Professional Values

Original Editor - Wanda van Niekerk based on the course by Andrea Sturm

Top Contributors - Wanda van Niekerk and Jess Bell  

Introduction

Values are fundamental beliefs about what individuals and social groups regard as morally right or worthwhile. They typically remain consistent over time, with change only occurring through sustained social and learning experiences. Values can be regarded as broad guiding principles that apply across many different contexts. For example, a value such as honesty can shape behaviour in various settings, including family environments, educational institutions, and professional situations.

Values influence an individual’s behaviour and how they evaluate others’ choices and actions. Everyone holds multiple values, but not all are considered simultaneously in each scenario. For example, a patient who values autonomy might particularly draw upon this value when confronted with a situation that restricts their freedom of choice.

Values function and overlap across different identity levels (personal, professional, and cultural). Certain values are shared by an entire group of professionals, while other values reflect an individual’s priorities.

Personal and Professional Values

Decisions on patient care are influenced by a healthcare professional’s personal and professional values. Personal values shape an individual’s behaviour and choices, while professional values guide their behaviour as a member of an occupational or professional group. Professional occupation groups carefully and deliberately select the values that define the group’s collective identity, principles and beliefs. These values are usually set out in a profession’s code of ethics or code of conduct and the group members agree that these values are important.

Personal values develop from a young age through learning from family, community interactions and educational experiences. This process of socialisation allows individuals to acquire the “skills, behaviours, values and norms important for a person to function as a member of a given society.” Professional values are acquired and developed at a later stage when an individual joins professional environments. When healthcare professionals enter their selected profession, they bring their personal values with them. They then learn professional values through formal education, observing role models and taking part in mentorship programmes.

Some personal values may already align with professional values, while others may change or adapt to fit with professional responsibilities and identity. Although different healthcare professions may prioritise different values, the process of socialisation appears to be similar across professions.

The relationship between personal and professional values is both complex and interconnected. Professional values guide and influence professional behaviour; however, an individual’s personal values remain significant in daily life and also impact their professional practice. Often, professional and personal values complement each other, but there are times when these two value systems clash, especially in situations where professional values differ from an individual’s personal values. This leads to “personal-professional value conflicts.”

Context always matters, particularly when there is a conflict between the specific values influencing a clinical decision. Healthcare professionals may find it challenging to separate their personal values and convictions from their professional values and responsibilities. When these situations occur, professionalism requires clinicians to reflect on their values and potential conflicts. This ensures that patient-centred decision-making remains at the forefront.  

Value Models

Schwartz (1992) described ten broad values in his values model. These values are power, achievement, hedonism, stimulation, self-direction, universalism, benevolence, tradition, conformity and security. These values are defined as motivational goals (see Table 1). Even though the list of personal values may be limitless, research has shown that a value generally fits into one of these ten broad value types. Moyo et al. translated these values into the context of personal and professional values of healthcare professionals. Table 1 compares the value models by Schwartz and the translation of these values to the personal and professional values of healthcare professionals.

Table 1. Description of Schwartz's values model and Moyo et al.'s translation of these values to healthcare professionals' personal and professional values

Schwartz Value Model		Value Model for Healthcare Professionals
Value	Goal Definition	Value	Goal Definition
Achievement	Personal success through demonstrating competence according to social standards	Capability	Competence, knowledge and research values
Benevolence	Preserving and enhancing the welfare of those with whom one is in frequent personal contact	Altruism	Caring, helping, emphathy, altruism, compassion
Conformity	Restraint of actions, inclinations and impulses likely to upset or harm others and violate social expectations or norms	Professionalism	Adherence to standards and professional code, self-discipline, professional behaviour, accountability, self-awareness, team-work and ethical behaviour
Hedonism	Pleasure or sensuous gratification for oneself	Pleasure	Pleasure from medicine or dentistry (i.e. healthcare profession)
Power	Social status and prestige, control or dominance over people and resources	Authority	Leadership, social or professional status, structure or hierarchy and medical authority or paternalism
Security	Safety, harmony, and stability of society, relationships and self	Safety	Confidentiality, patient privacy, patient safety, protection of public from unsafe health products or practices, providing safe and competent care, protection of the environment, emotional stability, prudence, vigilance, self-protection, financial stability
Self-direction	Independent thought and action—choosing, creating, exploring	Critical thinking	Self-direction values: freedom, independence, autonomy, education and self-direction for the patient. Self-oriented values for self-direction included critical thinking, problem-solving, imagination and creativity, objectivity, self-regulation and control of one's work
Stimulation	Excitement, novelty and challenge in life	Intellectual stimulation	Personal and intellectual stimulation and an "exciting life"
Tradition	Respect, commitment and acceptance of the customs and ideas that one's culture or religion provides	Morality	Honour, integrity, honesty, morality, duty, humility, temperance, ethics, grounded in culture and history
Universalism	Understanding, appreciation, tolerance and protection of welfare of all people and for nature	Equality	Acceptance of others, respect for others, advocacy, equality, equity, social justice, upholding human dignity and patient rights, charity, socialism, solidarity and humanism

Professionalism as a Core Value

Professionalism stands as a fundamental value within the medical culture, emphasising behaviours like honesty, trustworthiness, prioritising patients' needs over personal interests, striving for excellence, and being accountable to both patients and colleagues. It encompasses various aspects, including: the establishment of core values and moral principles, the acquisition of self-reflection and self-regulation skills, and learning how to coexist within a community of practice.

