Words in action: Examining what clinical education placement documents contribute to thinking, acting and feeling like a health professional


  • Linda Furness University of Southern Queensland Queensland Health Griffith University
  • Anna Tynan University of Southern Queensland Queensland Health Rural Clinical School, The University of Queensland
  • Jenny Ostini University of Southern Queensland




clinical education, clinical placement, allied health, professional identity, rural and regional


Introduction: Clinical placements are critical for student learning and transition to practice. They help students integrate their knowledge and skills and support their development of professional identity—so they come to “think, act and feel” like a member of their profession. Students have reported that placements play a role in development of professional identity. Documents are frequently the first contact students have with the placement setting. However, there are few studies examining the impact of clinical placement documents on the development of allied health students’ professional identity. This study examines what clinical placement documents contribute to the development of professional identity through facilitating thinking, feeling and acting like a health professional.

Methods: Thematic analysis of clinical education placement documents was conducted using a deductive framework based on review of literature considering how students can be supported to think, act and feel like a health professional.

Results: Thirteen placement orientation documents were reviewed. Reference to factors that support “thinking” described learning opportunities to enable students to develop knowledge for practice. Reference to factors that support “acting” described graded learning that enables student contribution to service delivery and recognition as a health professional, and reference to factors that support “feeling” described workplace culture and practices supporting connectedness.

Conclusions: This study identified that placement documents can contribute to allied health students thinking, acting and feeling like a health professional while on clinical placement. Academic staff and organisations reviewing clinical placement documents may wish to consider the implications identified in this study, which demonstrate how documents can include or exclude students in the workplace.


Billett, S. (2004). Workplace participatory practices: Conceptualising workplaces as learning environments. Journal of Workplace Learning, 16(6), 312–324.


Billett, S. (2014). Learning in the circumstances of practice. International Journal of Lifelong Education, 33(5), 674–693. https://doi.org/10.1080/02601370.2014.908425

Billett, S., & Sweet, L. (2015). Participatory practices at work: Understanding and appraising healthcare students learning through workplace experiences. In J. C. Steven & J. During (Eds.), Researching medical education (pp. 117–128). Wiley.

Bowen, G. A. (2009). Document analysis as a qualitative research method. Qualitative Research Journal, 9(2), 27–40. https://doi.org/10.3316/QRJ0902027

Bradshaw, C., Atkinson, S., & Doody, O. (2017). Employing a qualitative description approach in health care research. Global Qualitative Nursing Research, 4. https://doi.org/10.1177/2333393617742282

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77. https://doi.org/10.1191/1478088706qp063oa

Central Queensland University. (n.d.). Final field education report: SOWK13009—Field Education 1. Author.

Cruess, R. L., & Cruess, S. R. (2016). Professionalism and professional identity formation: The cognitive base. In R. L. Cruess, S. R. Cruess, & Y. Steinert (Eds.), Teaching medical professionalism: Supporting the development of a professional identity (2nd ed., pp. 5–25). Cambridge University Press.

Cruess, R. L., Cruess, S. R., Boudreau, J. D., Snell, L., & Steinert, Y. (2014). Reframing medical education to support professional identity formation. Academic Medicine, 89(11), 1446–1451. https://doi.org/10.1097/ACM.0000000000000427

Cruess, R. L., Cruess, S. R., Boudreau, J. D., Snell, L., & Steinert, Y. (2015a). Additional suggestions for facilitating professional identity formation [Comment in the article "In reply to Weissman"]. Academic Medicine, 90(6), 697–698. https://doi.org/10.1097/ACM.0000000000000727

Cruess, R. L., Cruess, S. R., Boudreau, J. D., Snell, L., & Steinert, Y. (2015b). A schematic representation of the professional identity formation and socialization of medical students and residents: A guide for medical educators. Academic Medicine, 90(6), 718–725. https://doi.org/10.1097/ACM.0000000000000700

Dall’Alba, G. (2009). Learning professional ways of being: Ambiguities of becoming. Educational Philosophy and Theory, 41(1), 34–45. https://doi.org/10.1111/j.1469-5812.2008.00475.x

Darling Downs Hospital and Health Service. (n.d.a). Occupational therapy welcome email template. Queensland Government.

Darling Downs Hospital and Health Service. (n.d.b). Psychology student orientation guide. Queensland Government.

Darling Downs Hospital and Health Service. (2016). Toowoomba Physiotherapy Department: Student orientation manual. Queensland Government.

Darling Downs Hospital and Health Service. (2017a). Onboarding student orientation presentation [PowerPoint slides]. Queensland Government.

Darling Downs Hospital and Health Service. (2017b). Speech pathology student orientation manual. Queensland Government.

Frost, H. D., & Regehr, G. (2013). "I AM a doctor": Negotiating the discourses of standardization and diversity in professional identity construction. Academic Medicine, 88(10), 1570–1577. https://doi.org/10.1097/ACM.0b013e3182a34b05

Furness, L., Tynan, A., & Ostini, J. (2019). What supports allied health students to think, feel and act as a health professional in a rural setting? Perceptions of allied health staff. Australian Journal of Rural Health, 27(6), 489–496. https://doi.org/10.1111/ajr.12557

Furness, L., Tynan, A., & Ostini, J. (2020). What students and new graduates perceive supports them to think, feel and act as a health professional in a rural setting. Australian Journal of Rural Health, 28(3), 263–270. https://doi.org/10.1111/ajr.12607

Hercelinskyj, G., Cruickshank, M., Brown, P., & Phillips, B. (2014). Perceptions from the front line: Professional identity in mental health nursing. International Journal of Mental Health Nursing, 23(1), 24–32. https://doi.org/10.1111/inm.12001

Holden, M., Buck, E., Clark, M., Szauter, K., & Trumble, J. (2012). Professional identity formation in medical education: The convergence of multiple domains. HEC Forum, 24(4), 245–255. https://doi.org/10.1007/s10730-012-9197-6.

