI identification numbers supplied by the departments of corrections to collect national criminal history records on the sample of former prisoners.

Work Cited

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The mission statement of the School of Exercise & Sport Science communicates how driven the school is to help us, the students, succeed in achieving our goals and reaching the level of education that we need to prepare us for our careers. It lets us know that we are going to be well prepared for our careers as long as we work hard and strive to reach our goals. It comforts me to know that while I am learning and studying, I am in a place of learning that supports me and that there are people here who are willing to help me when I need it. The mission statement also lets me know that I am in a place where I can receive the training and education I need to advance toward my goals and career. I continue to work hard knowing that I am preparing for a career that will one day support me and others in my future. I know I will be able to learn the ins and outs of my career and be able to know what to expect when I graduate. I will be able to gain experience in my profession through internships and on-the-job training thanks to the support of Mary Hardin Baylor. The mission statement makes it known that I will be prepared professionally through excellence in teaching, research, and service. I will be taught what it means to be a professional and how to act like one in my career, as well as, how to promote a commitment to healthy behaviors and active lifestyles across the lifespan.

A career that I have been interested in pursuing is physical therapy. Many physical therapists get their degrees in sciences like biology, physics, psychology, healthcare, chemistry, kinesiology, or exercise science. I am pursuing this career because I have an interest in helping people in hospital-like settings and would like to see my patients progress in their treatment. I aspire to be able to spend my time on my feet, actively working with patients and helping them recover rather than sitting at a desk or behind a counter. My passion for helping others combined with my interest in health science careers has led me to seek this career and I found myself studying for my degree at Mary Hardin Baylor, in the hope that one day I will be working as a physical therapist, hopefully in a hospital. During my education, I have learned about what physical therapists do and all the different settings in which you can find one. I personally, would like to work in a hospital and focus on acute care or work in a rehabilitation hospital. According to my strong interest in inventory results, I would most likely enjoy this profession as it is one of my top strongest occupations. I feel that the traits and skills I am equipped with will allow me to become a capable and reliable physical therapist in the future. One of the things I enjoy about physical therapy is that it is a very rewarding profession. You are able to work one on one with patients and be able to watch them progress and get better knowing that you are making a positive difference in someone’s life. There is also a very high demand for physical therapists because of the rise of the aging population needing more care and treatment. This means there is most likely going to be high job security and you have the ability to pick the setting you want to work in considering the large variety of workplace settings for physical therapists.

Professionals in physical therapy are a part of the many healthcare specialties out there that are able to diagnose and hopefully treat patients of any age group who have health-related conditions that have limited their abilities such as moving or performing activities that are part of their daily lives. A physical therapist professional examines patients and develops a plan of care that would effectively promote movement, reduce pain, restore function, or prevent further disability. The physical therapist works with the patient, family members, and other health care professionals in order to ensure the target or objectives of the plan of care are met and the patient’s results are ideal at the end of their treatment. The main role I would perform as a physical therapist would be to diagnose and create plans for the patient that could involve things such as stretching, strength training, exercises, and physical manipulation to help the patients recover. There are many different techniques, procedures, equipment, and technology that physical therapists have access to in order to aid them while treating their patients. These allow the physical therapist to accurately diagnose the patient and can then help the therapist treat the patient effectively and efficiently. Devices like electrical muscle stimulation can help a physical therapist create a plan that will discharge a patient quicker than they could before. According to Andrew Stark, the Electrical muscle stimulation device “is commonly used after an accident or severe injury to help promote muscle growth and fight off muscular atrophy. A skilled physiotherapist can use electrical stimulation equipment to help rebuild basic tone and strength in muscles that have gone unused or were severely damaged in the recent past. These devices are commonly used in the early stages of physical therapy when traditional exercise options are unavailable due to extreme weakness in necessary muscle groups.” (Stark, 2015). The physical therapists, “are experts at what the body can do, and will educate patients and families about what is possible, and keep patients motivated during ongoing therapy.” (Shafer, 2013). A physical therapists would also have to track the progress of their patients and report the results to patients and their families. Common functional measurement tools that physical therapists often use for recording patients’ progress include the timed up-and-go test, the Tinetti balance, and gait evaluation, the Berg balance scale, and/or the six-minute walk test.

