An ethnomethodological approach has focused on the perspectives, strategies and culture of physiotherapy students, as a way of understanding their world, and exploring the process of professional identity construction in the context of their development as autonomous practitioners.
The following significant themes arose from the data:
• biography of the student
• student self and relationships
• students' self evaluation and use of role models
• dynamics of construction and movement towards the accomplishment of professional identity, incorporating evidence of mastery of subject.
Key findings were:
• the curriculum structure experienced places emphasis on acquisition of propositional and professional craft/process knowledge
• the perception of disempowerment within the university learning environment, when compared to the clinical environment
• potential difficulties in managing role changes leading to role conflict
• construction of professional identity via the use of negative rather than positive role models
• judgement of personal performance only on the basis of formal transition points and the use of high status external cues
• little acknowledgement of the value of personal knowledge and understanding of self
• the learning experience does not facilitate professional identity construction
• students have an awareness of autonomy but are not enabled to function autonomously.
Recommendations include 'unloading' the curriculum and restructuring of the context of learning as experiential, offering students opportunities for the integration of knowledge, competencies, the exploration of self and enhanced self awareness. Increased understanding of self will promote skill in self evaluation, encourage emulation of more positive role models, enhance justification of effectiveness, and encourage movement away from the focus on time served and patient numbers treated as the bench-mark for denoting professional expertise.