Strengthening professional identity to address the nursing workforce crisis

Building on the framework of Nursing Outlook’s Blueprint for Change, Erica Schorr’s research examines how to strengthen students’ understanding of why nursing matters.

A multi-site study involving the University of Minnesota, Rutgers University, and California State University-Fresno evaluated educational interventions designed to strengthen nursing students’ professional identity and facilitate their transition to practice.

The research addresses a critical workforce challenge: high turnover rates among new nurses, many of whom leave the profession within their first year.

The study examined whether intentionally connecting students’ clinical observations to the Nine Practice Domains of Acute and Critical Care Nursing as outlined in the Nursing Outlook article Call to action: Blueprint for change in acute and critical care nursing could strengthen their professional identity and facilitate their transition to practice.

A key contributor to leaving the profession is that many nursing students struggle to develop a clear professional identity during their education, seeing themselves primarily as task-completers rather than as health care professionals who fundamentally impact patient outcomes.

“Without understanding why nursing matters and how their actions uniquely impact patients, students risk becoming disillusioned technicians rather than engaged professionals. Literature in a variety of fields supports that people don’t just need to know what they do and how they do it, they also need to understand why it matters,” says Associate Professor Erica Schorr, PhD, RN, who led the Minnesota study that focused on strengthening professional identity.

The study focused on Master of Nursing (MN) students in their final semester of nursing school. Half of the student cohort took part in structured conversations after their clinical shifts, where they talked about specific care they had provided or witnessed. They connected those actions to the Nine Practice Domains of Acute and Critical Care Nursing, like creating safe healing environments, collaborating with an interprofessional team, and advocating for patients. The other group completed the semester as usual.

At the start and end of the semester, all students completed the MacLeod Professional Identity Scale, which is a survey designed to measure how strongly students identify with the nursing profession. They also kept reflective journals throughout the semester, using a validated journaling framework.

The intervention group showed favorable changes. Most notably, the study found a statistically significant reduction in professional shame among students who engaged in the domain-based reflections.

“By helping students see and name the sophisticated, meaningful work that nurses do, through the lens of the Nine Practice Domains, we’re not just teaching them what nursing is. We’re helping them become the nurses they aspire to be, with the professional identity, confidence, and clarity of purpose needed to thrive in practice and consistently deliver care that improves patient outcomes,” says Schorr.