Professionalism in Healthcare: Difference between revisions
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Professionalism in healthcare requires a combination of abilities, knowledge and skill to provide services to patients. This is required for good treatment results while still focusing on patient safety. (reference)[It is a combination of having abilities, knowledge and skills which are sufficient to work and provide services to patients and those on the receiving end of the health service. This is in order to efficiently achieve good treatment results while ensuring safety in receiving such services.] | Professionalism in healthcare requires a combination of abilities, knowledge and skill to provide services to patients. This is required for good treatment results while still focusing on patient safety. (reference)[It is a combination of having abilities, knowledge and skills which are sufficient to work and provide services to patients and those on the receiving end of the health service. This is in order to efficiently achieve good treatment results while ensuring safety in receiving such services.] | ||
== Attributes and | == Attributes and Behaviours of Professionalism == | ||
Attributes, core competencies and | Attributes, core competencies and behaviours of professionalism include<ref name=":0" /><ref name=":1">Bhardwaj A. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9618247/pdf/jhl-14-183.pdf Medical professionalism in the provision of clinical care in healthcare organizations.] Journal of Healthcare Leadership. 2022 Jan 1:183-9.</ref>: | ||
* accountability | * accountability | ||
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* continuous learning and improvement | * continuous learning and improvement | ||
* humility | * humility | ||
** healthcare professionals acknowledge that humility is key to high quality, interdisciplinary team-based, patient-centered care<ref>Michalec B, Cuddy MM, Felix K, Gur-Arie R, Tilburt JC, Hafferty FW. Positioning humility within healthcare delivery-From doctors’ and nurses’ perspectives. Human Factors in Healthcare. 2024 Jun 1;5:100061.</ref>and professional humility can be a powerful force within healthcare when seen as a trait of strength and collectivity among colleagues.<ref>Michalec B, Xyrichis A, Arenson C. “Professional humility”: introducing a new framework to advance interprofessionalism. Journal of Interprofessional Care. 2024 Mar 21:1-6.</ref> | |||
<blockquote>"Professionalism emphasises humanistic aspects (attitude, behaviour, virtues and characteristics) desirable among healthcare professionals in all circumstances in addition to biomedical aspects (knowledge, clinical reasoning and technical skill)."<ref name=":0" /></blockquote>Prerequisite qualities for professionalism include<ref name=":0" />: | <blockquote>"Professionalism emphasises humanistic aspects (attitude, behaviour, virtues and characteristics) desirable among healthcare professionals in all circumstances in addition to biomedical aspects (knowledge, clinical reasoning and technical skill)."<ref name=":0" /></blockquote>Prerequisite qualities for professionalism include<ref name=":0" />: | ||
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=== Unprofessional Behaviour === | === Unprofessional Behaviour === | ||
Unfortunately in the clinical workplace, many healthcare professionals experience and perceive unprofessional behaviour. In a study investigating the type and frequency of perceived unprofessional behaviours among healthcare professionals it was found that 63 % experience unprofessional behaviour at least once a month. This includes behaviour such as professionals not responding to calls / requests, being excluded form decision-making and blaming behaviour. Dabekaussen KF, Scheepers RA, Heineman E, Haber AL, Lombarts KM, Jaarsma DA, Shapiro J. Health care professionals’ perceptions of unprofessional behaviour in the clinical workplace. PLoS One. 2023 Jan 19;18(1):e0280444. | Unfortunately in the clinical workplace, many healthcare professionals experience and perceive unprofessional behaviour. In a study investigating the type and frequency of perceived unprofessional behaviours among healthcare professionals it was found that 63 % experience unprofessional behaviour at least once a month. This includes behaviour such as professionals not responding to calls / requests, being excluded form decision-making and blaming behaviour.<ref>Dabekaussen KF, Scheepers RA, Heineman E, Haber AL, Lombarts KM, Jaarsma DA, Shapiro J. [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0280444 Health care professionals’ perceptions of unprofessional behaviour in the clinical workplace.] PLoS One. 2023 Jan 19;18(1):e0280444.</ref> Examples of unprofessional behaviours include<ref>MacLean L, Coombs C, Breda K. Unprofessional workplace conduct... defining and defusing it. Nursing Management. 2016 Sep 1;47(9):30-4.</ref>: | ||
