“I am I said to no-one there” – The Development of a Four Factor Model of Professional Identity -The 4FM-PI

Ms Lil Vrklevski1,2, Dr  Kathy Eljiz2, Professor  David Greenfield2

1Sydney Local Health District (SLHD), Concord, Australia, 2Australian Institute of Health Service Management, Tasmanian School of Business and Economics (TSBE), University of Tasmania, Sydney, Australia.

Background of Project: Multi-graded positions on community mental health teams have led to blurred boundaries and role overlap between psychiatry, nursing and allied health professionals. Evidence from the frontline of clinical care suggests that a loss of professional identity (PI) and feelings of disempowerment can result. The aim of this study was to develop a new model of PI. PI has been associated with less turnover in teachers, doctors, social workers and nurses, increased job satisfaction, greater motivation and effort to provide high quality patient care and optimal performance in multidisciplinary teams.

Method: The setting was a large metropolitan Mental Health Service (MHS) and participants were drawn from the five largest disciplines – nursing, occupational therapy, psychiatry, psychology and social work. An on-line survey was administered and consisted of four psychometric measures: the Demographic Data Questionnaire (DDQ), Mental Health Activities Checklist (MHAC), Professional Identity Scale (PIS) and Power Questionnaire (POWQ). Data was analysed using inferential statistics.

Results: Across the five professions, 320 staff elected to participate, for a 44% response rate. The average PIS scores for each discipline were Social Work (PIS= 4.40), Psychology (PIS= 4.48), Occupational Therapy (PIS= 4.54), Nursing (PIS= 4.58) and Psychiatry (PIS= 4.62). There was a weak positive correlation (r=0.230, n=320, p <.0001) between PIS and time spent on discipline specific activities (MHAC). There was a weak positive correlation (r=0.359, n=320, p <.0001) between PIS and Power. The results confirmed a four-factor model of professional identity which includes: belonging (tribal theory), attachment (role theory), power (organisational hierarchy) and activities (discipline specific and generic).

Discussion: The model of professional identity developed and empirically tested by the researcher here offers a theory-driven, multifactorial and nuanced approach to this construct. The Four-Factor Model of Professional Identity, or 4FM-PI, has the following components: belonging, attachment, activities and power. Strong PI in health professionals is associated with high quality patient care.


Lil is currently employed as Principal Clinical Psychologist and Director of Psychology, Sydney Local Health District, NSW. She is currently completing her PhD titled: “Professional roles and identity in public mental health services: the multifaceted interaction of belonging, attachment, power and activities”.  Lil is a reviewer on Traumatology and Journal of Patient Safety, a thesis examiner with Macquarie University, conjoint lecturer at UNSW, Clinical Associate at USyd, Macquarie University, UoW, and ACU. She clinically supervises provisionally registered psychologists from a number of universities as well as lecturing on law and ethics for psychologists. Lil sits on the NSW Psychology Board.

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