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1 - Defining, Teaching, and Learning Professionalism

Published online by Cambridge University Press:  25 February 2010

Louise Arnold
Affiliation:
Professor, Associate Dean Office of Medical Education and Research University of Missouri-Kansas City School of Medicine
George Thompson
Affiliation:
Associate Professor Office of Medical Education and Research University of Missouri-Kansas City School of Medicine
John Spandorfer
Affiliation:
Jefferson Medical College, Philadelphia
Charles A. Pohl
Affiliation:
Jefferson Medical College, Philadelphia
Susan L. Rattner
Affiliation:
Jefferson Medical College, Philadelphia
Thomas J. Nasca
Affiliation:
Jefferson Medical College, Philadelphia
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Summary

Professionalism is frequently described as the fundamental core of medicine. This chapter discusses the importance of professionalism, its historical contexts, the current challenges, and the Physician Charter as a worldwide medical response to these challenges. The chapter also examines and elaborates on other definitions of professionalism, explores how professionalism is acquired and strengthened, and summarizes current medical education approaches to promoting professionalism.

PROFESSIONALISM TODAY

Why Is Professionalism Important?

The Physician Charter avers in its preamble that “professionalism is the basis of medicine's contract with society.” This pact or agreement denotes a reciprocal, though tacit, relationship between the public and the medical profession. The public gives physicians rights and privileges in return for their adherence to values that enable them to protect the public health, which is vital to the very existence of society itself. That is, in exchange for authority to control key aspects of their working conditions, the public expects physicians to maintain high standards of competence and moral responsibility. According to the Charter, trust is essential to this contract. Public trust depends on whether the actions of physicians and their leaders demonstrate the values of medical professionalism.

Why Is Professionalism Increasingly Important?

Healers across time and cultures have embraced the values of professionalism. Derived from the need to care for the sick, professionalism in Western societies expanded in Hellenic Greece to include service and in medieval England to include obligations to society and individual patients.

Type
Chapter
Information
Professionalism in Medicine
A Case-Based Guide for Medical Students
, pp. 7 - 22
Publisher: Cambridge University Press
Print publication year: 2009

