Professionalism: Evolution of the concept (original) (raw)
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Professionalism beyond medical school: An educational continuum?
European Journal of Internal Medicine, 2009
Given the changes in society we are experiencing, the increasing focus on patient centred care and acknowledgment that medical education needs to continue not only in the residency programmes but throughout the doctors career, is not surprising. This article describes the attention currently paid to professionalism in the residency programmes, differences in perception of professionalism between patients, faculty, students and residents, differences in professionalism issues in the different educational phases, as well as their consequences for training and assessment regarding professionalism. Continuous medical education in professionalism is thereafter briefly discussed.
Contours of Medical Professionalism
SBV Journal of Basic, Clinical and Applied Health Science, 2019
One of the widely debated issues in current times is medical professionalism. While medical professionals have proved their mettle as teachers, researchers, or patient care providers, the public perception is different and plagued by mistrust. We wish to present a series of articles to paint a neutral and holistic picture of the problem. In the present article, we explore the meaning of medical professionalism, which is still an enigma for many. Next, we identify the various factors that have led to the perceived "lack of professionalism" in various domains of functioning of a medical faculty. The factors contributing to this perception are quite complex, interrelated ,and often rooted outside the ambit of medical education. Nevertheless, they call for a multipronged strategy and collective participation of all stakeholders, the faculty, students, medical establishments, regulators, and civil society for upholding the image of this noble profession.
JAMA, 2015
A comprehensive discussion of professionalism in medicine must include its impact on successive generations of physicians. Fifty years ago, doctors acting professionally emphasized medicine as a calling and an ability to act as the authority for patients in crisis at home and in hospitals.Therapeutic options were limited relative to the modern era, and the laying on of hands was practiced as science and art. Today, doctors balance increasing demands on time and efficiency with the sense of primacy of patient care.Technological innovation and patients' increasing access to medical knowledge through varying media of inconsistent quality challenge physicians in novel ways. Fifty years in the future, doctors will have access to vast amounts of information through a multitude of noninvasive diagnostics. Progressively more personalized medicine should inspire doctors to become even more adept at communicating effectively with patients. Professionalism in medicine throughout these generations embodies similar fundamental behaviors, such as demonstrating compassion, respect, and humility; adhering to high ethical and moral standards; subordinating personal interest to that of others; and reflecting on actions and decisions. Despite the dynamic nature of the profession itself, the omnipresent need for such traits will define medical professionalism for decades to come. U NDERSTANDING PROFESSIONALISM in modern medicine occupies a great deal of attention in medical education, research, and practice. A universally recognized definition eludes the profession, but professionalism itself may be considered in the context of the era in which it applies.This exploration of pro
Professionalism in medical education
Teaching and Teacher Education, 2007
Medical professionalism in today's society requires the exhibition of a range of qualities deployed in the service of patients, rather than more traditionally defined aspects such as mastery, autonomy and self-regulation. These qualities incorporate demonstrated clinical competence; aspiring to excellence in practice while demonstrating humility and recognition of personal limitations; exercising professional judgement; and maintaining a fiduciary relationship with patients by the earning and maintenance of trust.
Professionalism in the Training of Medical Specialists: an Integrative Literature Review
Revista Brasileira de Educação Médica, 2019
Introduction The construct professionalism is increasingly being recognized as an important component of medical education; fundamental to the physician’s role in society Objective: To group in a concise and systemized way the information available in scientific productions on the concept of medical professionalism and its applications in medical residency programs. Methods A total of 85 articles were found in 2018, of which 13 were excluded for duplication using the Mendeley platform. Of the 72 remaining articles, 35 were excluded for not answering the research question. Of the 37 articles selected for reading of the abstract, eight were not available, leaving 29 articles. After reading all articles for the final selection, 11 articles were excluded. Six papers did not fulfill the goals of the research, and five were opinion articles. Results The production included 18 articles, from which analysis emerged three thematic categories: (a) professionalism: multidimensional construct; ...
Military Medicine, 2016
Background: Many medical institutions have moved forward with curricular objectives aimed at teaching professionalism, but the question remains: are we teaching the most appropriate content at the most opportune times to maximize sustained learning? The students' point of view of professionalism is helpful in addressing this question. Aim: To describe the views of professionalism held by students and faculty at the Uniformed Services University of the Health Sciences. Methods: In e-mailed surveys, students and faculty free-texted the three most important characteristics of a professional. Qualitative analysis was used to analyze the results. Data were compared on the basis of the percentage of each group affirming one of the characteristics. Results: Fourteen characteristics of professionalism were found. There were significant differences across all participant groups in the characteristics that each indicated were most important. Conclusion: Differences emerge between definitions of professionalism that appear to relate to training and experience. Students' views of professionalism reflect the immediate context of their educational environment. Curricula targeted to the students' foci are relevant in teaching professionalism.
