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Professionalism and Revalidation

This article explores the concept of professionalism in the medical field, emphasizing its crucial role in maintaining public trust. It defines professionalism through key attributes such as integrity, compassion, and continuous improvement, and highlights the partnership between doctors and patients based on mutual respect. The historical context, current expectations, and challenges in measuring professionalism are discussed, alongside the importance of regulatory frameworks to ensure accountability. By instilling professionalism as a core competency in training, the healthcare system can enhance the quality of care provided to patients.

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Professionalism and Revalidation

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  1. Professionalism and Revalidation Day release 3/11/09

  2. Perspectives • “Professional men they have no cares; whatever happens they get theirs” • Ogden Nash • “All professions are conspiracies against the laity” • George Bernard Shaw • Pearly gates

  3. TASK! • Professionalism: what do you understand by it? • List & describe attributes or qualities which make up professionalism • Come up with a definition of professionalism • What do you think the public understands by professionalism?

  4. Professionalism-what is it? • Medical professionalism signifies a set of values, behaviours, and relationships that underpins the trust the public has in doctors • Medicine is a vocation in which a Dr’s knowledge, clinical skills, and judgement, are put in the service of protecting and restoring human well-being. This purpose is realised through a partnership between patient & Dr, one based on mutual respect, individual responsibility,& appropriate accountability • Royal College of Physicians 2005

  5. In their practice, Drs are committed to: • Integrity • Compassion • Altruism • Continuous improvement • Excellence • Working in partnership with members of the wider healthcare team • RCP 2005

  6. What’s in a word? • Professional: • Opposite of amateur-paid • Military-ruthless efficiency • Hitman-as above • Sport-”professional” foul

  7. Hippocrates • “father of medicine” • Practised around 420BC • Closed societies on island of Cos-medicine competed • Oath contains elements of the Dr as an altruistic healer • Also reinforces idea of the closed shop-mysteries of health only to be known by the privileged few

  8. North America • Defines professionalism in education & practice • Since 1999 all specialist training has incorporated professionalism as a core competency

  9. NHS report by the National Clinical Assessment Service 2009 • Professionalism is comprised of 6 domains: • Competency; encompassing knowledge, skills & ethics, & their application in practice • Personal relationships; communication, teamworking • Professional boundaries; awareness, conflicting roles, friends • Consistency & reliability of practice; mistakes (no. or judgement) • Reflection & learning; for the Dr & delegated tasks • Commitment to service; private behaviour, personal beliefs

  10. Ct • “In conclusion, professionalism is more than being competent & must • cover all domains as well as leadership & integrity; it should be embedded • in policy, standards & guidelines to ensure compliance. Managing • perceived deficiencies in professionalism requires expertise, & a • structured, transparent process, paying proper regard to the rights of all • involved, who themselves should receive the support they need” • NCAS 2009

  11. Professionalism under threat • Due to: • Incidents-Bristol, Shipman • Expectations-public, government, new developments • Demand-politics, population changes, innovations • Managerial control-strategies, targets, budgets • Teamworking-loss of control, appropriate delegation • Legislation-working hours, equality & diversity

  12. Licensure • A regulative bargain whereby: • “Society grants the profession autonomy in return for the profession guaranteeing standards of care and safety” • Because………… There is such an unusual degree of knowledge of skill that non professionals are not equipped to evaluate or regulate Professionals are responsible A profession will take regulatory action incases of incompetent or unethical practice

  13. So.. What do we expect of professionals • Good at their day to day job (performance) • Able to deal with rarer and more unusual facets (keeping up to date) • Someone we can trust (the right sort of person) • “An individual who acts on behalf of another in situations of complexity and uncertainty”

  14. Can it be measured? • Day to day work – GPs diagnose and manage. (audit, SEA) • Deal with rare but important – knowledge test / CPD • Can be trusted - views of patients / colleagues / complaints

  15. For what purpose? • To attest those on the Specialty Register have the knowledge, skills and behaviours required of their discipline • To encourage excellence / CQI • To determine when targeted help is needed • To build public confidence in the system

  16. Assessment of professionalism • Students moral reasoning • Not measured=not valued • Context • Include conflict • Resolve dilemmas-rarely black & white • Formative/summative • Multiple raters/triangulation: clinical competence/communication skills/ethical & legal understanding as foundation. Excellence/humanism/accountability/altruism as pillars. All leading to professionalism

  17. Darzi (NHS next stage review) • Over regulation can damage morale • Dismiss regulation as an organising principle • Replace regulation with quality, as defined by clinical effectiveness, patient safety & patient experience • Devolve power to regions • Use professionalism as a lever to raise standards • Reduce professional boundaries • Innovation & research • Leadership development to make the NHS work

  18. TASK • Dilemmas/scenarios

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