Factors Influencing the Professional Identity of Student and Licensed Professional Members of the American Dental Hygienists’ Association

Discussion

Study results indicate both SMs and LMs felt that several ADHA membership benefits supported the development and sustainment of their professional identity, however differences between the two groups exist. Of the 14 ADHA benefits listed in the survey, both SM and LM selected continuing education and evidence-based research as being very influential in relation to their professional identity (development and sustainment of). One would have assumed that these differences would have been seen, especially in the category of continuing education, since SMs are still engaged in their educational programs and LMs are in the sustainment phase of PIF. While previous literature has reported the importance of mentors and mentoring, experiential learning, reflection, and community of practice as being key elements in PIF, it has not explicitly identified continuing education and evidence-based research as being influential in PIF. Perhaps these two factors tie into the element of community of practice and therefore align with previously published literature. Licensure renewal requirements call for the licensee to complete continuing education courses directly related to the practice of dental hygiene. Prior to the COVID pandemic, these courses were in-person, providing an additional opportunity for attendees to network with colleagues and additional opportunities to gain a sense of belonging and membership. Earlier literature has studied PIF in health care students but not necessarily focused on those who are already licensed and praciticing.^{4,5,8-12, 27-28}

Statistically significant differences were observed between SM and LM responses in several categories. Specifically, SM rated patient care resources, professional and personal relationships, support in their career, volunteer opportunities, maintaining a positive work environment, and having a solid work life balance higher than the LM rated these factors. Kwon et al also found a similar result in their study of dental students. Dental students reported that having relationships with peers played a significant role in their PIF as it provided an opportunity to gain a sense of belonging to their professional community of practice.⁸ Snell et al also supports the theme that an important influence in the PIF of allied health professional students is through social relationships and informal sharing of information among the students communities of practice.²⁷

It appears that SMs sought benefits which might aid in their transition from student to licensed dental hygienist. Kwon’s study of dental students reported the importance of a positive, supportive learning environment in PIF.⁸ In this study, SMs seemed to expand that factor to their future work environment, stating that a healthy work environment positively affects their professional identity. Furthermore, one could argue that life-long learning never ends, so the fact that SM identified this factor as influencing the PIF seems logical. These respondents may have selected ADHA benefits which they believe are integral in their overall job satisfaction, such as a personal well-being work life balance.

ADHA’s support of SM and new graduates as they enter the profession and begin their careers is evident by the multitude of resources dedicated to this population including career path webinars, student loan repayment resources, and advice for new professionals.³² Additionally, ADHA’s website offers an array of continuing education courses covering a variety of topics, including several patient care, which also was an important factor SM identified as being involved in their professional identity.³²

The student members rated the Journal of Dental Hygiene (JDH) and Access Magazine as the two least important ADHA benefits which they perceived as playing a role in developing or sustaining their professional identity. The demographic results of the study indicate that the majority of the SM were first year students and may not have been exposed to these publications. Dental hygiene educators may want to utilize the JDH in their courses as a way of encouraging students to better appreciate the role that original, peer-reviewed research plays in establishing a unique body of knowledge for the dental hygiene discipline and providing a framework for evidence-based decisions.

The licensed professional members ranked advocacy efforts, the Journal of Dental Hygiene, and Access Magazine as statistically more influential in terms of their professional identity development and sustainment than the SMs. Given the importance of communities of practice, these publications may fulfill LM’s need for a sense of belonging to a wider professional community as a way to support their professional identity.^8,27 Role models, mentoring, and experiential learning experiences has been reported to be key factors influencing PIF, yet it is interesting that LM did not rank these ADHA factors higher.^8,16,19-20

Snell et al. found that PIF was positively impacted when allied health students were introduced early to their professions and communities of practice.²⁷ While the majority of SMs reported being required to join ADHA, well over half of the SMs indicated that they planned on converting their SM to a LM after graduating. The question to be asked is whether or not simply being a member of ADHA has some influence on dental hygiene students’ PIF.²⁷

A majority of LMs had been a dental hygienist for thirty-one years or more, but most have only held an ADHA membership for ten years or less. The discrepancy between years working in relation to the years holding a membership may have influenced how the LM answered the survey questions. During the years when a member was not an ADHA member, it is unknown what factors influenced their professional identity.

It was surprising that the ADHA annual conference was not selected by either respondent group as being an important factor influencing one’s professional identity, especially since continuing education was identified as a factor. Perhaps the respondents did not associate the annual session as a source of continuing education courses. Monrouxe reported that one factor which plays into a student developing their professional identity is the sense that they are joining community of practice.⁵ Since the ADHA annual conference is an event which brings dental hygienists of all ages and career lengths together to network and engage in continuing education sessions to advance their professional skills, one would think that it would have been perceived by the participants as playing a more important part in their professional identities. However, it is possible that the annual conference is misperceived in terms of what it actually offers the attendees.

ADHA advocacy efforts were rated statistically higher by LMs than SMs. One could speculate that LMs simply had more career experiences and opportunities to witness the role of ADHA in advancing the profession of dental hygiene through their state and national efforts. Dental hygiene students may be too novice to appreciate the critical role ADHA has in representing the profession and across their lifelong careers.

LM were asked whether they had active roles in ADHA at the local (component), state (constituent), or national levels and if not, why (data not shown). The fact that LMs stated they were somewhat or not active may be deceiving as one could argue that by voluntarily paying membership dues to belong to the ADHA constitutes a level of activity. New marketing strategies by the ADHA have focused on its SMs which will hopefully have a positive impact on the transition from SM to LM status. New benefits have been directed toward students to promote their involvement in the organization. In addition to the National Board Dental Hygiene Examination Resources and volunteer opportunities, students are also able to apply for scholarships through the ADHA.³² Student engagement through the ADHA can impact the student chapters, which provides students with the opportunity to engage with faculty role models and mentors. As previously reported, the impact of role models and mentors during the formative years of training plays a critical role in a student developing their professional identity.^8,16,19-20

Professional identity also plays a pivotal role in the success of interprofessional collaborative teams in health care settings. To be an effective collaborative team member, one must have a clear understanding of one’s professional identity in order to confidently participate with other professionals to provide improved health care outcomes for patients.³³ Morison et al. also reported the importance of each collaborative team member having a sense of their professional identity and stated that this is an essential factor in the development of the team.³³ Considering the impact on collaborative health care, understanding the factors which influence the professional identity in dental hygienists is critical. Given that ADHA is a national organization representing the dental hygiene profession, it is even more important that ADHA support its members with this collaborative model in mind and seek resources which strengthen a member’s professional identity. Findings from this study also have direct implications for dental hygiene educators and programs as structuring learning experiences which help a student develop their professional identity can aid in the overall development of the student.

This study had limitations. The response rate was low and cannot be generalized to represent all ADHA members or the profession as a whole. Electronic surveys have historically low return rates and the timing of this study over the summer may have negatively impacted the results. The length of the survey may have impacted the respondents desire to complete it. While the survey had been pilot-tested for clarity, the wording may still have caused confusion. In addition, SMs may have interpreted the questions based on what benefits might be beneficial in the future while LMs may have viewed the items based on present day needs. Other methods of participant recruitment would have been beneficial to increase the number of respondents and include non-member students and licensed professionals.

Over the past few decades common themes in PIF among health care students have emerged and implications for educators have been recommended. One key goal of dental hygiene educators is to develop the next generation of dental hygiene oral health care specialists. Dental hygiene educators need to understand the critical role they play in the PIF of dental hygiene students and make a concerted effort to incorporate PIF strategies into the curriculum.