Professional Confidence and Expertise in Allied Health: A Narrative Study of Critical Incidents

Abstract

Highly experienced allied health professionals possess extensive knowledge and skill developed through sustained professional practice and have the potential to support the development of others. However, their willingness, capacity, or opportunity to enact an identity as an expert varies. This study explored how highly experienced allied health professionals in Aotearoa New Zealand construct and negotiate expert identity through narratives of critical workplace incidents. Focusing on therapy professionals across disciplines, the study examined how expertise is narrated, recognised, and sustained within professional communities rather than treating expertise as a fixed individual attribute. Using an interpretive, critical pragmatic methodology, critical incident narratives were collected from 45 highly experienced practitioners, most of whom were women and did not identify as Māori or Pacific peoples. Affirming, challenging, and transformative incidents provided insight into how participants made meaning of their professional experiences and positioned themselves as experts in relation to colleagues, organisations, and professional norms. Analysis showed that professional confidence was central to the construction and expression of expert identity. Confidence functioned both as an outcome of experience and as a narrative resource that enabled practitioners to act, share knowledge, and navigate uncertainty and vulnerability. Affirming incidents often reinforced expert identity through role clarity, professional recognition, and value alignment, while challenging incidents prompted reflection, narrative reframing, and changes in practice. The findings highlight expertise as a relational and socially supported identity, constructed through storytelling, professional interaction, and collective recognition, offering a nuanced understanding of how expert identity is sustained in allied health practice.