Master the Skill of Professionalism

Original Editor - Wanda van Niekerk based on the course by Benita Olivier

Top Contributors - Wanda van Niekerk and Jess Bell  

Introduction

Self-mastery skills are valuable to all healthcare professionals. The ability to manage stress, maintain self-awareness and give and receive constructive feedback are competencies that every healthcare professional should acquire. A commitment to lifelong learning and creating a vision for personal and professional growth contribute to professionalism. By mastering these skills, healthcare professionals can achieve success and make a difference to the lives of every patient they treat.

Stress Management for Personal Well-being

Unprofessional Behaviour and Stress

Unprofessional behaviour in healthcare affects patient safety by negatively influencing interprofessional communication and the clinical environment. This can lead to adverse events and errors in care. Healthcare professionals subjected to unprofessional behaviours can have increasing self-doubt and lower morale. This can all contribute to burnout. Dabekaussen et al. states: "Recognising that unprofessional behaviours may exacerbate by increasing workloads and stress, potentially leading to burnout, is needed to address the existing well-being crisis among healthcare professionals."

Burnout in Healthcare Professionals

"Burnout is an exhaustion of physical, emotional and mental domains, a condition resulting from a long-term commitment to emotionally challenging related work." Key factors of burnout are fatigue and exhaustion on a personal level, a work-related level or a client/patient-related level. Burnout is associated with:

• higher risk for cardiovascular disease
• overall mortality
• alcohol abuse
• broken relationships
• premature retirement
• depression
• anxiety
• sleep disturbance
• suicide
• higher medical errors due to poor decision-making
• poor adherence to clinical guidelines
• hostile relationships with patients and colleagues
• negative attitudes
• detachment from work
• high turnover rates
• medical leave
• absenteeism

If you'd like, you can read more about burnout and wellbeing here.

Personal Well-being

"Personal well-being encompasses physical, mental and emotional health as well as a sense of balance and fulfillment in one's personal and professional life."

If you're interested in learning more, you can read about stress and health here.

Stress Management Strategies for Healthcare Professionals

Stress management strategies can include:

• self-care practices
• mindfulness and relaxation techniques
  • please read these articles if you'd like to learn more:
    • Mindfulness for Clinicians
    • Relaxation Techniques
• effective time management
  • you can find some valuable tips on time management and productivity here
• adaptability and flexibility
• resilience and well-being
• establishing healthy boundaries
• social support networks

Self-awareness and Self-assessment

Self-awareness is "the conscious knowledge of one's thoughts, feelings, behaviours and values" and understanding that this can influence our daily personal and professional interactions. Another description can be "an interpersonal process of self-discovery."

Self-awareness can allow healthcare professionals to recognise their:

• potential
• temperament
• stress management abilities

Healthcare professionals who are self-aware are able to provide culturally competent care to diverse patient populations. As a healthcare competency, it can improve:

• decision-making skills
• critical thinking skills
• forming of therapeutic relationships
• holistic and patient-centred care

Strategies for Self-awareness and Self-assessment

Strategies to cultivate self-awareness and self-assessment may include:

• reflective practice
  • a study investigating how engaging in reflective practice can impact the self-care of emerging clinicians found the following:
    • clinicians were better at caring for themselves on a personal and professional level
    • improved emotional health
    • increased satisfaction, sustainability and longevity in their job as a clinician
    • decreased burnout
  • if you'd like, you can read more about clinical reflection here
• feedback and peer review
• cultural competence and diversity training
  • you can read more about cultural competency and sensitivity here

Benefits of Self-awareness for Healthcare Professionals

The benefits of increased self-awareness by healthcare professionals include:

• enhanced communication skills
• heightened awareness of ethical decision-making
• sense of accountability to oneself
• improved team collaboration

Furthermore, increased self-awareness has positive effects on:

• self-confidence
• decision-making
• people management
• stress management

Use of Constructive Feedback

Constructive Feedback Frameworks

Using constructive feedback frameworks may help a person stay on track with the feedback they want to give. It may also help avoid unnecessary drama and emotions that sometimes appear when feedback is given. Table 1 highlights a few constructive feedback models and an explanation of each model. The different frameworks are also applied to a single example: a senior therapist has to provide feedback to another therapist who regularly runs behind with appointments, causing delays and patient frustration.