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References

,ABIM Foundation. American Board of Internal Medicine, ACP-ASIM Foundation. American College of Physicians-American Society of Internal Medicine, European Federation of Internal Medicine. Medical professionalism in the new millennium: A physician charter. Ann Intern Med. 2002;136(3):243–246.CrossRefGoogle Scholar
Arnold, L. Assessing professional behavior: Yesterday, today, and tomorrow. Acad Med. 2002;77(6):502–515.CrossRefGoogle ScholarPubMed
Brody, H. Professionalism, ethics, or both? Does it matter?Med Hum Rep. 2003;24:1–4.Google Scholar
,Working Party of the Royal College of Physicians. Doctors in society. medical professionalism in a changing world. Clin Med. 2005;5(6 Suppl. 1):S5–40.Google Scholar
Swick, HM. Academic medicine must deal with the clash of business and professional values. Acad Med. 1998;73(7):751–755.CrossRefGoogle ScholarPubMed
Bruhn, JG. Being good and doing good: The culture of professionalism in the health professions. Health Care Manag (Frederick). 2001;19(4):47–58.Google ScholarPubMed
Association of American Medical Colleges, The National Board of Medical Examiners. Embedding professionalism in medical education: Assessment as a tool for implementation.
Bligh, J. Professionalism. Med Educ. 2005;39(1):4.CrossRefGoogle ScholarPubMed
Hafferty, F. Viewpoint: The elephant in medical professionalism's kitchen. Acad Med. 2006;81(10):906–914.CrossRefGoogle ScholarPubMed
Cruess, RL, Cruess, SR, Johnston, SE. Professionalism: An ideal to be sustained. Lancet. 2000;356(9224):156–159.CrossRefGoogle ScholarPubMed
Cruess, SR, Cruess, RL. Professionalism must be taught. BMJ. 1997;315(7123):1674–1677.CrossRefGoogle ScholarPubMed
Rothman, DJ. Medical professionalism – focusing on the real issues. N Engl J Med. 2000;342(17):1284–1286.CrossRefGoogle ScholarPubMed
Cruess, RL, Cruess, SR. Teaching medicine as a profession in the service of healing. Acad Med. 1997;72(11):941–952.CrossRefGoogle ScholarPubMed
Cruess, SR. Professionalism and medicine's social contract with society. Clin Orthop Relat Res. 2006;449:170–176.Google ScholarPubMed
Cruess, SR, Johnston, S, Cruess, RL. “Profession”: A working definition for medical educators. Teach Learn Med. 2004;16(1):74–76.CrossRefGoogle ScholarPubMed
Arnold, L, Stern, DT. What is medical professionalism. In: Stern, DT, ed. Measuring Medical Professionalism. Oxford, England: Oxford University Press; 2006:15–37.Google Scholar
Parsons, T. The Social System. Glencoe, IL: The Free Press; 1951.Google Scholar
Evaluation of humanistic qualities in the internist. Ann Intern Med. 1983;99(5):720–724.CrossRef
,American Board of Internal Medicine. Guide to Awareness and Evaluation of Humanistic Qualities in the Internist. Philadelphia, PA: American Board of Internal Medicine; 1992.Google Scholar
,American Board of Internal Medicine. Project Professionalism. Philadelphia, PA: American Board of Internal Medicine; 1994.Google Scholar
ACGME Outcome Project. Enhancing Residency Education through Outcomes Assessment, General Competencies, Version 1.2. ACGME Web site. http://www.acgme.org/outcome/comp/compFull.asp. Updated 1999. Accessed October 26, 2007.
Swick, HM. Toward a normative definition of medical professionalism. Acad Med. 2000;75(6):612–616.CrossRefGoogle Scholar
,Association of American Medical Colleges Group on Educational Affairs. Assessment of Professionalism Project. www.aamc.org/members/gea/professionalism.pdf. Updated 2002. Accessed October 26, 2007.
,National Board of Medical Examiners. Professional Behaviors. Assessment of Professional Behaviors Web site. http://professionalbehaviors.nbme.org/current-work.html. Accessed June 22, 2007.
Gruen, RL, Pearson, SD, Brennan, TA. Physician-citizens – public roles and professional obligations. JAMA. 2004;291(1):94–98.CrossRefGoogle ScholarPubMed
Brennan, TA. Physicians' professional responsibility to improve the quality of care. Acad Med. 2002;77(10):973–980.CrossRefGoogle ScholarPubMed
Frankford, DM, Patterson, MA, Konrad, TR. Transforming practice organizations to foster lifelong learning and commitment to medical professionalism. Acad Med. 2000;75(7):708–717.CrossRefGoogle ScholarPubMed