According to the APTA, “Physical therapists formed their first professional association in 1921, called the American Women’s Physical Therapeutic Association. Led by President Mary McMillan, an executive committee of elected officers governed the association, which included 274 charter members” (American Physical Therapy Association, 2019). Physical therapy seems to have started back in the 19th century in Europe, with the promotion of massage and manual muscle therapy. Nowadays there is a high demand for the profession in the workforce, “According to the Bureau of Labor Statistics, employment of physical therapists is expected to grow by 36 percent from 2014 to 2024, much faster than the average for all occupations” (American Physical Therapy Association, 2019).

While many physical therapists practice in hospitals, more than 80% of them practice in other settings like acute care, rehab clinics, subacute rehab clinics, extended care facilities, nursing homes, skilled nursing facilities, outpatient clinics, schools, sports and fitness centers, and many others. I would prefer to work in a hospital or acute care setting after I get my degree and license. Furthermore, physical therapists are generally paid very well with an average median income of $86,850 per year, “Top earners make $101,790 and up. Approximately 25 percent of those who work in this niche earn $71,670 annually. Depending on where you live, you could earn a lot more.” (Picincu, 2019). Even though there is a wide variety of settings, the highest demand for a physical therapists is found in rural settings. They also tend to get paid more in rural settings as there are fewer of them there leading to the high demand for them.

Students that are studying to be physical therapist study many topics such as human anatomy, biomechanics, musculoskeletal system, pathology, kinesiology, and neurological dysfunction management. They also participate in many internships and take hands-on clinical courses, which provide training in patient care and give them experience in the workplace setting. In order for students to gain admission to a professional physical therapy program, we would typically need to have earned a bachelor’s degree, completed science prerequisites, have gained volunteer hours or observation experience in physical therapy settings, and maintain an acceptable grade-point average. After graduation from an accredited physical therapy education program, I would have to pass a state-administered national exam. Licensure is required in every state however the requirements for licensure vary in each state according to the physical therapy practice acts or state regulations governing physical therapy. Licensed physical therapists can then choose to continue their education and go after residency or fellowship programs to further their knowledge and practice.

There are many important traits a physical therapist should have in order to handle and treat patients with respect and support. Since physical therapists work with people all the time, it is expected that they are able to effectively communicate with their patients in order to understand the scope of their problems and abilities. Without good communication skills, a physical therapist would not be able to comprise an effective treatment plan for the patient or be able to have them follow it. Another important trait for physical therapists is to be compassionate and supportive of patients and their family members. Physical therapists will have to be supportive of their patients because they often experience many personal, heart-to-heart moments with patients who may be feeling vulnerable or might be at their lowest point during the recovery period. It’s important for a physical therapist to be compassionate and patient because the treatment plan may be tough or stressful for the patient. The therapy will be hard for many people and without patience, a physical therapist could end up straining or injuring the patient or making them upset leading to more problems. I feel it is necessary to have determination and confidence in yourself while working as patients can often endure slow recovery processes over a long period of time, and sometimes the treatment is painful or difficult. Patients can take their anger and pain out on the therapist, which is why tolerance and thick skin are also essential traits in physical therapy. I feel I have many of these traits which is why I enjoy learning more about this career and working towards getting my degree.

Based on the research I have done on physical therapists I have found what I will need to work on and improve in order to become a capable physical therapist. There are many traits I will need to improve for the sake of those I will be working with and for. For instance, I plan on working on my confidence and resilience which I feel will be important if I have any patients that are agitated or distressed. Thanks to the help and support from my family and many of my teachers, I was able to continue pursuing my interests and worked hard towards my goals with their encouragement. A big part of why I pursued physical therapy is thanks to my health science teacher, Mrs, Susan Von Rosenburg. I had her for three years of high school, for classes such as anatomy and physiology, medical microbiology, principles of health sciences, and medical terminology. She not only encouraged me to pursue this career but also made learning the subjects interesting and enjoyable. Mrs, Von taught each subject in such a way that it drew me in and made me actually want to learn more about each subject. I definitely looked forward to each of her classes with enthusiasm and excitement. I am able to remember almost everything she taught us because she taught us in such a captivating way that helped us retain the information. She has helped me develop many skills that someone in the medical field would need, as well as, helping me gain the knowledge and vocab that would aid me in this career. Mrs, Von undoubtedly played a big part in helping me down the path I have chosen.