Table 1. Constructive Feedback Models

Feedback Model	Explanation	Example
"Feedback sandwich"	Feedback begins and ends with positive feedback and the more "critical" feedback is sandwiched in the middle	"I appreciate your expertise and commitment to providing quality care. However, the delay in starting appointments today caused some frustration for patients who had to wait. Going forward, better time management or overbooking safeguards could help ensure that appointments run according to the schedule."
Situation - Behaviour - Impact (SBI) model	Situation - describe the situation and the details of what occurred Behaviour - explain the observed behaviour, which you would like to address Impact - describe the impact of the behaviour on the clinic, colleagues, patients, etc.	Situation - "During today's appointment schedule, several patients had their appointment times delayed by 20 to 30 minutes" Behaviour - "The appointments were running behind schedule because some earlier appointments took longer than their allocated time" Impact - "As a result, patients who were here on time for their appointments became frustrated by the lengthy waiting times. A few patients even left before being seen due to the delays"
Chronological feedback model	This model "focuses on reflecting observations chronologically"	"Earlier today, I noticed that your 9 am appointment ran over by about 20 minutes. Then, when Mr. X arrived at 9:30 am for his 9:30 slot, he had to wait 25 minutes to be seen. By 10:30, a few patients were waiting to be called and some expressed frustration over the delays. A few patients couldn't wait any longer and ended up rescheduling. In the future, it may help to start appointments promptly and tell patients of significant delays so they have the option to reschedule if needed. Building some more buffer time into your schedule may help prevent this domino effect of increasing waiting times."
Pendleton model	Ask the therapist what was good in their performance State areas of agreement and elaborate on good performance Ask the therapist what was poor or could have been improved State areas that you think could have been improved	"How did you feel today's appointment schedule went in terms of running on time? What was good in your performance today? ... Yes, you are right, some lengthy delays led to extended waiting times. You remained professional and composed even as the schedule fell behind. You gave each patient your full attention during their appointments. The first few appointments ran over, affecting the schedule. Patients were not updated on the delay as the morning went on. I would recommend that you give yourself some more buffer time between appointments, and provide waiting patients with status updates on delays. If the delays become excessive, consider offering to reschedule some appointments. What are your thoughts and do you have any other ideas for improving appointment timeliness?"

There are many more frameworks available. If you're interested in learning more, you can read the following articles for more detail on these, and other, frameworks.

• How to give and receive feedback effectively.
• Common models and approaches for the clinical educator to plan effective feedback encounters.

Tips on Providing and Receiving Constructive Feedback

Table 2. Tips on Providing and Receiving Constructive Feedback (adapted from Hardavella et al.)

Tips on providing constructive feedback

Plan ahead or in advance Use a balanced approach - positive affirmations with areas for improvement Give prompt and timely feedback Know what you want to achieve with feedback and drive the conversation accordingly Preferably provide feedback in a one-on-one conversation Start gently Be specific Be supportive Encourage an open dialogue Encourage self-reflection Be aware of non-verbal clues and cues Self-reflect on the feedback session afterwards

Tips on receiving constructive feedback

Be a good listener Ask for clarification if you do not understand See this feedback as a learning opportunity Pause and think before responding Do not jump to conclusions hastily, show that you are invested in the learning process and that you are keen to improve your skills Stay open-minded and receptive Stay positive and open to helpful hints, tips and tricks Learn from your mistakes Stay motivated Show appreciation Reflect on feedback Be proactive

Commitment to Continual Learning and Professional Development

Strategies to Embrace Continual Learning

Strategies can include:

• formal education and training
  • for example, advanced degrees, certification and specialised training programmes
• other professional development opportunities
  • for example, workshops, conferences, seminars and webinars
• self-directed learning
  • for example, taking the initiative to read up on relevant literature, completing online courses in your own time
• mentorship and collaborative learning
  • for example, mentorship programmes and collaborative learning opportunities with colleagues
  • if you would like to learn more about mentorship, please see Introduction to Mentorship

Professional Development Planning

Some tips on creating an effective professional development plan include:

• self-assessment and reflective practice
• goal setting
• identification of learning opportunities
• networking and mentorship
• integration into daily practice