Sullivan, WM. What is left of professionalism after managed care?Hastings Cent Rep. 1999;29(2):7–13.CrossRefGoogle ScholarPubMed
Sullivan, WM. Medicine under threat: Professionalism and professional identity. CMAJ. 2000;162(5):673–675.Google ScholarPubMed
Sullivan, WM. Can professionalism still be a viable ethic?The Good Society. 2004;13:15–20.CrossRefGoogle Scholar
Irvine, D. The performance of doctors: The new professionalism. Lancet. 1999;353(9159):1174–1177.CrossRefGoogle ScholarPubMed
Irvine, D. Patients, professionalism, and revalidation. BMJ. 2005;330(7502):1265–1268.CrossRefGoogle ScholarPubMed
Swick, HM, Bryan, CS, Longo, LD. Beyond the physician charter: Reflections on medical professionalism. Perspect Biol Med. 2006;49(2):263–275.CrossRefGoogle ScholarPubMed
Gawande, A. The bell curve: What happens when patients find out how good their doctors really are. The New Yorker. December 6, 2004.Google Scholar
Cruess, RL, Cruess, SR, Johnston, SE. Renewing professionalism: An opportunity for medicine. Acad Med. 1999;74(8):878–884.CrossRefGoogle ScholarPubMed
Epstein, RM. Mindful practice. JAMA. 1999;282(9):833–839.CrossRefGoogle ScholarPubMed
Fiester, A. Viewpoint: Why the clinical ethics we teach fails patients. Acad Med. 2007;82(7):684–689.CrossRefGoogle ScholarPubMed
Camp, K, Vernooij-Dassen, M, Grol, R, Bottema, B. Professionalism in general practice: Development of an instrument to assess professional behaviour in general practitioner trainees. Med Educ. 2006;40(1):43–50.CrossRefGoogle ScholarPubMed
Emanuel, EJ, Emanuel, LL. What is accountability in health care?Ann Intern Med. 1996;124(2):229–239.CrossRefGoogle ScholarPubMed
Evetts, J. The sociological analysis of professionalism: Occupational change in the modern world. Int Sociol. 2003;18:395–415.CrossRefGoogle Scholar
Ross, LF. What is wrong with the physician charter on professionalism. Hastings Cent Rep. 2006;36(4):17–19.CrossRefGoogle ScholarPubMed
Inui, T. A Flag in the Wind. https://services.aamc.org/Publications. Updated 2003. Accessed October 26, 2007.
Cruess, RL, Cruess, SR. Teaching professionalism: General principles. Med Teach. 2006;28(3):205–208.CrossRefGoogle ScholarPubMed
Schon, DA. The Reflective Practitioner: How Professionals Think in Action. New York, NY: Basic Books; 1983.Google Scholar
Thompson, GS, Arnold, L. Strengthening Professionalism through Humanistic Narratives. www.umkc.edu/profstories. Accessed October 26, 2007.
Hilton, SR, Slotnick, HB. Proto-professionalism: How professionalisation occurs across the continuum of medical education. Med Educ. 2005;39(1):58–65.CrossRefGoogle ScholarPubMed
Crain, WC. Theories of Development. New York: Prentice-Hall; 1985.Google Scholar
Peterson, C, Seligman, MEP. Character Strengths and Virtues: A Handbook and Classification. Oxford and New York: Oxford University Press; 2004.Google Scholar
Quaintance, JL, Arnold, L, Thompson, G. Promoting medical professionalism through narratives: The students' perspective. poster presentation, research in medical education session, central group on educational affairs, Indianapolis, IN, 2007.
Patterson, K, Grenny, J, McMillan, R, Switzler, A, Covey, SR. Crucial Conversations: Tools for Talking When the Stakes Are High. New York: McGraw Hill; 2002.Google Scholar
Palmer, H. Living Deliberately. Altamonte Springs, FL: Star's Edge International; 1994.Google Scholar
Strayhorn, JM. Self-control: Toward systematic training programs. J Am Acad Child Adolesc Psychiatry. 2002;41(1):17–27.CrossRefGoogle ScholarPubMed
Seligman, ME, Steen, TA, Park, N, Peterson, C. Positive psychology progress: Empirical validation of interventions. Am Psychol. 2005;60(5):410–421.CrossRefGoogle ScholarPubMed
Seligman, ME, Csikszentmihalyi, M. Positive psychology: An introduction. Am Psychol. 2000;55(1):5–14.CrossRefGoogle Scholar
Eisenberg, N, Fabes, RA, Murphy, B, Karbon, M, Smith, M, Maszk, P. The relations of children's dispositional empathy-related responding to their emotionality, regulation and social functioning. Dev Psychol. 1996;32:195–209.CrossRefGoogle Scholar
Goleman, D. Emotional Intelligence. New York: Bantam Books; 1995.Google Scholar
Fawcett, J. It's a wonder that we make it. Psychiatric Annals. 2007;376:385.Google Scholar

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