Clinical commitment and competence: a qualitative study

  • Somaye Zamanian Jahromi ORCID Researcher, School of Rehabilitation Sciences of Iran University of Medical Sciences, Tehran, Iran.
  • Narges Shafaroodi ORCID Mail Associate Professor, Occupational Therapy Department, School of Rehabilitation Sciences of Iran University of Medical Sciences, Tehran, Iran.
  • Laleh Lajevardi ORCID Assistant Professor, Occupational Therapy Department, School of Rehabilitation Sciences of Iran University of Medical Sciences, Tehran. Iran.
Occupational therapy; Commitment; Qualitative research; Clinical competence.


Commitment, a component of clinical competence, includes accountability and responsibility for professional roles and tasks; and, it has a positive correlation with job satisfaction and performance. This study aimed to elaborate on the concept of commitment in the field of occupational therapy using qualitative content analysis. The data was collected through interviewing 13 occupational therapists both in a focus group interview (including four participants) and in one-to-one interviews (nine other participants). The collected data was analyzed based on the Grenheim method, and commitment concept was defined under three main themes: (i) commitment to patient (five subthemes), (ii) commitment to self (three subthemes), and (iii) commitment to profession (three subthemes). This study’s findings indicated that to acquire clinical competence, therapists should be committed to their patients, to themselves, and to their profession. Future research is needed to further examine how and to what extent these commitment themes affect clinical competence as well as the interaction among them.


Parsa Yekta Z, Ahmadi F, Tabari R. Factors defined by nurses as influential upon the development of clinical competence. Journal of Guilan University of Medical Sciences. 2005; 14(54): 9-23.

Watson R, Stimpson A, Topping A, Porock D. Clinical competence in nursing: a systematic review of the literature. J Adv Nurs. 2002; 39(5): 421-31.

Carr SJ. Assessing clinical competency in medical senior house officers: how and why should we do it? Postgrad Med J. 2004; 80(940): 63-6.

Boyt Schell BA, Glen Gillen G, Scaffa M, Cohn E. Willard & Spackman's Occupational Therapy, 12th ed. USA: Lippincott Williams & Wilkins; 2014.

Adib Hagbaghery M, Salsali M, Ahmadi F. A qualitative study of Iranian nurses' understanding and experiences of professional power. Hum Resour Health. 2004; 2(1): 9.

Memarian R, Salsali M, Vanaki Z, Ahmadi F, Hajizadeh E. Professional ethics as an important factor in clinical competency in nursing. Nursing Ethics. 2007; 14(2): 203-14.

Turner A, Alsop A. Unique core skills: exploring occupational therapists' hidden assets. British Journal of Occupational Therapy. 2015; 78(12): 739-49.

Anonymous. Association of Canadian Occupational Therapy Regulatory Organizations (ACOTRO). Essential competencies of practice for occupational therapists in Canada. [Cited 2020 Sep]; available from:

Rodger S, Clark M, Banks R, O’Brien M, Martinez K. A comparison of international occupational therapy competencies: implications for Australian standards in the new millennium. Aust Occup Ther J. 2009; 56(6):372-83.

Allami A, Mohammadi N, Shirazi M. Faculty members experience about teaching of medical professionalism in Qazvin university of medical sciences. Research in Medical Education. 2015; 7(2):1-11.

Thorner S. The essential skills of an occupational therapist. British Journal of Occupational Therapy. 1991; 54(6): 222-3.

Kalantari M, Kamali M, Joolaee S, Rassafiani M, Shafarodi N. Perception of professional ethics by Iranian occupational therapists working with children. J Med Ethics Hist Med. 2015; 8: 8.

Barkhordari-Sharifabad M, Ashktorab T, Atashzadeh-Shoorideh F. Obstacles and problems of ethical leadership from the perspective of nursing leaders: a qualitative content analysis. J Med Ethics Hist Med. 2017; 10: 1.

Shafaroodi N, Kamali M, Parvizy S, Mehraban AH, O’Toole G. Factors affecting clinical reasoning of occupational therapists: a qualitative study. Med J Islam Repub Iran. 2014; 28: 8. eCollection 2014.

Kak N, Burkhalter B, Cooper M. Measuring the Competence of Healthcare Providers. Operations Research Issue Paper. 2001; 2(1):1-28.

Vahidi H, Shafaroodi N, Joolaee S. Occupational therapists’ perception of unethical practice in adults’ physical dysfunction field. Scientific Journal of Rehabiliation Medicine. 2015; 4(2): 70-8.

Brown T, Tseng MH, Casey J, McDonald R, Lyons C. Research knowledge, attitudes, and practices of pediatric occupational therapists in Australia, the United Kingdom, and Taiwan. J Allied Health. 2010; 39(2): 88-94.

Santos S, Not-Land E. Factors related to commitment of extension professionals in the Dominican Republic: Implications for theory and practice. Journal of Agricultural Education. 2006; 35(3): 57-63.

Mael, F.A. Ashforth, B.E. Loyal from day one: biodata, organizational identification, and turnover among newcomers. Personnel Psychology. 1995; 48(2):309- 33.

Wallace JE. Organizational and professional commitment in professional and nonprofessional organizations. Administrative Science Quarterly. 1995; 40(2): 228-55.

Vanderkaay S, Jung B, Letts L, Moll SE. Continuing competency in ethical decision making: an interpretive description of occupational therapists’ perspectives. Canadian Journal of Occupational Therapy. 2019; 86(3): 209-19.

Ballard P, Trowbridge C. Critical care clinical experience for novice students: reinforcing basic nursing skills. Nurse Educ. 2004; 29(3): 103-6.

Ghmari N, Derakhshanrad SA, Ghamari M. Examining the motivational power of occupational therapy profession among occupational therapist in Fars providence in 1390. Journal of Modern Rehabiliation.2012; 6(3):5-12.

How to Cite
Zamanian Jahromi S, Shafaroodi N, Lajevardi L. Clinical commitment and competence: a qualitative study. J Med Ethics Hist Med. 13.
Original Article(s)