Towards optimizing professional practice: Understanding registered respiratory therapists’ role as scholarly practitioners

Scholarly practice is a competency common to most healthcare professions. It aims to equip professionals with the essential knowledge, skills, behaviours, and attitudes to ground their practice in theory and research, critically evaluate practice, and integrate evidence-based literature into their work. Despite the purported benefits for patients, professionals and organizations, such as professional empowerment, a positive work environment, and improved patient outcomes, scholarly practice is often misunderstood due to the conceptual ambiguity and inconsistent use of terminology and definitions. This misunderstanding leads to variations in the ways in which scholarly practice is enacted in routine practice and a misalignment between the teaching and assessment of this competency. Consequently, many healthcare professionals may not fully appreciate their roles as scholarly practitioners, perceiving it as less important in their education and in how they deliver patient care. Combined, these challenges underscore the necessity of clarifying what scholarly practice is, understanding its component parts, how it is operationalized in different professions and identifying ways it might be measured. These challenges are particularly noticeable in younger rehabilitation professions like respiratory therapy. Though respiratory therapists (RTs) are expected to enact aspects of scholarly practice for effective patient care, scholarly practice is formally excluded from their competency frameworks. The aim of this dissertation is to explore how practicing RTs conceptualize, describe and enact their roles as scholarly practitioners through four distinct but interconnected phases, each targeting a specific objective.In Phase 1, a scoping review was used to ascertain what is known about scholarly practice amongst healthcare professionals. Scholarly practice was conceptualized as the interdependent relationship between scholarship and practice, to advance a profession and is core to being a healthcare practitioner. Attributes of scholarly practitioners were organized into five themes: 1) possessing a commitment to excellence in practice, 2) having a collaborative nature, 3) the presence of virtuous characteristics, 4) having effective communication skills, and 5) possessing an adaptive change ethos. While some papers offered explicit definitions of scholarly practice, there was no consensus on what scholarly practice is, suggesting that it may be a complex and multifaceted concept. Finally, the review revealed an absence of psychometrically validated measurement tools of scholarly practice.In Phase 2, interpretive description methodology was used to explore what scholarly practice means and how it manifests in daily practice from RTs’ perspectives. Five themes were identified: (i) the identity of a scholarly practitioner in RTs; (ii) the factors influencing scholarly practice; (iii) one's impression of their professional self‐image; (iv) scholarly practice as a vehicle for changing practice and (v) the complex interconnections between knowledges and practices. Scholarly practice appears to be a multifaceted phenomenon encompassing a wide range of activities and skills, including conducting research, reflective practice, applying research to practice, and contributing to the advancement of the profession and healthcare.In Phase 3, a cross-sectional study was conducted to describe the demographic characteristics, scholarly and practice profile of RTs across Canada. The results revealed limited participation in research activities and scholarly practice, such as low rates of engaging in literature or scientific presentations. Supportive work environments, access to resources and professional development opportunities can help advance the scholarly practice of RTs.In Phase 4, the findings from Phase 3 were used to develop, pilot, and generate preliminary validity evidence for a tool designed to measure scholarly practice among RTs, following DeVellis’ 9-step scale development process and exploratory factor analysis. The four factors include: 1) professional development and credibility; 2) elements supporting scholarly practice; 3) perceived impact of scholarly activities on practice; and 4) scholarly practitioner identity and ability. By serving as a catalyst for self-reflection, the tool has the potential to foster the advancement of scholarly practice within the profession and among other healthcare professions.The research reported in this dissertation advances the theoretical understanding of scholarly practice as a multidimensional phenomenon essential for providing legitimacy and credibility to a profession and can serve to stimulate discussions of scholarly practice within the respiratory therapy profession. The newly developed tool for measuring scholarly practice can support RTs to engage in self-reflection

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