Thanks to my experiences and traits, I have gained many abilities that would help me with my vocation. For instance, a physical therapist needs to be supportive, patient, positive, knowledgeable, fit, and a good listener and I believe I have many of these traits. I have worked on developing many of these traits and still have many more opportunities to develop new and old traits. I have led certain clubs and groups that helped me gain skills and traits like leading, good communication and listening well, patience, etc. While I would not claim to always be perfect at these or even claim to have all the traits required to be a physical therapist, I would say that I am determined and eager to better myself and further my knowledge and understanding while studying at Mary Hardin Baylor. Like how my teacher had a great impact on me, I want to be able to help and guide others through my profession with the enthusiasm and encouragement that Mrs, Von had when she helped me. I want to make that impact, especially for people who are having a hard time in their life and could use all the support and encouragement they can in order to get better. When I help injured or ill people, I will need to be able to manage their pain and provide swift treatment, but it will be difficult to improve what has been lost. I will need to be as compassionate and determined as I can be in order to help them improve. I want to pursue physical therapy because this is how I can make a difference for people who are struggling with problems that can be fixed with some time and effort.

Abstract

This paper critically reviews the concept of professionalism. Despite the best efforts by theorists to define the concept, there is no singular definition. This paper considers political and policy contexts, by reviewing the concepts of, traditional, managerial, and democratic professionalism. I shape my own perspective of professionalism emerging from literature and my school experience to conceptualize a working definition of professionalism. I conclude that my professional identity is shaped by conforming to standards.

What does it mean to be a professional?

The Supporting Teacher Professionalism Report (OECD, 2016) from TALIS 2013 presents teacher professionalism as a composite of three dimensions: knowledge base, autonomy, and peer networks. Knowledge base refers to teachers having a secure understanding of content and engaging in professional development activities. Autonomy explores the decision-making power that teachers have over their work. Peer networks reflect the importance of collaborative working. Hoyle and John (1995) similarly acknowledge that knowledge and autonomy are key defining elements of a professional teacher. They argue that teachers with secure theoretical knowledge and training earn the privilege to exercise their autonomy in the face of uncertain scenarios. However, the authors build on the importance of professional teachers having responsibility, in terms of being held accountable to formal standards, which the OECD definition fails to mention in their definition. The OECD overlooks ethical factors such as honesty, upholding public trust (DfE, 2011), and personal integrity (Carr, 2006; Crook, 2008), which are important considering teachers work in the public domain.

Professionalism can also be considered from a political lens, concerning power relations between teachers and the government, and the degree to which teachers have autonomy in shaping their own professional values. McClelland distinguishes between professionalism “from within” (referring to teacher agency) and “from above” (referring to the government and/or organization) which is a good starting point when considering who has the power to decide on what constitutes professionalism (McClelland, 1990: 107). Traditional professionalism is associated with teachers’ having full autonomy over their work with minimal government intervention (Whitty and Whisby, 2006). Whilst McClelland portrays professionalism “from within” as idealistic, this can be problematic given that traditional professionalism has been criticized as paternalistic and elitist (Davies, 1996) due to a lack of accountability regimes. Sachs (2011) reminds us that accountability should not be viewed in a wholly negative light as it serves to increase public confidence and transparency in the system. McClelland’s interpretation of professionalism imposed “from above” is useful in establishing the discourse of managerial professionalism (Sachs, 2001), which is rooted in compliance with traditional hierarchal systems. The focus is on standardization and regulation against a set of measurable outcomes imposed by the government (O’Day, 2002).

