Professionalism education should reflect reality: findings from three health professions.

Abstract:

CONTEXT:Despite a growing and influential literature, 'professionalism' remains conceptually unclear. A recent review identified three discourses of professionalism in the literature: the individual; the interpersonal, and the societal-institutional. Although all have credibility and empirical support, there are tensions among them. OBJECTIVES:This paper considers how these discourses reflect the views of professionalism as they are expressed by students and educator-practitioners in three health care professions, and their implications for education. METHODS:Twenty focus groups were carried out with 112 participants, comprising trainee and educator paramedics, occupational therapists and podiatrists. The focus group discussions addressed participants' definitions of professionalism, the sources of their perceptions, examples of professional and unprofessional behaviour, and the point at which participants felt one became 'a professional'. RESULTS:Analysis found views of professionalism were complex, and varied within and between the professional groups. Participants' descriptions of professionalism related to the three discourses. Individual references were to beliefs or fundamental values formed early in life, and to professional identity, with professionalism as an aspect of the self. Interpersonal references indicated the definition of 'professional' behaviour is dependent on contextual factors, with the meta-skill of selecting an appropriate approach being fundamental. Societal-institutional references related to societal expectations, to organisational cultures (including management support), and to local work-group norms. These different views overlapped and combined in different ways, creating a complex picture of professionalism as something highly individual, but constrained or enabled by context. Professionalism is grown, not made. CONCLUSIONS:The conceptual complexity identified in the findings suggests that the use of 'professionalism' as a descriptor, despite its vernacular accessibility, may be problematic in educational applications in which greater precision is necessary. It may be better to assume that 'professionalism' as a discrete construct does not exist per se, and to focus instead on specific skills, including the ability to identify appropriate behaviour, and the organisational requirements necessary to support those skills.

journal_name

Med Educ

journal_title

Medical education

authors

Burford B,Morrow G,Rothwell C,Carter M,Illing J

doi

10.1111/medu.12368

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

361-74

issue

4

eissn

0308-0110

issn

1365-2923

journal_volume

48

pub_type

杂志文章
  • Professional identity in clinician-scientists: brokers between care and science.

    abstract:CONTEXT:Despite increasing numbers of publications, science often fails to significantly improve patient care. Clinician-scientists, professionals who combine care and research activities, play an important role in helping to solve this problem. However, despite the ascribed advantages of connecting scientific knowledg...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.13241

    authors: Kluijtmans M,de Haan E,Akkerman S,van Tartwijk J

    更新日期:2017-06-01 00:00:00

  • Dimensions, discourses and differences: trainees conceptualising health care leadership and followership.

    abstract:CONTEXT:As doctors in all specialties are expected to undertake leadership within health care organisations, leadership development has become an inherent part of medical education. Whereas the leadership literature within medical education remains mostly focused on individual, hierarchical leadership, contemporary the...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.12832

    authors: Gordon LJ,Rees CE,Ker JS,Cleland J

    更新日期:2015-12-01 00:00:00

  • Medical teaching of the cultural aspects of ethnic minorities: does it exist?

    abstract::The development of published material relating to the practice of medicine in multiracial and multicultural Britain is briefly reviewed. The utilization of such information in English medical schools is found to be absent or at a low level of priority. A more detailed study of one region demonstrates that junior hospi...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1986.tb01388.x

    authors: Poulton J,Rylance GW,Johnson MR

    更新日期:1986-11-01 00:00:00

  • Standard setting in an objective structured clinical examination: use of global ratings of borderline performance to determine the passing score.

    abstract:BACKGROUND:Objective structured clinical examination (OSCE) standard-setting procedures are not well developed and are often time-consuming and complex. We report an evaluation of a simple 'contrasting groups' method, applied to an OSCE conducted simultaneously in three separate schools. SUBJECTS:Medical students unde...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.2001.01041.x

    authors: Wilkinson TJ,Newble DI,Frampton CM

    更新日期:2001-11-01 00:00:00

  • Supervised role-play in the teaching of the process of consultation.

