“Growing through relationship” - the Engagement of the Health Professional Students in the Internship Experience: a Grounded Theory Research

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Cinzia Merlini
Mariarosaria Savarese https://orcid.org/0000-0003-0809-100X
Lara Pierboni
Barbara Mazzocchi
Tiziana Benedetti
Rachele La Sala
Alessio Boggian
Maria Teresa Rinieri
Leopoldo Sarli
Giovanna Artioli


Clinical Practice, Grounded Theory, Health Professionals, Learning, Student Engagement


Background and aim:

Little is known about the students’ engagement in the training experience and how it is lived by the health professional students. We aim at building a theoretical model of the engagement process starting from their lived experiences with Grounded Theory approach.

Methods:In-depth qualitative interviews are conducted with 12 students from the Master Degree Courses in Nursing, Physiotherapy and Prevention Techniques in the environment and in the workplace, who had carried out and/or were doing internships in the same territory (2nd and 3rd year).

Results The health professions' student engagement in the training program is developed in three main phases: initial phase, central phase and final phase, where emotions, behaviours, awareness contribute to the development of the entire engagement process with different relevance. The intertwining of these different components that develop along the stages of the experience gives life to the core category: growing through relationship, which expressed the crucial role of the relational network built during the internship experience in shaping students’ engagement.

Conclusions: The results of this study underline the crucial role of students’ engagement in the internship experience in favouring both better learning outcomes and perspective professional success and wellbeing. (www.actabiomedica.it)


