Department of Philosophy, Macquarie University, Sydney, Australia.
J Med Ethics. 2010 Apr;36(4):250-4. doi: 10.1136/jme.2009.035121.
Professionalism remains a challenging part of the medical curriculum to define, teach and evaluate. We suggest that one way to meet these challenges is to clarify the definition of professionalism and distinguish this from medical ethics.
Our analysis is two staged. First, we reviewed influential definitions of professionalism and separated elements relating to (a) ethico-legal competencies, (b) clinical competence and (c) professionalism. In reference to professionalism, we then distinguished between aspirational virtues/values and specific behaviours. From these, we develop a working definition of medical professional behaviour consisting of six domains of behaviour: responsibility; relationships with and respect for patients; probity and honesty; self awareness and capacity for reflection; collaboration and team work; and care of colleagues. Second, we tested this working definition against empirical data concerning disciplinary action against practising doctors using (a) sources in the literature and (b) an original analysis of complaints received by the Medical Board of South Australia.
Our empirical analysis supports the relevance of four of the six potential domains: responsibility; relationships with and respect for patients; probity and honesty; self awareness and capacity for reflection. There are additional reasons for retaining 'collaboration and team work' in the medical professional behaviour curriculum but 'care of colleagues' may be better addressed in the ethico-legal curriculum. Our definition of professional behaviour is consistent with the theoretical literature, captures behaviours that predict future complaints against practitioners and is consistent with current complaints about professionalism in South Australian practitioners. This definition can further the teaching and assessing of professional behaviour in medical schools.
专业精神仍然是医学课程中一个具有挑战性的定义、教学和评估部分。我们建议，应对这些挑战的一种方法是澄清专业精神的定义，并将其与医学伦理区分开来。
我们的分析分为两个阶段。首先，我们回顾了有影响力的专业精神定义，并将与（a）伦理法律能力、（b）临床能力和（c）专业精神相关的要素分开。关于专业精神，我们然后区分了理想的美德/价值观和具体行为。从这些中，我们制定了一个医学专业行为的工作定义，由六个行为领域组成：责任；与患者的关系和尊重；正直和诚实；自我意识和反思能力；协作和团队合作；以及同事关怀。其次，我们使用（a）文献来源和（b）对南澳大利亚医学委员会收到的投诉的原始分析，针对针对执业医生的纪律处分的实证数据检验了这个工作定义。
我们的实证分析支持六个潜在领域中的四个的相关性：责任；与患者的关系和尊重；正直和诚实；自我意识和反思能力。在医学专业行为课程中保留“协作和团队合作”还有其他原因，但“同事关怀”可能在伦理法律课程中更好地解决。我们对专业行为的定义与理论文献一致，捕捉到预测未来对从业者投诉的行为，并且与南澳大利亚从业者专业精神方面的当前投诉一致。这个定义可以进一步促进医学院校的专业行为的教学和评估。
