Professionalism in Medicine: Critical Perspectives (Google eBook)

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Springer Science & Business Media, Aug 18, 2006 - Education - 288 pages
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The topic of professionalism has dominated the content of major academic medicine publications (e.g. Journal of the American Medical Association, New England Journal of Medicine, Academic Medicine, Annals of Internal Medicine, The Lancet) during the past decade and continues to do so. The message of this current wave of professionalism is that medical educators need to be more attentive to the moral sensibilities of trainees, to their interpersonal and affective dimensions, and to their social conscience, all to the end of skilled, humanistic physicians. Urgent calls to address professionalism from such groups as the Association of American Medical Colleges (representing the nation's 126 accredited medical schools and nearly 400 major teaching hospitals), the American Board of Internal Medicine, and the Accreditation Council for Graduate Medical Education, among others. In fact, at the 2004 annual meeting of the AAMC six separate presentations addressed professionalism with such titles as 'Evaluating Humanism and Professionalism,' Professionalism: Expectation, Education, Evaluation,' or 'Toward Assessing Professional Behaviors of Medical Students through Peer Observations' (note the preoccupation with assessment). Professionalism, then, has become part of the current academic medicine parlance, used by administrators, clinical faculty, residency programs, and professional organizations with an expectation of shared meanings and goals. All of these stakeholders focus on what has become a consistent list of attributes deemed to be the essence of professionalism, which usually include variations on altruism, duty, excellence, honor and integrity, accountability, and respect. In fact, most of the scholarly work to date has been listing (attributes of professionalism), describing (activities that may foster it), decrying (the environment that works against it), and measuring/evaluating it. In this collection of essays, we donít argue with these attributes. Instead, we ask questions of the discourse from which they arise, how the specialized language of academic medicine disciplines has defined, organized, contained, and made seemingly immutable a group of attitudes, values, and behaviors subsumed under the label 'professional' or 'professionalism.' This collection aims to be a critical text, one that questions the professionís beliefs about the nature of its work and how such beliefs are enacted (or not) in medical education, particularly as they fuel the professionalism discourse. In addition, we will scrutinize how the discourse is enacted in both the formal and hidden curriculum, and in the larger medical environment.
  

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Contents

Introduction
Conceptualizing Professionalism
2
The Complexities of Medical Professionalism A Preliminary Investigation
3
An Analysis of the Discourse of Professionalism
24
Professionalism Curriculum Goals and Meeting Their Challenges
43
Teaching Professionalism
60
Medical Professionalism The Nature of Story and the Story of Nature
63
Respect for Patients A Case Study of the Formal and Hidden Curriculum
87
Assessing Professionalism
162
Educating for Professionalism at Indiana University School of Medicine Feet on the Ground and Fresh Eyes
163
The Problem with Evaluating Professionalism The Case against the Current Dogma
185
How Medical Training Mangles Professionalism The Prolonged Death of Compassion
199
Wit is Not Enough
211
Professionalism and the Heisenberg Uncertainty Principle
233
Coda
255
List of Contributors
261

You Say SelfInterest I Say Altruism
102
The Role of Ethics within Professionalism Inquiry Defining Identity and Distinguishing Boundary
129
Medical Professionals and the Discourse of Professionalism Teaching Implications
148

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