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1. Spencer JA, Jordan RK. Learner centred approaches in medical education. British Medical Journal. 1999.
2. Baker C, Pulling C, McGraw R, Dagnone JD, Hopkins-Rosseel D, Medves J. Simulation in interprofessional education for patient-centred collaborative care. J Adv Nurs. 2008;
3. World Health Organization W. Transforming and Scaling up health professionals’ education and training. WHO Publ. 2013;
4. Gee JP. Identity as an analytic lens for research in education. Rev Res Educ. 2000;
5. Madi M, Hamzeh H, Griffiths M, Rushton A, Heneghan NR. Exploring taught masters education for healthcare practitioners: a systematic review of literature. BMC Med Educ. 2019;
6. Snook AG. Parallels in patient-, student- and faculty-centred education: Identity development in health science educators. Medical Education. 2020.
7. Bodenheimer T, Sinsky C. From triple to Quadruple Aim: Care of the patient requires care of the provider. Ann Fam Med. 2014;
8. Gonzalo JD, Davis C, Thompson BM, Haidet P. Unpacking Medical Students’ Mixed Engagement in Health Systems Science Education. Teach Learn Med. 2020;
9. Winstone NE, Nash RA, Parker M, Rowntree J. Supporting Learners’ Agentic Engagement With Feedback: A Systematic Review and a Taxonomy of Recipience Processes. Educational Psychologist. 2017.
10. Billett S, Cain M, Le AH. Augmenting higher education students’ work experiences: preferred purposes and processes. Stud High Educ. 2018;
11. Kahu ER, Nelson K. Student engagement in the educational interface: understanding the mechanisms of student success. High Educ Res Dev. 2018;
12. Pascarella ET, Terenzini PT. How college affects students: A third decade of research. How College Affects Students: A Third Decade of Research. 2005.
13. Fredricks, J., Blumenfeld, P., & Paris A. School Engagement: Potential of the Concept, State of the Evidence, Review of Educational Research, 2004. Rev Educ Res. 2004;
14. Leong F. National Survey of Student Engagement. In: Encyclopedia of Counseling. 2014.
15. Coates H. The value of student engagement for higher education quality assurance. Quality in Higher Education. 2005.
16. Dilullo C, Mcgee P, Kriebel RM. Demystifying the Millennial student: A reassessment in measures of character and engagement in professional education. Anatomical Sciences Education. 2011.
17. Stoeber J, Childs JH, Hayward JA, Feast AR. Passion and motivation for studying: Predicting academic engagement and burnout in university students. Educ Psychol. 2011;
18. Heiskanen H, Lonka K. Are Epistemological Beliefs and Motivational Strategies Related to Study Engagement in Higher Education? Procedia - Soc Behav Sci. 2012;
19. Ouweneel E, Schaufeli WB, Le Blanc PM. Believe, and you will achieve: Changes over time in self-efficacy, engagement, and performance. Appl Psychol Heal Well-Being. 2013;
20. Siu OL, Bakker AB, Jiang X. Psychological Capital Among University Students: Relationships with Study Engagement and Intrinsic Motivation. J Happiness Stud. 2014;
21. Shih SS. An examination of academic burnout versus work engagement among Taiwanese adolescents. J Educ Res. 2012;
22. Salmela-Aro K, Upadyaya K. School burnout and engagement in the context of demands-resources model. Br J Educ Psychol. 2014;
23. Strauser DR, O’Sullivan D, Wong AWK. Work personality, work engagement, and academic effort in a group of college students. J Employ Couns. 2012;
24. Casuso-Holgado MJ, Cuesta-Vargas AI, Moreno-Morales N, Labajos-Manzanares MT, Barón-López FJ, Vega-Cuesta M. The association between academic engagement and achievement in health sciences students. BMC Med Educ. 2013;
25. Trowler V. Student engagement literature review. High Educ [Internet]. 2010;(November):1–15. Available from: http://americandemocracy.illinoisstate.edu/documents/democratic-engagement-white-paper-2_13_09.pdf
26. Kuh GD, Cruce TM, Shoup R, Kinzie J, Gonyea RM. Unmasking the effects of student engagement on first-year college grades and persistence. J Higher Educ. 2008;
27. Nghia TLH, My Duyen NT. Internship-related learning outcomes and their influential factors: The case of Vietnamese tourism and hospitality students. Educ Train. 2018;
28. Zanchetta M, Schwind J, Aksenchuk K, Gorospe FF, Santiago L. An international internship on social development led by Canadian nursing students: Empowering learning. Nurse Educ Today. 2013;
29. Mollica M, Hyman Z. Professional development utilizing an oncology summer nursing internship. Nurse Educ Pract. 2016;
30. Bruce M, Omne-Pontén M, Gustavsson PJ. Active and emotional student engagement: A nationwide, prospective, longitudinal study of Swedish nursing students. Int J Nurs Educ Scholarsh. 2010;
31. Popkess AM, McDaniel A. Are nursing students engaged in learning? A secondary analysis of data from the National Survey of Student Engagement. Nursing Education Perspectives. 2011.
32. Seib C, English R, Barnard A. Teaching undergraduate students community nursing: Using action research to increase engagement and learning. Journal of Nursing Education. 2011.