    abstract::Supervised role-play is presented as a method for teaching the process of the medical consultation. The process of the consultation is reviewed and a brief description of supervised role-play is given with some of its advantages and disadvantages. Some simple devices used in the method are explained with examples. The...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1991.tb00102.x

    authors: Mansfield F

    更新日期:1991-11-01 00:00:00

  • Content specificity and oral certification exams.

    abstract::This study reports on the generalizability of different skills assessed in the oral certification examinations in Internal Medicine of the Royal College of Physicians and Surgeons of Canada. Assessments from the 1992 examination were examined prospectively to determine (i) inter-rater reliability, (ii) correlation fro...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1996.tb00718.x

    authors: Turnbull J,Danoff D,Norman G

    更新日期:1996-01-01 00:00:00

  • Service increment for teaching (SIFT): a review of its origins, development and current role in supporting undergraduate medical education in England and Wales.

    abstract:OBJECTIVES:To describe the ways in which total resources available for the Service Increment for Teaching (SIFT) have been determined and related to numbers of undergraduate medical students; and the development and current arrangements for allocating SIFT to the providers of service support for teaching. DESIGN:The d...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.1999.00310.x

    authors: Clack GB,Bevan G,Eddleston AL

    更新日期:1999-05-01 00:00:00

  • Contribution of medical student research to the Medline-indexed publications of a German medical faculty.

    abstract::Medical students in Germany have to write a research thesis to acquire the title of medical doctor. This study evaluates the contribution of student research to the Medline-indexed publications of a German medical faculty. A 1993-1995 Medline-publication list, on which medical students among authors should be marked, ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.1998.00255.x

    authors: Cursiefen C,Altunbas A

    更新日期:1998-07-01 00:00:00

  • Patient involvement in teaching and assessing intimate examination skills: a systematic review.

    abstract:OBJECTIVES:There are recognised difficulties in teaching and assessing intimate examination skills that relate to the sensitive nature of the various examinations and the anxiety faced by novice learners. This systematic review provides a summary of the evidence for the involvement of real patients (RPs) and simulated ...

    journal_title:Medical education

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2923.2009.03608.x

    authors: Jha V,Setna Z,Al-Hity A,Quinton ND,Roberts TE

    更新日期:2010-04-01 00:00:00

  • Medical teachers' discursive positioning of doctors in relation to patients.

    abstract:CONTEXT:An important part of a doctor's identity is the social position he or she adopts relative to patients. Dialogic theory predicts that medical school discourses influence the positions students incorporate into their professional identities. As this may affect how students later exercise power in doctor-patient r...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.14074

    authors: Dornan T,Roy Bentley S,Kelly M

    更新日期:2020-07-01 00:00:00

  • Management of somatic presentations of psychiatric illness in general medical settings: evaluation of a new training course for general practitioners.

    abstract::An improved teaching package is described which aims to help general practice trainees manage somatized presentations of psychological distress. The package comprises a training videotape in which a reattribution model is demonstrated, with material for role-play of new skills and small-group video feedback of consult...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1992.tb00139.x

    authors: Kaaya S,Goldberg D,Gask L

    更新日期:1992-03-01 00:00:00

  • The use of the nominal group technique as an evaluative tool in medical undergraduate education.

    abstract:OBJECTIVES:In the present state of flux affecting UK medical undergraduate education, there is a pressing need for evaluative methods which will identify relevant outcomes both expected and unanticipated. The student perspective is now legitimately accepted to form part of any evaluative exercise but qualitative method...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.1999.00288.x

    authors: Lloyd-Jones G,Fowell S,Bligh JG

    更新日期:1999-01-01 00:00:00

  • A solution to the cueing effects of multiple choice questions: the Un-Q format.

    abstract::Although the cueing effects inherent in conventional multiple choice questions (MCQs) present serious limitations, this format continues to dominate testing programmes. The present study was undertaken to estimate the effects of cueing when MCQs are used to test medical students, and to evaluate the reliability, valid...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1993.tb00284.x

    authors: Veloski JJ,Rabinowitz HK,Robeson MR

    更新日期:1993-07-01 00:00:00

  • Predictive validity of the multiple mini-interview for selecting medical trainees.