Whitty (2006) asserts the view that teachers have been made to be more accountable for their work following the election of the New Labour to power in 1977. Furlong (2005) notes that New Labour aimed to ensure that decisions taken about education were made at a national level, rather than by teachers themselves, thus reducing teachers’ autonomy. The election of New Labour paved the way for the National Curriculum, which was introduced in 1988. Furlong (2005) argues that such reforms “from above” have contributed to the deskilling or de-professionalization of teachers. Whilst the National Curriculum serves to equalize opportunities across schools, it drastically eroded the self-sufficiency and autonomy that teachers used to have. (Whitty, 2008) This leads to teachers focusing more on implementing the curriculum, rather than formulating new policies of creating a culture of standardization in schools.

Democratic professionalism can be thought of as a bottom-up response to managerial professionalism. The former is premised on teachers forming strategic networks and alliances with stakeholders in the education community. Whitty and Wisby (2006) stress that teachers should not view democratic professionalism as ‘de-professionalization’ but as an opportunity for stakeholders to liaise with the government to improve education standards. A critique of McClelland’s professionalism “from above” and “from within” reveals that it is difficult to treat both concepts as mutually dichotomous when considering the notion of democratic professionalism. I argue that there is an intersection of both discourses as teachers can collectively assert their power but are constrained by external conditions mandated by the government. Sachs (2003) contributed to the development of the “activist identity” which portrays the teacher as an agent of social change, working to reduce social inequality and re-assert moral leadership. This notion is developed further by Menter et al. (2010) in the ‘transformative’ teacher model, which similar to the “activist identity”, involves teachers engaging with the wider social, moral, and ethical discourse in education. Teachers work beyond the classroom and immediate school community to ensure pupils’ are geared to make a positive impact in society. The idea of activist teaching aligns with my personal philosophy that professional teachers have a responsibility to mirror the values of a robust civil society and contribute to the larger public, underpinned by values of social justice and mutual respect. Further, I view democratic professionalism as progressive and central to my professional identity, echoing the view of Whitty and Wisby. I believe that engaging stakeholders, such as parents carers, and teachers in policy development is fundamental as teachers, along with the rest of society have a collective responsibility to educate the next generation. Thus, my professional identity is greatly shaped by collaboration with stakeholders to serve society and deliver high standards in education.

Hoyle (1974) presents the restricted-extended continuum to depict two modes of teacher professionalism. Teachers positioned at the ‘restricted’ end of the continuum often place considerable emphasis on classroom autonomy and experience-centric learning. ‘Restricted’ individuals are implied to display a one-dimensional outlook of the classroom, with a reluctance to explore alternative classroom and school settings, beyond their own. On the other hand, ‘extended’ professionals demonstrate an unwavering commitment to personal development and a curiosity to examine the broader educational context, mediating theory, and practice. When this model was originally devised by Hoyle (1974), it was unclear as to whether the two concepts were to be treated as mutually exclusive ends of the continuum. Evans (2008), however, develops the concept by suggesting that a teacher’s orientation may involve factors from both ends of the continuum and that professional development facilitates the movement along the continuum from ‘restricted’ to ‘extended’ professionalism. I view the continuum as more of a fluid concept that should reflect the learning environments that teachers are situated in, as a teacher’s professional identity is subject to change “across time and place” (Whitty and Wisby, 2006:26). This echoes the thinking of Fuller and Unwin (2003) who coined the expansive-restricted continuum, which considers the possible learning barriers teachers’ experience on their roadmap to enhancing their professional status. Their study argued that the restrictive and expansive learning environments may occupy a range of points on the continuum, depending on the school that teachers work in. Thus, it is important to note that some school environments may pose barriers to teachers’ professional development through hierarchical structures and cultural practices which may limit a teacher’s professional development due to barriers “from above”.

