PROFESSIONALISM and Ethics in Medicine.ppt

Professionalism

1. PROFESSIONALISM & ETHICS

IN MEDICAL EDUCATION
Study Skill Course
Medical Education Department
College of Medicine

2. Think of some Think of some Excellent Teachers Excellent Teachers who who
Influenced your Learning.Influenced your Learning.
Mention Some of Their Qualities and Mention Some of Their Qualities and
AttributesAttributes

3. OBJECTIVES
●Define Professionalism.
●Identify some professional & unprofessional behaviors.
●Recognize as an important part of the curriculum.

4. CONTENTS:
●What is professionalism?
●What are Unprofessional behaviors?
●How can we Implement it in the Curriculum?
●How can we Teach/learn it?
●How can we Assess it?

5. What does professionalism means to you?
•Take two minutes and write down your
thoughts … as a definition or description

6. What is Professionalism?
•It is not easy to define a profession, but it is likely to
have all or Some of the following characteristics:
–It is a vocation that implies service to others.
–It has a distinctive knowledge base which is kept
up to date.
–It determines its own standards.
–It has a special relationship with those whom it
serves e.g. patients.
–It has particular ethical principles

7. Professionalism in Curriculum
•General Medical Council 1993
•AAMC Medical School Objectives Project (MSOP)
1999
•ACGME Outcomes Project 2000
•Can-MEDS 2000
•KSU medical College Outcomes 2009

8. WHAT MEDICAL COLLEGES WANT?
•Proficiency
•Communication skills
•Interpersonal skills
•Confidence
•Critical thinking & problem solving skills
•Flexibility
•Self motivation
•Leadership
•Teamwork

9. Professionalism
is a term which embodies numerous
qualities of physicians as public
servants.

10. It has been described by The American
Board of Internal Medicine as:
“Constituting those attitudes and behaviors
that serve to maintain others interest above
physician Self-interest”

11. هعبطب
ٌينهم ملسملا بيبطلا
مكدحأ لمع اذإ بحي هللا نإ”
“هنقتي نأ لامع
اونسحأف مكتحبذ اذإ و”
“.........ةحبذلا

12. 'Project Professionalism' (ABIM, 2001)
Identified six key elements of professionalism:
1- Altruism
2- Accountability
3- Excellence
4- Duty
5- Honor and integrity
6- Respect for other

13. Main Characteristics of professional conduct
(by the American Board of Internal Medicine)
ALTRUISM is the essence of professionalism.
The best interest of the patients, not self-
interest, is the rule.

14. ACCOUNTABILITY is required at many levels:
individual patients, society and the
profession.

15. EXCELLENCE entails a conscientious effort to
exceed normal expectations and make a
commitment to life-long learning

16. “It will become increasingly difficult for
professions to sustain the policy that
qualification is for life. Most
professionals need to make a
commitment to lifelong learning”.
Professor Eraut.

17. DUTY is the free acceptance of a
commitment to service.

18. HONOUR AND INTEGRITY are the
consistent regard for the highest
standards of behaviour and refusal to
violate one’s personal and professional
codes.

19. RESPECT FOR OTHERS, like patients and
their families, other physician and
professional colleagues such as nurses,
medical students, residents, subspecialty
fellows.

20. 'Project Professionalism' (ABIM, 2001)
Identified six key elements of professionalism:
1- Altruism
2- Accountability
3- Excellence
4- Duty
5- Honor and integrity
6- Respect for other

21. The concept of professionalism
includes the following values:
HonestyHonesty
TrustTrust
ServiceService
CommitmentCommitment
CommunicationCommunication
AccountabilityAccountability
Life-long learningLife-long learning

22. Signs and Symptoms
•ABIM, (2001) describes unprofessional behaviour
in terms of seven broad categories of 'signs and
symptoms'.
1- Abuse of power
2- Arrogance
3- Greed
4- Misrepresentation
5- Impairment
6-Lack of conscientiousness
7- Conflicts in interests

23. Signs and Symptoms
1- Abuse of power (abuse while interacting with
patients and colleagues; bias and sexual
harassment; and breach of confidentiality);
2- Arrogance (offensive display of superiority and
self-importance);
3- Greed (when money becomes the driving force);

24. Signs and Symptoms
4- Misrepresentation (lying, which is
consciously failing to tell the truth; and fraud,
which is conscious misrepresentation of
material fact with the intent to mislead);
5- Impairment (any disability that may
prevent the physician from discharging
his/her duties);

25. Signs and Symptoms
6- Lack of conscientiousness (failure to fulfill
responsibilities);
7- Conflicts in interests (self-promotion/
advertising or unethical collaboration with
industry; acceptance of gifts; and misuse of
services – overcharging, inappropriate
treatment or prolonging contact with patients).