* Bullying | |||
** Defined according to direction | |||
*** Lateral violence – professional against professional | |||
*** Vertical violence – bullying from the top | |||
**** Employers against employees | |||
***** Unfair work practices | |||
***** Abuse of power | |||
*** Vertical violence - bullying from the bottom up | |||
**** Employers against employees | |||
***** Strikes / work slow downs | |||
***** Refusal to follow procedures | |||
* Mobbing | |||
** group “ganging up” on an individual with goal to remove individual from group or intimidating individual | |||
** Methods used include sabotage, slander, petitions, votes of no confidence | |||
* Toxic workplaces behaviours | |||
** Eye rolling | |||
** Sarcasm | |||
** Threats | |||
** Aggression | |||
** Withholding important patient information | |||
** Disrespect | |||
** Rude | |||
** Condescending remarks | |||
** Scapegoating | |||
==== Drivers of Unprofessional Behaviour ==== | |||
Bhardwaj<ref name=":1" /> (2022) identifies some drivers of unprofessional behaviour. These are listed below. | |||
* High or extra workload due to limited staff or resources | |||
* Chronic fatigue | |||
* Sleep deprivation | |||
* Burnout | |||
* Low self-esteem | |||
* Personal stressors such as difficult relationships | |||
* Unsupportive leadership | |||
* Inadequate supervision | |||
* Poor organizational culture and work environment | |||
* Tolerance of unprofessional behaviour | |||
* Bigotry | |||
* Unconscious bias | |||
* Tolerance for aggression | |||
* Ill recognition for performance | |||
* Lack of opportunity for professional growth and development | |||
* Lack of social support systems | |||
* Limited or constricted resources | |||
* Loss of autonomy and decision-making capabilities | |||
* Toxic and substance abuse | |||
High or extra workload due to limited staff or resources | |||
Chronic fatigue | |||
Sleep deprivation | |||
Burnout | |||
Low self-esteem | |||
Personal stressors such as difficult relationships | |||
Unsupportive leadership | |||
Inadequate supervision | |||
Poor organizational culture and work environment | |||
Tolerance of unprofessional behaviour | |||
Bigotry | |||
Tolerance for aggression | |||
Ill recognition for performance | |||
Lack of opportunity for professional | |||
Lack of social support systems | |||
Limited or constricted resources | |||
Loss of autonomy and decision-making capabilities | |||
Toxic and substance abuse | |||
== Patient Perspectives on the Professionalism of Healthcare Professionals == | |||
Regis, Steiner, Ford, Byerly have highlighted some aspects of professionalism that are highly regarded and valued by patients. These include: | Regis, Steiner, Ford, Byerly have highlighted some aspects of professionalism that are highly regarded and valued by patients. These include: | ||
Revision as of 16:42, 30 March 2024
Original Editor - User Name
Top Contributors - Wanda van Niekerk and Jess Bell
Introduction[edit | edit source]
Professionalism is an important but complex concept in healthcare. A multitude of studies on the definition of professionalism in healthcare highlights this complexity. It is clear though that without professionalism the quality of healthcare, patient and illness outcomes, patient safety and trust between healthcare professionals are negatively affected.[1]
Definitions of Professionalism in Healthcare[edit | edit source]
Literature and Dictionary Definitions[edit | edit source]
Some definitions of professionalism as found in the literature are seen in Table 1.
Source | Definition |
---|---|
Merriam Webster Dictionary | "the conduct, aims or qualities that characterise or mark a profession or a professional person"[2] |
Cambridge Dictionary | "the combination of all the qualities that are connected with trained and skilled people"[3] |
Desai and Kapadia[4] | "the attributes, behaviours, responsibilities, principles and objectives that characterise a profession or professional person. It implies the quality of service.” |
Epstein and Hundert [5] | "Professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotion, values and reflections in daily practice for the benefit of the individual and community" |
Healthcare Professional Regulatory Bodies and Professionalism Definitions[edit | edit source]
We recommend that you consult with your country’s professional body on their definition and guidelines on professionalism. The professional bodies below are used as examples.