The American Physical Therapy Association (APTA) has developed core values that outline specific professional values for its members. These values are widely accepted and adopted by other world regions. The core values include: accountability, altruism, collaboration, compassion and caring, duty, excellence, inclusion, integrity and social responsibility. If you would like to learn more, you can read about these values here: Core Values for the Physical Therapist and Physical Therapist Assistant.

Global Research Insights on Professional Values of Physiotherapists

Research shows interesting patterns in how professional values are understood across different cultures and career stages. These findings highlight differences between students and experienced clinicians.

Student Insights

Professional values are an important building block and contributor to ethics, playing a key role in the development of a profession. Students bring their own set of personal values when they attend university, but these may not ensure the development of professional values. Clinicians are bound to experience ethical dilemmas throughout their different career stages, and the advancement of professional values in student education is crucial to assisting in the resolution of these ethical dilemmas. Research shows that professional values influence how physiotherapy students approach professional ethics, making increased awareness of these values essential for promoting positive ethical attitudes.

In one study, physiotherapy students identified several professional values as essential, including: benevolence, equity and non-discrimination, prudence, respect for life and respect for the autonomy of users. However, other important values, such as altruism, diligence, empathy and compassion, along with scientific quality and knowledge, were not considered compulsory values.

In another study, Canadian physical therapy and occupational therapy students were asked to define professionalism from their perspectives. They viewed professionalism as a multi-dimensional and context-specific concept. For these students, professionalism is shaped by an interplay of factors, such as context, relationships, personal characteristics, and societal demands. Values across three dimensions were identified as follows:

• relational dimension: communication, respect, honesty, trust, and collaboration
• personal dimension: integrity, honesty, dignity, self-regulation, and motivation
• societal dimension: accountability, responsibility, advocating, and educating 

Research also highlights an interesting pattern in how students prioritise different values. Physiotherapy students deem the values of altruism and compassion as less important than the values of social responsibility, integrity and excellence, whereas qualified and more experienced clinicians deemed all professional values of the American Physical Therapy Association (including altruism and compassion) as important. This suggests there may be a lack of awareness regarding the importance of altruism and compassion among students, but this changes with professional experience.

Qualified Clinicians

A study on the ethical behaviour of physiotherapists in professional practice had several important findings. It found that the ethics of the clinical relationship between the therapist and patient are mainly determined by the therapist's attitudes, which stem from their personal values and experiences. This study showed that many professional physiotherapists focus on "ethics of indication", which is mainly founded on the principles of benevolence and non-maleficence. A shift toward a model of shared responsibility that better incorporates patient autonomy, freedom and judgment is necessary.

McGinnes et al. researched the development and integration of the professional core values of physiotherapists. They found that personal values were the foundation for the development of professional values, further experiences shaped professional values and that the "development and integration of core values into practice are independent of practice setting and varied career paths." This implies that these professional core values apply to diverse settings and provide strong overarching guidance, making them very useful across different healthcare contexts.

The Polish Chamber of Physiotherapists identified eight basic moral values: professionalism, care, fairness, dignity, autonomy, responsibility, trust and professional integrity. Research by Skiba and Pedzek found that sex/gender can influence a person's perceptions of these moral values. For example, women more often chose fairness as a key value while more men the chose ethics of care. This is interesting as it seems to be different to the traditional patterns seen in research. Workplace also had an impact—physiotherapists in private practice showed stronger adherence to moral values and greater autonomy compared to their public sector colleagues. Experience was another important factor. More experienced physiotherapists (i.e., over 10 years of clinical practice) depicted stronger moral attitudes than newer qualified physiotherapists. This study also showed that knowing the professional ethics codes did not have a significant impact on moral behaviour. This suggests that professional values and ethical practice may develop more through experience and workplace culture.

To summarise, key findings from the research include:

• professional values develop and strengthen through clinical experience
• students often undervalue altruism and compassion compared to experienced clinicians, suggesting that these core values require targeted educational attention
• professional values provide consistent guidance across different clinical settings and career paths

Professional Values and Culture

Rehabilitation professionals should have the ability to reflect on their personal and professional values and those of their patients in different settings. They need to recognise that people around the world have different cultural views about health, illness and healing. They should learn to work effectively within different cultural frameworks.

While rehabilitation professionals aim to follow professional values and act in a patient's best interest, they should also consider their professional boundaries. Patient welfare also needs to be balanced with practical realities. The ethical reasoning bridge is an ethical reasoning framework that supports mutual understanding and transformative learning within the therapeutic relationship. It provides a structured approach to navigating complex situations. If you would like to read more about this framework, please see: Ethical Reasoning Bridge.