Professionalism: a framework to guide medical education
Despite considerable advances in the incorporation of professionalism into the formal curriculum, medical students and residents are too often presented with a mechanical, unreflective version of the topic that fails to convey deeper ethical and humanistic aspirations. Some misunderstandings of professionalism are exacerbated by commonly used assessment tools that focus only on superficially observable behaviour and not on moral values and attitudes.Methods Following a selective literature review, we engaged in philosophical ethical analysis to identify the key precepts associated with professionalism that could best guide the development of an appropriately reflective curriculum.ResultsThe key precepts needed for a robust presentation of professionalism can be grouped under two headings: ‘Professionalism as a trust-generating promise’ (representing commitment to patients’ interests, more than a mere business, a social contract, a public and collective promise, and hard work), and ‘Professionalism as application of virtue to practice’ (based on virtue, deeper attitudes rather than mere behaviour, and requiring of practical wisdom).Conclusions These key precepts help students to avoid many common, unreflective misunderstandings of professionalism, and guide faculty staff and students jointly to address the deeper issues required for successful professional identity formation.
The challenge of teaching professionalism
Annals of the Academy of Medicine, Singapore, 2004
The medical profession has been conscious of all the changes happening in society in the last quarter of the 20th century and has tried to cope with it. Numerous criticisms about the profession and its professionals have stimulated a revision of the professional's behaviour and professionalism. The Royal College of Physicians and Surgeons of Canada has launched its own proposal under the name of CanMEDS 2000. Among the revised roles and competences one find professionalism. This theme is at the heart of our profession since the early days of the 20th century when medicine became a modern profession. Responsibility for the patient remains fundamental for any doctor but, today, society expects more accountability from the medical profession. We have the obligation to educate our residents not only for healing and caring of patients but also for active participation in managing the healthcare system. In this paper, we examine this renewed post-modern professionalism. My intention i...
2020
I would like to acknowledge my thesis advisor, and mentor, Dr. Debrah Wirtzfeld. Without your passion and dedication for positive change, and without your encouragement and support, this project would not exist. Thank you for believing in me. I would also like to thank Margaret Shiels for your invaluable administrative support throughout this entire project. I would like to acknowledge the unwavering support and encouragement of my family, and especially my husband, and son. You have been my greatest cheerleaders and this accomplishment would not have been possible without your support or your sacrifice. And finally, I would like to thank my Father. Your steadfast kindness to me is unfathomable. From you and through you and to you are all things. Results: With the administration of a Professionalism Education Program (PEP), selfperceptions of professionalism showed significant improvement in the area of Social Responsibility, and trends towards significant improvement in several other core components of professionalism. There were also improvements in self-awareness as it related to professionalism. This self-awareness lead to a self-perceived improvement in professional behaviour. History and Evolution of Professionalism in Medicine The origins of the medical profession, along with law and the clergy, began in medieval times and gave rise to our modern-day social contract. 9 This social contract includes the premises that 1) non-members are unable to practice, 2) the profession is self-regulated (who is permitted to enter the profession, length of training, and evaluation is decided upon by the profession), and 3) cooperation with governmental agencies is necessary for the purpose of monitoring.10 This social contract creates the basis for the fiduciary relationship between the medical profession and society, and is the foundation of trust, between the profession and society, and between caregiver and patient. Established in 1847, the American Medical Association (AMA) set as its primary goal raising ethical standards in the medical field.11 In 1876, the Association of American Medical Colleges (AAMC) was formed to restructure medical education and influence standards and codes of ethics for medical schools, residency programs, medical boards, and other areas of healthcare. The Flexner report and the subsequent restructuring of medical training in 1910, marshalled the first wave of "medical professionalism" and the recognition that explicit acknowledgment and education in professionalism was imperative.12 Between 1942 and 1981, multiple committees and working groups were initiated to continue to discuss and coordinate changes to professional standards and medical education. Since the mid 1980's, there has been a shift and an ongoing commitment to advance the principles of professionalism in the context of medicine.13 14 The AMA and AAMC have now recognized the importance of fostering and evaluating professionalism in physicians in training and in practice.15 16 The AAMC Medical School Objectives Project urges medical schools to teach these skills.17 The Accreditation Council for Graduate Medical Education (ACGME) defined these skills as core competencies that programs must include and evaluate in their training programs.18 The American Board of Internal Medicine (ABIM) has included an evaluation of communication skills and professionalism in the recertification process of practicing physicians.19 Finally, the Royal College of Physicians and Surgeons of Canada (RCPSC) has now included 'Professional' in their CanMEDS teaching.20