Advances in Health Sciences Education

, Volume 18, Issue 4, pp 745–754 | Cite as

Reconciling the professional and student identities of clinical psychology trainees

  • Karen McKenzieEmail author
  • Jill A. Cossar
  • Tim Fawns
  • Aja L. Murray


The study explored the ways in which qualified and trainee clinical psychologists perceived professional behaviour, as illustrated in a series of short vignettes, in student and clinical practice contexts. Comparisons were made to identify the extent to which ideas of professionalism differed across different learning contexts and between qualified and unqualified staff, with the aim of adding to the literature on which factors influence the development of professional identity in health professionals. An online questionnaire depicting a range of potentially unprofessional behaviours was completed by 265 clinical psychology trainees and 106 qualified clinical psychologists. The data were analysed using a general linear model with simultaneous entry in which rater (trainee vs qualified clinical psychologist), setting (student vs placement) and their interaction predicted acceptability ratings. We found that, in general, trainees and qualified staff agreed on those behaviours that were potentially unprofessional, although where significant differences were found, these were due to trainees rating the same behaviours as more professionally acceptable than qualified clinical psychologists. Despite trainees identifying a range of behaviours as professionally unacceptable, some percentage reported having engaged in a similar behaviour in the past. Irrespective of the status of the rater, the same behaviours tended to be viewed as more professionally unacceptable when in a placement (clinical) setting than in a student (university) setting. Generally, no support was found for a rater by setting interaction. The study suggests that trainee clinical psychologists are generally successful at identifying professional norms, although they do not always act in accordance with these. Conflicting student and professional norms may result in trainees viewing some potentially unprofessional behaviour as less severe than qualified staff. Health professional educators should be aware of this fact and take steps to shape trainee norms to be consistent with that of the professional group.


Professionalism Clinical psychology Student Clinical practice 



The authors would like to thank Sadia Shah and Emma Fielding for their support with the study.