33. Goldin GA, Epstein YM, Schorr RY, Warner LB. Beliefs and engagement structures: Behind the affective dimension of mathematical learning. ZDM - Int J Math Educ. 2011;
34. Strauss A, Corbin J. Basics of Qualitative Research: Techniques and Grounded Theory Procedures for Developing Grounded Theory. The Modern Language Journal. 1998.
35. Strauss A, Corbin J. StraussCorbin Grounded Theory Methodology. In: Handbook of Qualitative Research, 2nd Ed. 1994.
36. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Heal Care. 2007;
37. Thomson SB. Sample size and grounded theory. J Adm Gov. 2011;
38. Crozier G, Denzin N, Lincoln Y. Handbook of Qualitative Research. Br J Educ Stud. 1994;
39. Bryant A, Charmaz K. The SAGE Handbook of Grounded Theory. The SAGE Handbook of Grounded Theory. 2012.
40. Flick U, Thornberg R, Charmaz K. Grounded Theory and Theoretical Coding. In: The SAGE Handbook of Qualitative Data Analysis. 2014.
41. Gilbert BL, Banks J, Houser JHW, Rhodes SJ, Douglas Lees N. Student development in an experiential learning program. J Coll Stud Dev. 2014;
42. Hou Y-A. Avoiding the Gap of College Students’ Internship Expectations and Perceptions—A Case Study in Taiwan. Open J Nurs. 2018;
43. Sauder MH, Mudrick M, Strassle CG, Maitoza R, Malcarne B, Evans B. What Did You Expect? Divergent Perceptions Among Internship Stakeholders. J Exp Educ. 2019;
44. Bailey SF, Barber LK, Nelson VL. Undergraduate internship supervision in psychology departments: Use of experiential learning best practices. Psychol Learn Teach. 2017;
45. Bhattacharya S, Neelam N. Perceived value of internship experience: a try before you leap. High Educ Ski Work Learn. 2018;
46. Yoonjoung Heo C, Kim S (Sam), Kim B. Investigating the Impact of Relationship Quality During an Internship on Millennials’ Career Decisions and Gender Differences. J Hosp Tour Educ. 2018;
47. Ripamonti S, Galuppo L, Bruno A, Ivaldi S, Scaratti G. Reconstructing the internship program as a critical reflexive practice: the role of tutorship. Teach High Educ. 2018;
48. Tuma, J. M., & Pratt, J. M. (1982). Clinical child psychology practice and training: A survey. \ldots of Clinical Child & Adolescent Psychology, 137(August 2012) 37–41. http://doi.org/10.1037/a0022390, Gobry, F. (1999). {T}his is a title. {M}y Journal, 1 120–130., Osment SE (1980). TA of R 1250-1550. … and RH of LM and R…. R from http://scholar. google. com/scholar?hl=en&btnG=Search&q=intitle:THE+AGE+OF+REFORM+125.-1550#2%5Cnhttp://scholar. google. com/scholar?hl=en&btnG=S., Caprara, G., & Fida, R. (2008). Longitudinal analysis of the role of perceived self-efficacy for self-regulated learning in academic continuance and achievement. … of Educational …, 100(3) 525–534. http://doi.org/10.1037/0022-0663.100.3.525, Shanker, S. (2003). Philosophy of science logic and mathematics in the twentieth century. … PL and NYR http://doi. org/10. 4324/978020302947., Marenbon J (1998). RH of PI… PL and NYR http://doi. org/10. 4324/978020306227., et al. Innovations in Education and Teaching International Rethinking PhD learning incorporating communities of practice Rethinking PhD learning incorporating communities of practice. Innov Educ Teach Int. 2009;
49. Tayama J, Schaufeli W, Shimazu A, Tanaka M, Takahama A. Validation of a Japanese Version of the Work Engagement Scale for Students. Jpn Psychol Res. 2019;
50. Usán Supervía P, Salavera Bordás C. Academic performance, emotional intelligence and academic engagement in adolescents. Electron J Res Educ Psychol. 2019;
51. Lei H, Cui Y, Zhou W. Relationships between student engagement and academic achievement: A meta-analysis. Soc Behav Pers. 2018;
52. Ayaz-Alkaya S, Yaman-Sözbir Ş, Bayrak-Kahraman B. The effect of nursing internship program on burnout and professional commitment. Nurse Educ Today. 2018;
53. Miranda-Ackerman RC, Barbosa-Camacho FJ, Sander-Möller MJ, Buenrostro-Jiménez AD, Mares-País R, Cortes-Flores AO, et al. Burnout syndrome prevalence during internship in public and private hospitals: a survey study in Mexico. Med Educ Online. 2019;
54. Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition. 2007.
55. Douglas HE, Bore M, Munro D. Coping with University Education: The relationships of Time Management Behaviour and Work Engagement with the Five Factor Model Aspects. Learn Individ Differ. 2016;
56. Keyko K, Cummings GG, Yonge O, Wong CA. Work engagement in professional nursing practice: A systematic review. International Journal of Nursing Studies. 2016.
57. Zhang W, Meng H, Yang S, Liu D. The influence of professional identity, job satisfaction, and work engagement on turnover intention among township health inspectors in China. Int J Environ Res Public Health. 2018;
58. Gonzalo JD, Dekhtyar M, Hawkins RE, Wolpaw DR. How Can Medical Students Add Value? Identifying Roles, Barriers, and Strategies to Advance the Value of Undergraduate Medical Education to Patient Care and the Health System. Acad Med. 2017;
59. Losasso AA, Lamberton CE, Sammon M, Berg KT, Caruso JW, Cass J, et al. Enhancing student empathetic engagement, history-taking, and communication skills during electronic medical record use in patient care. Acad Med. 2017;

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