- Chartered Society of Physiotherapy: What is Professionalism
- World Physiotherapy: Ethical principles and the responsibilities of physiotherapists and member organisations
- American Pharmaceutical Association Academy of Students of Pharmacy: White paper on pharmacy student professionalism[6]
- General Medical Council (UK): Domain 4: Trust and professionalism
- New Zealand Nurses Organisation: Standards of professional nursing practice
- American Academy of Physical Medicine and Rehabilitation: Professionalism in rehabilitation: Peer, student, resident and fellow recommendations / assessment
- Australian Occupational Therapy: Competency standards
- Australian Orthotic Prosthetic Association: Ethical principles and code of professional conduct
- Royal College of Occupational Therapists: Professional standards for occupational therapy practice, conduct and ethics
- European Speech and Language Therapy Association: Professional profile
Professionalism in healthcare requires a combination of abilities, knowledge and skill to provide services to patients. This is required for good treatment results while still focusing on patient safety. (reference)[It is a combination of having abilities, knowledge and skills which are sufficient to work and provide services to patients and those on the receiving end of the health service. This is in order to efficiently achieve good treatment results while ensuring safety in receiving such services.]
Attributes and Behaviours of Professionalism[edit | edit source]
Attributes, core competencies and behaviours of professionalism include[4][7]:
- accountability
- dependability
- responsibility
- appreciation of duty
- selflessness
- commitment to excellence
- empathy
- truth
- honesty
- rectitude and integrity
- sensitivity to the needs of diverse populations
- adherence to ethical principles
- respect
- altruism
- collegiality
- continuous learning and improvement
- humility
"Professionalism emphasises humanistic aspects (attitude, behaviour, virtues and characteristics) desirable among healthcare professionals in all circumstances in addition to biomedical aspects (knowledge, clinical reasoning and technical skill)."[4]
Prerequisite qualities for professionalism include[4]:
- professional competence
- good communication skills
- trustworthy
- soft skills
- ethical codes
There seems to be an overlap between ethics and professionalism. Table 2 shows some of the overlapping principles and attributes of ethics and professionalism.
Ethical Principles | Professionalism Attributes |
---|---|
Autonomy:
Respect the patient; Rights of patient to choose or refuse treatment; Patient involved in decision making |
Respect, compassion, empathy |
Beneficence:
Decision should be made in the best interest of the patient |
Altruism, commitment to excellence |
Non-maleficence
First do no harm |
Care, sensitivity , responsiveness |
Justice
Fair selection and distribution of resources |
Integrity, truth, honesty, accountability |
Unprofessional Behaviour[edit | edit source]
Unfortunately in the clinical workplace, many healthcare professionals experience and perceive unprofessional behaviour. In a study investigating the type and frequency of perceived unprofessional behaviours among healthcare professionals it was found that 63 % experience unprofessional behaviour at least once a month. This includes behaviour such as professionals not responding to calls / requests, being excluded form decision-making and blaming behaviour.[10] Examples of unprofessional behaviours include[11]:
- Bullying
- Defined according to direction
- Lateral violence – professional against professional
- Vertical violence – bullying from the top
- Employers against employees
- Unfair work practices
- Abuse of power
- Employers against employees
- Vertical violence - bullying from the bottom up
- Employers against employees
- Strikes / work slow downs
- Refusal to follow procedures
- Employers against employees
- Defined according to direction
- Mobbing
- group “ganging up” on an individual with goal to remove individual from group or intimidating individual
- Methods used include sabotage, slander, petitions, votes of no confidence
- Toxic workplaces behaviours
- Eye rolling
- Sarcasm
- Threats
- Aggression
- Withholding important patient information
- Disrespect
- Rude
- Condescending remarks
- Scapegoating
Drivers of Unprofessional Behaviour[edit | edit source]
Bhardwaj[7] (2022) identifies some drivers of unprofessional behaviour. These are listed below.
- High or extra workload due to limited staff or resources
- Chronic fatigue
- Sleep deprivation
- Burnout
- Low self-esteem
- Personal stressors such as difficult relationships
- Unsupportive leadership
- Inadequate supervision
- Poor organizational culture and work environment
- Tolerance of unprofessional behaviour
- Bigotry
- Unconscious bias
- Tolerance for aggression
- Ill recognition for performance
- Lack of opportunity for professional growth and development
- Lack of social support systems
- Limited or constricted resources
- Loss of autonomy and decision-making capabilities
- Toxic and substance abuse
Patient Perspectives on the Professionalism of Healthcare Professionals[edit | edit source]
Regis, Steiner, Ford, Byerly have highlighted some aspects of professionalism that are highly regarded and valued by patients. These include:
Good communication
Caring attitude
Honesty
Attitude
Research into patient perspectives on the professionalism in healthcare providers have identifies four interconnected themes that describes professionalism from a patient perspective. Bulk LY, Drynan D, Murphy S, Gerber P, Bezati R, Trivett S, Jarus T. Patient perspectives: four pillars of professionalism. Patient Experience Journal. 2019;6(3):74-81.