    abstract:INTRODUCTION:In this paper we report on further tests of the validity of the multiple mini-interview (MMI) selection process, comparing MMI scores with those achieved on a national high-stakes clinical skills examination. We also continue to explore the stability of candidate performance and the extent to which so-call...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2009.03407.x

    authors: Eva KW,Reiter HI,Trinh K,Wasi P,Rosenfeld J,Norman GR

    更新日期:2009-08-01 00:00:00

  • 'More shades of grey in my answers': an interview study revisiting attitude erosion during clerkships.

    abstract:CONTEXT:Small declines in patient-centred attitudes during medical education have caused great concern. Although some of the self-report scales applied have solid psychometric foundations, validity evidence for the interpretation of attitude erosion during clerkships remains weak. OBJECTIVES:We sought to address this ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.12102

    authors: Bombeke K,Symons L,Mortelmans D,Debaene L,Schol S,Van Royen P,De Winter B

    更新日期:2013-05-01 00:00:00

  • Pre-registration house officer rotations incorporating general practice: does the order of rotation matter?

    abstract:CONTEXT:In relation to pre-registration house officer (PRHO) rotations incorporating general practice, previous research has recommended that where possible, no PRHO should undertake general practice as the first placement, because of the difficulties encountered. It was recognized that logistically, this could make su...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.2001.00922.x

    authors: Williams C,Cantillon P,Cochrane M

    更新日期:2001-06-01 00:00:00

  • Prior academic background and student performance in assessment in a graduate entry programme.

    abstract:OBJECTIVES:This study aims to identify whether non-science graduates perform as well as science graduates in Basic and Clinical Sciences (B & CS) assessments during Years 1-3 of a four-year graduate-entry programme at the University of Sydney (the 'USydMP'). METHODS:Students were grouped into five categories: Health P...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2929.2004.02043.x

    authors: Craig PL,Gordon JJ,Clark RM,Langendyk V

    更新日期:2004-11-01 00:00:00

  • Medical students' understanding of empathy: a phenomenological study.

    abstract:CONTEXT:Empathy towards patients is associated with improved health outcomes. However, quantitative studies using self-reported data have not provided an in-depth opportunity to explore the lived experiences of medical students concerning empathy. OBJECTIVES:This study was designed to investigate undergraduate medical...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2011.04152.x

    authors: Tavakol S,Dennick R,Tavakol M

    更新日期:2012-03-01 00:00:00

  • Why people apply to medical school: implications for widening participation activities.

    abstract:OBJECTIVES:This research aims to identify the influences contributing to students' decisions to study medicine and to apply the findings to the design and targeting of outreach activities aimed at widening participation. METHODS:Semi-structured interviews were carried out with 15 medical students at a UK medical schoo...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2007.02798.x

    authors: McHarg J,Mattick K,Knight LV

    更新日期:2007-08-01 00:00:00

  • Diagnostic error and clinical reasoning.

    abstract:CONTEXT:There is a growing literature on diagnostic errors. The consensus of this literature is that most errors are cognitive and result from the application of one or more cognitive biases. Such biased reasoning is usually associated with 'System 1' (non-analytic, pattern recognition) thinking. METHODS:We review thi...

    journal_title:Medical education

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2923.2009.03507.x

    authors: Norman GR,Eva KW

    更新日期:2010-01-01 00:00:00

  • Attitudes of house-physicians towards self-poisoning patients.

    abstract::Eighty-two house-physicians filled in a questionnaire concerning the care of self-poisoning patients with special emphasis on training and attitudes. These recently qualified doctors dealt with large numbers of such patients and expressed dissatisfaction with their training in this respect. Hostile attitudes towards t...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1981.tb02500.x

    authors: Creed FH,Pfeffer JM

    更新日期:1981-09-01 00:00:00

  • Outcomes of longitudinal integrated clinical placements for students, clinicians and society.

    abstract:CONTEXT:Longitudinal integrated clerkships (LICs) have been widely implemented in both rural and urban contexts, as is now evident in the wealth of studies published internationally. This narrative literature review aims to summarise current evidence regarding the outcomes of LICs for student, clinician and community s...