The challenge of teacher conformity

My own experience as a trainee teacher, working in a school that teaches a Mastery approach to mathematics, has allowed me to synthesize an understanding of how conforming to a prescribed, commercialized curriculum can encroach on teacher professionalism. In the context of my school, the implementation of a commodified curriculum, using pre-packaged teaching and assessment materials arguably limits the scope for initiative and innovation. This may undermine the opportunity for teachers to apply their own creative stance on lesson planning. Further, this may contribute to the diminishing autonomy of teachers. This view is supported by Apple (1983) who argues that whilst subscribing to a pre-packaged curriculum can reduce planning time for teachers, it often leads to the teacher being subservient to the demands of the externally imposed curriculum. A parallel can be drawn to the notion of a teacher being a technician (Winch et al, 2015), which promotes an instrumentalist view of the teacher, as merely a knowledge transmitter. I subscribe to the view that the term ‘technician’ portrays a reductionist sense of the teacher (Locke et al., 2005) that can be likened to operating in a vacuum, with limited scope for critical thinking and pedagogical conduct. Drawing upon my school experience, meetings were held to ensure a shared understanding of the resources and the curriculum guidelines. However, I observed a recurring reluctance for teachers to deviate from the recommended guidelines or apply their own personalized stance. This resonates with Apple’s (1995) observation that some teachers direct more of their energies on adhering to the guidelines of a manual rather than using their own decision-making or craft, hence channeling a technicist approach to teaching. As each school community stipulates its own expectations of what ought to be taught, I am obliged to conform to these standards. This reiterates my view that teacher conformity is central to my definition of teacher professionalism.

Furthermore, my school experience has highlighted the professional challenges associated with teacher conformity, as a direct result of managerial professionalism. As teachers, we must conform to the Teachers’ Standards (DfE, 2011) set by the government to be awarded QTS, which inevitably shapes my philosophy as a teacher. I believe that the Teachers’ Standards serves as a technicist framework that moves a teacher towards ‘restricted’, rather than ‘extended’ professionalism (Hoyle, 1974). This is because as teachers, our professional competence is assessed by our ability to conform to a prescribed set of standards, creating a culture of performativity in schools (Jeffrey, 2002). The National Curriculum for Mathematics states that “the majority of pupils will progress through the programs of study at broadly the same pace”. (DfE, 2013: 3) The rationale behind this is to ensure students develop mathematical fluency in one topic before accelerating onto another. This is important as in mathematics, pupils are required to make links between multiple representations of mathematical ideas. However, the issue of expecting all students to work at the same pace and achieve the same key stage expectations in depth is unproductive as it undermines the notion of Teacher Standard 5 related to adaptive practice (DfE, 2011). In my placement school, teachers are increasingly challenged with the growing intake of EAL students. For example, I observed students taking dictionaries into maths classes to translate word problems, which delayed their ability to work at the pace of fluent English speakers. Whilst the DfE recommends differentiation, there is no explicit guidance on how to execute differentiation strategies suitably, which leaves teachers with some autonomy over the strategies they implement. Considering the challenges above, I regard peer collaboration as a key aspect of my professional identity that allows me to overcome any barriers associated with teaching. In light of the literature presented earlier on peer collaboration, discussing my intended teaching approaches with experienced teachers may serve to be a useful tool in shaping my practice. As an aspiring ‘extended’ professional, I value the importance of looking beyond my placement school and engaging in theoretical and practical learning to guide my practice, which is central to my core professional ethos.

Conclusion

This paper reveals that professionalism in teaching is a conceptually complex idea with several normative interpretations of its meaning. Whilst there is some common agreement over its key dimensions; namely, knowledge, autonomy, responsibility, and peer networks, the contestation surrounding professionalism is largely influenced by political forces. I conclude that managerial professionalism is a top-down concept that limits teacher autonomy, whereas democratic professionalism serves as an antidote that is closely aligned with my values centered around collaborative and activist professionalism. I conclude that the restricted-extended continuum (Hoyle, 1974) is best viewed as a fluid concept that is context-dependent. I shape a personal philosophy of professionalism premised on teacher conformity. Reflecting on my observations of managerial professionalism being enacted in schools, I recognize adhering to prescribed standards can encroach on my professional identity. Further, I address that adopting a collaborative and ‘extended’ professional mindset can alleviate some of the challenges I associate with managerial professionalism. I conclude that teacher conformity to standards is central to teacher professionalism.