Taking a collaborative human-first approach
Key aspects of this theme are that patients should be
perceived as a complex human who deserves to be treated as a priority
And
A vital part of the interdisciplinary team
Summary by a patient on their view of professionalism
“It’s important for people, even if they’ve been in practice a long time, to maintain some sense of humility in the face of their patient. They don’t know what it is to be the patient and to live with whatever that is that their patient has.
Clinicians must patients as humans above all so that they maintain a collaborative person-first approach to care”
Read more about person-centered care
Communicating with heart and mind
Clinicians should communicate with the hearth through demonstrating emotion and empathy and with the head through clinical reasoning and applying their clinical knowledge.
Aspects of communication that are important to patients are:
Listening
Be attentive
Implicit Communication skills such using understandable language
Clinicians should be polite and respectful,ability to develop a rapport with a patient
“Effective communication must balance pertinent information. Explicit skills (listening, building rapport, caring) and implicit skills (come from the heart, empathy)
Patients want clinicians to “think about what the patient is hearing”
Behaving with integrity
Patients expect clinicians to tell the truth
Clinicians should maintain professional boundaries
Adhere to ethical standard and maintain confidentiality
Patients ask of clinicians to be honest even if clinicians need to admit that they are uncertain or don’t have the answers. As long as they are willing to take action around their limitation in knowledge to allow for optimal care of the patient.
Practicing competently
Patients assume that their healthcare professionals are competent. This competence encompasses skill and knowledge, appropriate education and the correct licensing to practice their profession.
Frameworks
Medical Professional Framework
Eight identified components of professionalism in healthcare professionals
Humanism
Communication
Acountability
Ethics
Clinical competence
Altruism
Excellence
Integrity
CanMeds Framework
Seven different roles
Professional
Communicator
Scholar
Collaborator
Health advocate
Leader
Sub Heading 2[edit | edit source]
Sub Heading 3[edit | edit source]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
References[edit | edit source]
- ↑ Chan LY, Ganapathy S. Exploring the understanding of healthcare professionalism and perceived barriers and enablers towards the display of professionalism: a qualitative study. MedEdPublish. 2024 Mar 20;14:15.
- ↑ Merriam Webster Dictionary. Professionalism. Available from https://www.merriam-webster.com/dictionary/professionalism (last accessed 30/3/2024)
- ↑ Cambridge Dictionary. Professionalism. Available from https://dictionary.cambridge.org/dictionary/english/professionalism (last accessed 30/03/2024)
- ↑ 4.0 4.1 4.2 4.3 4.4 Desai MK, Kapadia JD. Medical professionalism and ethics. Journal of Pharmacology and Pharmacotherapeutics. 2022 Jun;13(2):113-8.
- ↑ Epstein RM, Hundert EM. Defining and assessing professional competence. Jama. 2002 Jan 9;287(2):226-35.
- ↑ Hill Jr WT. White Paper on Pharmacy Student Professionalism: What we as pharmacists believe our profession to be determines what it is. Journal of the American Pharmaceutical Association (1996). 2000 Jan 1;40(1):96-102.
- ↑ 7.0 7.1 Bhardwaj A. Medical professionalism in the provision of clinical care in healthcare organizations. Journal of Healthcare Leadership. 2022 Jan 1:183-9.
- ↑ Michalec B, Cuddy MM, Felix K, Gur-Arie R, Tilburt JC, Hafferty FW. Positioning humility within healthcare delivery-From doctors’ and nurses’ perspectives. Human Factors in Healthcare. 2024 Jun 1;5:100061.
- ↑ Michalec B, Xyrichis A, Arenson C. “Professional humility”: introducing a new framework to advance interprofessionalism. Journal of Interprofessional Care. 2024 Mar 21:1-6.
- ↑ Dabekaussen KF, Scheepers RA, Heineman E, Haber AL, Lombarts KM, Jaarsma DA, Shapiro J. Health care professionals’ perceptions of unprofessional behaviour in the clinical workplace. PLoS One. 2023 Jan 19;18(1):e0280444.
- ↑ MacLean L, Coombs C, Breda K. Unprofessional workplace conduct... defining and defusing it. Nursing Management. 2016 Sep 1;47(9):30-4.