Professional stance development in nursing students: An analysis of patient-student interactions through...

To explore the construction processes of professional stance among nursing students during their interactions with patients and identify the underlying mechanisms of this identity development.

Professional stance constitutes the behavioral translation of professional identity, representing how future caregivers "act, feel and think" as profession members. While patient-student interactions are recognized as fundamental for professional development, current studies focus primarily on tutors or reflective processes, insufficiently exposing internal mechanisms at work within students during patient interactions for professional stance construction.

A qualitative longitudinal study anchored in professional didactics, conducted over seven years following students throughout their three-year nursing program.

Fourteen first-year nursing students from two institutes were followed throughout their three-year training. Data collection involved video recording of real patient-student interactions during clinical placements, followed by self-confrontation interviews. Analysis employed NVivo® software using a three-level approach: scheme component coding, thematic categorization of concepts-in-action and scheme consolidation.

Professional stance construction emerged as a complex, non-linear process involving four key dimensions: identity transition under tension requiring separation of personal/professional identities; legitimation strategies including simulation of assurance and emotional protection; plural stance adaptability with students developing contextually-adjusted repertoires; and mobilization of material (uniforms) and symbolic resources (experience, knowledge, peer observation).

Professional stance represents a sophisticated, multifaceted competency emerging through identity negotiation rather than simple role adherence. Results challenge traditional pedagogical approaches, suggesting need for explicit acknowledgment and support of identity work during clinical placements to enhance professional development and ultimately patient care quality.