    journal_title:Medical education

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2923.2012.04331.x

    authors: Walters L,Greenhill J,Richards J,Ward H,Campbell N,Ash J,Schuwirth LW

    更新日期:2012-11-01 00:00:00

  • Married women doctors' training and re-employment schemes in the West Midlands Region, with particular reference to psychiatry.

    abstract::The response of one region to the Department of Health and Social Security recommendations on re-employment of women doctors contained in H.M. 69(6) is described. In many specialities there has been an encouraging return of married women doctors to medical practice within the hospital service. In the field of psychiat...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1976.tb00463.x

    authors: Bluglass K,Dunn TL,Gaston FW

    更新日期:1976-07-01 00:00:00

  • Who are the providers of postgraduate medical education?

    abstract::The view, background and motivation of providers of medical education was studied using a structured questionnaire which was sent to all those who organized courses for the Postgraduate Education Allowance in the West of Scotland. Two hundred and twenty-five replies were received from 254 course providers, giving an 8...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1993.tb00300.x

    authors: Kelly MH,Murray TS

    更新日期:1993-09-01 00:00:00

  • Role of clinical context in residents' physical examination diagnostic accuracy.

    abstract:CONTEXT:Clinical context may act as both an aid to decision making and a source of bias contributing to medical error. The effect of clinical history, a form of clinical context, on the diagnostic accuracy of the physical examination is unknown. METHODS:We randomised internal medicine residents to receive either no hi...

    journal_title:Medical education

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2923.2010.03896.x

    authors: Sibbald M,Panisko D,Cavalcanti RB

    更新日期:2011-04-01 00:00:00

  • A pilot study of microcomputer testing in paediatrics.

    abstract::A system for administering multiple choice questions and for providing immediate feedback via microcomputer was designed and field-tested by three groups of paediatric residents. Only minor technical problems were encountered, and these can be resolved easily. Attitudes towards the system were strongly positive. Resid...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1984.tb01279.x

    authors: Butzin DW,Friedman CP,Brownlee RC

    更新日期:1984-09-01 00:00:00

  • A healing curriculum.

    abstract:CONTEXT:The banner of patient-centredness flies over many academic institutions; however, the practice and teaching of medicine remain oriented to disease. This incongruence is the result of an original Flexnerian dichotomy between the basic and clinical sciences and is maintained by a more recent distinction between d...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2007.02905.x

    authors: Boudreau JD,Cassell EJ,Fuks A

    更新日期:2007-12-01 00:00:00

  • Speaking up, support, control and work engagement of medical residents. A structural equation modelling analysis.

    abstract:OBJECTIVES:Medical residents can play key roles in improving health care quality by speaking up and giving suggestions for improvements. However, previous research on speaking up by medical residents has shown that speaking up is difficult for residents. This study explored: (i) whether two main aspects of medical resi...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.13951

    authors: Voogt JJ,Taris TW,van Rensen ELJ,Schneider MME,Noordegraaf M,van der Schaaf MF

    更新日期:2019-11-01 00:00:00

  • Medical students' attitudes to psychiatric illness in primary care.

    abstract:CONTEXT:Previous research has shown that general practitioners (GPs) hold negative attitudes towards patients with schizophrenia, which do not simply reflect the nature or chronic aspects of the illness. This study aimed to describe the attitudes and predicted behaviour of medical students towards patients with mental ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2008.03183.x

    authors: Dixon RP,Roberts LM,Lawrie S,Jones LA,Humphreys MS

    更新日期:2008-11-01 00:00:00

  • Students conducting consultations in general practice and the acceptability to patients.

    abstract:OBJECTIVES:The General Medical Council has recommended that medical students should gain more experience in general practice. The study set out to determine patients' reactions to consultations conducted by a medical student alone prior to seeing their GP. DESIGN:A random sample of patients attending general practice ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.1999.00410.x

    authors: Bentham J,Burke J,Clark J,Svoboda C,Vallance G,Yeow M

    更新日期:1999-09-01 00:00:00