Holden, M. D., Buck, E., Luk, J., Ambriz, F., Boisaubin, E. V., Clark, M. A., Mihalic, A., Sadler, J., Sapire, K., Spike, J., Vince, A., & Dalrymple, J. L. (2015). Professional identity formation: Creating a longitudinal framework through time (transformation in medical education). Academic Medicine, 90(6), 761–767. https://doi.org/10.1097/ACM.0000000000000719

Jaye, C., & Egan, T. (2006). Communities of clinical practice: Implications for health professional education. Focus on Health Professional Education: A Multi-disciplinary Journal, 8(2), 1–10.

Li, L. C., Grimshaw, J. M., Nielsen, C., Judd, M., Coyte, P. C., & Graham, I. D. (2009). Evolution of Wenger's concept of community of practice. Implementation Science, 4, 1–8. https://doi.org/10.1186/1748-5908-4-11

Lingard, L. (2015). The art of limitations. Perspectives on Medical Education, 4(3), 136–137. https://doi.org/10.1007/s40037-015-0181-0

McBride, L.-J., Fitzgerald, C., Morrison, L., & Hulcombe, J. (2015). Pre-entry student clinical placement demand: Can it be met? Australian Health Review, 39(5), 577–581. https://doi.org/10.1071/AH14156

Merton, R. K. (1957). Some preliminaries to a sociology of medical education. In R. K. Merton, G. G. Reader, & P. L. Kendall (Eds.), The student-physician: Introductory studies in the sociology of medical education. A report of the Bureau of Applied Social Research of Columbia University (pp. 3–81). Harvard University Press.

Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook. Sage.

Miller, F. A., & Alvarado, K. (2005). Incorporating documents into qualitative nursing research. Journal of Nursing Scholarship, 37(4), 348–353. https://doi.org/10.1111/j.1547-5069.2005.00060.x

Monrouxe, L., & Poole, G. (2013). An onion? Conceptualising and researching identity. Medical Education, 47(4), 425–429. https://doi.org/10.1111/medu.12123

Mylrea, M. F., Gupta, T. S., & Glass, B. D. (2017). Developing professional identity in undergraduate pharmacy students: A role for self-determination theory. Pharmacy, 5(2), 1–9. https://doi.org/10.3390/pharmacy5020016

Nicola-Richmond, K. M., Pepin, G., & Larkin, H. (2016). Transformation from student to occupational therapist: Using the Delphi technique to identify the threshold concepts of occupational therapy. Australian Occupational Therapy Journal, 63(2), 95–104. https://doi.org/10.1111/1440-1630.12252

Occupational Therapy Clinical Education Program. (2018). Student practice placement handbook. Queensland Government.

O'Leary, Z. (2007). The essential guide to doing research. Sage.

Ó Lúanaigh, P. (2015). Becoming a professional: What is the influence of registered nurses on nursing students' learning in the clinical environment? Nurse Education in Practice, 15(6), 450–456. https://doi.org/10.1016/j.nepr.2015.04.005

Psychology Clinical Education Program. (n.d.). Fact Sheet 2.1: Multidisciplinary teams in Department of Health. Queensland Government.

Sharpless, J., Baldwin, N., Cook, R., Kofman, A., Morley-Fletcher, A., Slotkin, R., & Wald, H. S. (2015). The becoming: Students' reflections on the process of professional identity formation in medical education. Academic Medicine, 90(6), 713–717. https://doi.org/10.1097/ACM.0000000000000729

Social Work and Welfare Clinical Education Program. (n.d.). Social work welcome email template. Queensland Government.

The University of Queensland. (n.d.). Clinical Psychology Practicum Competencies Rating Scale: End placement review form (CΨYPRS-EP). Author.

Vivekananda-Schmidt, P., Crossley, J., & Murdoch-Eaton, D. (2015). A model of professional self-identity formation in student doctors and dentists: A mixed method study. BMC Medical Education, 15(83), 1–9. https://doi.org/10.1186/s12909-015-0365-7

Wald, H. S. (2015). Professional identity (trans)formation in medical education: Reflection, relationship, resilience. Academic Medicine, 90(6), 701–706. https://doi.org/10.1097/ACM.0000000000000731

Weaver, R., Peters, K., Koch, J., & Wilson, I. (2011). "Part of the team": Professional identity and social exclusivity in medical students. Medical Education, 45(12), 1220–1229. https://doi.org/10.1111/j.1365-2923.2011.04046.x

Wilson, I., Cowin, L. S., Johnson, M., & Young, H. (2013). Professional identity in medical students: Pedagogical challenges to medical education. Teaching and Learning in Medicine, 25(4), 369–373. https://doi.org/10.1080/10401334.2013.827968

Workman, B. (2007). "Casing the Joint": Explorations by the insider-researcher preparing for work-based projects. Journal of Workplace Learning, 19(3), 146–160. https://doi.org/10.1108/13665620710735620




How to Cite

Furness, L., Tynan, A., & Ostini, J. (2020). Words in action: Examining what clinical education placement documents contribute to thinking, acting and feeling like a health professional. Focus on Health Professional Education: A Multi-Professional Journal, 21(2), 17–31. https://doi.org/10.11157/fohpe.v21i2.380