26. Signs and Symptoms
•ABIM, (2001) describes unprofessional behaviour
in terms of seven broad categories of 'signs and
symptoms'.
1- Abuse of power
2- Arrogance
3- Greed
4- Misrepresentation
5- Impairment
6-Lack of conscientiousness
7- Conflicts in interests

27. Defining Un-professional Behaviors
What specific behaviors are
unprofessional in:
▫classroom and
▫clinical settings?
•For teachers & students

28. Examples of Unprofessional Behaviors
Classroom Setting-Students
•Arriving for class late and/or leaving early
•Being unprepared for group sessions
•Not completing assigned tasks
•Disrupting class sessions
•Failing to attend scheduled class sessions
•Cheating on an exam
•Cheating attendace

29. Examples of Unprofessional Behaviors
Classroom Setting-Students
•Using Mobile Phone during class
•Chatting during class
•Focusing on the test vs. learning
•Prejudging content in advance.
•Intolerance of the opinions of others
•Entitlement and inappropriate demands

30. Examples of Unprofessional Behaviors
Classroom Setting-Faculty
•Plagiarism
•Judgmental attitude or favoritism
•Coming late
•Not giving breaks
•Sloppy handouts and syllabi
•Abusive behavior
•Using Mobile Phone during class

31. Examples of Unprofessional Behaviors:
Clinical Setting-Students
•Coming late to schedule clinics
•Dressing inappropriately
•Avoiding work and/or responsibilities
•Exhibiting little empathy for patients
•Demonstrating lack of sensitivity to patients’
cultural backgrounds
•Not protecting patient confidentiality

32. Examples of Unprofessional Behaviors:
Clinical Setting: Faculty
•Coming late to schedule clinics
•Failing to attend scheduled sessions
•Showing favoritism
•Using inappropriate language or behavior
•Using “isms-”-sexism, ageism, racism
•Asking learners to perform personal tasks, for
example, picking up laundry

33. How professionalism can be
implemented?

34. Professionalism and Curriculum Design
Performance
Of Task

35. Performance
Of task
Attitudes, ethical understanding and
Legal responsibility
Decision making skills and clinical
Reasoning and judgment
Basic, Social and
clinical sciences
Personal Development
Role of the doctor within the health service and community
Medical informatics
Patient management
Patient investigation
Clinical Skills
Practical procedures
Health promotion and
Disease prevention

36. Professionalism
•Role of the doctor within
the health service
–Understanding of the
health care system
–Understanding of clinical
responsibilities
–Appreciation of doctor as
researcher
–Appreciation of doctor as
mentor or teacher
–Appreciation of doctor as
manager including
quality control
–Team working
•Personal Development
–Lifelong Learner
–Self awareness
–Self confidence
–Self regulation
•Self care
•Self control
•Personal time
management
– Motivation
•Achievement drive
•Commitment
•initiative
–Career choice

37. How professionalism can be How professionalism can be
taught?taught?

38. Professionalism in the Curriculum
▫A learning outcome (ACGME, 2007; Harden et al.,
1999; CanMeds 2000),
▫A skill set (Emanuel, 2004)
▫A competence (Leach, 2004; Hester and Kovach,
2004; Fryer-Edwards & Baernstein, 2004).
▫KSU – college of medicine outcomes

39. Curriculum content relating to
professionalism:
•The key attributes of a professional:
ethics, decision making/moral reasoning, humanism,
multiculturalism, empathy values, truth telling, care for
the vulnerable, trust, attitudes and communication,
confidentiality of patient data, contact with patients,
emotional intelligence, mental health, and self-
assessment (using reflective practice).
systematic review, Veloski et al. (2005)
•These should be integrated into the component courses
of the curriculum rather than taught as a stand alone
course.

40. How Students Learn Professional values?
▫Some bring to medical college with them
▫Some learn through the formal curriculum
▫Some learn from role models

41. How can We Teach Professionalism?
•Role Modeling
•Bed Side Teaching
•Simulated Patients
•Small Group Cases Discussions

44. How can professionalism be
Assessed?

45. P
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Performance or
hands on
assessment
Portfolios
Written, Oral
or
Computer
based
assessment
Does
Shows how
Knows how

Knows
Miller’s Triangle

46. Use Suitable Assessment Tools
•Multiple choice questions-Knows??
•Faculty evaluations-Knows, knows how,
shows how??
•Clinical vignettes & OSCE & OSOE-Knows,
knows how??
•Standardized patients-Knows how, shows
how??

47. How can We Assess Professionalism?
•Peer Evaluation-Does
•Patient Surveys-Does
•Staff evaluations-Does
•Professionalism Portfolio (self evaluation)-
Does
•360 degree evaluation-Does

48. Final Word
“There is a tendency to underemphasize the
personal characteristics… , because they are
harder to measure, and to overemphasize the
more easily measured indices of academic
achievement”
Cohen (2002)

49. Take Home Messages
•Professionalism should be part of the
formal curriculum
•Professionalism must be taught and
assessed
•Professionalism must be relevant to the
society it serves

50. Take Home Messages
•Dress your….
•Give your ….
•Speak your ….
•Listen your ….
•Work your ….
•Live Your ….