Conflict of interest



  1. Anthias, F. (2001). New hybridities, old concepts: The limits of ‘culture’. Ethnic Racial Studies, 24, 619–641.CrossRefGoogle Scholar
  2. Bandura, A. (1986). Social foundations of thought and action. New Jersey: Prentice Hall.Google Scholar
  3. Barnett, R. (2000). Learning to work and working to learn. In D. Boud & J. Garrick (Eds.), Understanding learning at work (pp. 29–46). London: Routledge.Google Scholar
  4. Bers, M. U. (2001). Identity construction environments: Developing personal and moral values through the design of a virtual city. Journal of Learning Science, 10, 365–415.CrossRefGoogle Scholar
  5. Bodner, K. E. (2012). Ethical principles and standards that inform educational gatekeeping practices in psychology. Ethics and Behaviour, 22, 60–74.CrossRefGoogle Scholar
  6. British Psychological Society: BPS. (2008). Generic professional practice guidelines. Leicester: BPS.Google Scholar
  7. British Psychological Society: BPS. (2009). Code of ethics and conduct. Leicester: BPS.Google Scholar
  8. British Psychological Society: BPS. (2012). Accreditation through partnership handbook: Guidance for clinical psychology programmes. Leicester: BPS.Google Scholar
  9. Burton, J., & Jackson, N. (2003). Work-based learning in primary care. Oxon, Radcliffe: Medical Press Ltd.Google Scholar
  10. Chatterton, P., & Hollands, R. (2003). Urban nightscapes: Youth cultures, pleasure spaces and corporate power. London: Routledge.CrossRefGoogle Scholar
  11. Currer, C. (2009). Assessing student social workers’ professional suitability: Comparing university procedures in England. British Journal of Social Work, 39, 1481–1498.CrossRefGoogle Scholar
  12. Elman, N. S., Illfelder-Kaye, J., & Robiner, W. N. (2005). Professional development: Training for professionalism as a foundation for competent practice in Psychology. Professional Psychology: Research and Practice, 36, 367–375.CrossRefGoogle Scholar
  13. Finn, G., Garner, J., & Sawdon, M. (2010). ‘You’re judged all the time! ‘Students’ views on professionalism: a multicentre study. Medical Education, 44, 814–825.CrossRefGoogle Scholar
  14. Ginsburg, S., Regehr, G., & Lingard, L. (2003). To be and not to be: The paradox of the emerging professional stance. Medical Education, 7, 350–357.CrossRefGoogle Scholar
  15. Goff-Kfouri, C. A. (2011). Civility in the university classroom. Arab World England Journal, 2, 115–127.Google Scholar
  16. Hafler, J. P., Ownby, A. R., Thompson, B. M., Fasser, C. E., Grigsby, K., Haidet, P., et al. (2011). Decoding the learning environment of medical education: A hidden curriculum perspective for faculty development. Academic Medicine, 86, 440–444.CrossRefGoogle Scholar
  17. Hardacre, K. & Schneider, K. (2007). A review of WBL in the UK Health Sector: Interim report for the Higher Education Academy. Retrieved 6th May, 2012. Available at;
  18. Hodge, P., Wright, S., Barraket, J., Scott, M., Melville, R., & Richardson, S. (2011). Decoding the learning environment of medical education: A hidden curriculum perspective for faculty development. Academic Medicine, 86, 440–444.CrossRefGoogle Scholar
  19. Holdsworth, C. (2009). Between two worlds: Local students in higher education and ‘Scouse’/student identities. Population Space and Place, 15, 225–237.CrossRefGoogle Scholar
  20. Lave, J., & Wenger, E. (1991). Situated learning: Legitimate peripheral participation. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  21. Lewis, T. F., & Clemens, E. (2008). The influence of social norms on college student alcohol and marijuana use. Journal of College Counselling, 11, 19–31.CrossRefGoogle Scholar
  22. Lightstone, K., Francis, R., & Kocum, L. (2011). University faculty style of dress and students’ perception of instructor credibility. International Journal of Business and Social Science, 2, 15–22.Google Scholar
  23. Lingard, L., Garwood, K., Szauter, K., & Stern, D. (2001). The rhetoric of rationalization: How students grapple with professional dilemmas. Academic Medicine, 76, s45–s47.CrossRefGoogle Scholar
  24. McKenzie, K., O’Shea, C., McLeod, H., & Begg, M. (2008). An evaluation of the effectiveness of online clinical ‘Quandaries’ in promoting effective clinical decision making by trainee clinical psychologists. Journal of Practice Teaching in Social Work and Health, 8, 7–24.Google Scholar
  25. Michalec, B. (2012). The rhetoric of rationalization: How students grapple with professional dilemmas. International Journal of Medical Education, 3, 37–45.CrossRefGoogle Scholar
  26. Moore, S., Armstrong, C., & Pearson, J. (2008). Lecture absenteeism among students in higher education: A valuable route to understanding student motivation. Journal of High Education Policy and Management, 30, 15–24.CrossRefGoogle Scholar
  27. O’Donovan, A., Halford, W. K., & Walters, B. (2011). Towards best practice supervision of clinical psychology trainees. Australian Psychologist, 46, 101–112.CrossRefGoogle Scholar
  28. Papadakis, M. A., Hodgson, C. S., Teherani, A., & Kohatsu, N. D. (2004). Unprofessional behavior in medical school is associated with subsequent disciplinary action by a state medical board. Academic Medicine, 79, 244–249.CrossRefGoogle Scholar
  29. Piaget, J. (1953). The origins of intelligence in the child. London: Routledge and Kegan Paul.Google Scholar
  30. R Development Core Team. (2011). R: A language and environment for statistical computing. Available at:
  31. Reed, M. B., Lange, J. E., Ketchie, J. M., & Clapp, J. D. (2007). The relationship between social identity, normative information, and college student drinking. Social Influence, 2, 269–294.CrossRefGoogle Scholar
  32. Spouse, J. (2001). Work-based learning in health care environments. Nurse Education Practice, 1, 12–18.CrossRefGoogle Scholar
  33. Steadman, R. H., Coates, W. C., Huang, Y. M., Matevosian, R., Larmon, B. R., McCullough, L., et al. (2006). Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills. Critical Care Medicine, 34(1), 151–157.CrossRefGoogle Scholar
  34. Stern, D. T. (2000). The development of professional character in medical students. The Hastings Center Report, 30(4 suppl), S26–S29.CrossRefGoogle Scholar
  35. Stupans, I., Scutter, S., & Sawyer, T. (2011). Fostering professionalism through scaffolding in first year clinical placements. Innovations in Education and Teaching International, 48, 263–274.CrossRefGoogle Scholar
  36. VanZandt, C. E. (1990). Professionalism: A matter of personal initiative. Journal of Counselling and Development, 68, 243–245.CrossRefGoogle Scholar
  37. Wenger, E. (1998). Communities of practice: Learning, meaning, and identity. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  38. Willeyn, L., & Burkenn, D. D. (2011). A constructivist approach to business ethics: Developing a student code of professional conduct. Journal of Legal Studies Education, 28, 1–38.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Karen McKenzie
    • 1
    Email author
  • Jill A. Cossar
    • 1
  • Tim Fawns
    • 1
  • Aja L. Murray
    • 2
  1. 1.Clinical PsychologyUniversity of EdinburghEdinburghUK
  2. 2.Psychology DepartmentUniversity of EdinburghEdinburghUK

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