Healthcare Professionalism Improving Practice through Reflections on Workplace Dilemmas

Healthcare Professionalism: Improving Practice through Reflections on Workplace Dilemmas provides the tools and resources to help raise professional standards within the healthcare system. Taking an evidence and case-based approach to understanding professional dilemmas in healthcare, this book examines principles such as applying professional and ethical guidance in practice, as well as raising concerns and making decisions when faced with complex issues that often have no absolute right answer.

Key features include:

• Real-life dilemmas as narrated by hundreds of healthcare students globally
• A wide range of professionalism and inter-professionalism related topics
• Information based on the latest international evidence

Using personal incident narratives to illustrate these dilemmas, as well as regulatory body professionalism standards, Healthcare Professionalism is an invaluable resource for students, healthcare professionals and educators as they explore their own professional codes of behaviour.

About the authors

Lynn V. Monrouxe is Professor and Director of the Medical Education Research Centre at Chang Gung Memorial Hospital, Linkou, Taiwan.

Charlotte E. Rees is Professor and Director of Health Professions Education and Education Research (HealthPEER), and Director of Curriculum (MBBS), Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia.

Foreword xi

About the Authors xiii

Acknowledgements xv

Author Contributions xvii

1 Introduction 1

References 4

2 What is Healthcare Professionalism? 7

Introduction 8

Who is Responsible for Setting Professionalism Codes of Conduct? 8

What is the Ethical Basis of Healthcare Professionalism? 10

How is Professionalism Understood Across Regulatory Bodies’ Codes of Conduct? 12

How is Professionalism Linguistically Framed Across Healthcare Professionalism Codes of Conduct? 15

What are Stakeholders’ Understandings of Professionalism Across Different Country Cultures? 16

What are Students’ Understandings of Professionalism Across Country Cultures? 19

Professionalism: Embodied Identities? 23

Chapter Summary 25

References 26

3 Teaching and Learning Healthcare Professionalism 31

Introduction 32

Why Teach and Learn Professionalism? 32

What is a Curriculum? 33

How is Professionalism Taught and Learnt? 35

What Curricula‐related Professionalism Dilemmas do Healthcare Students Experience? 42

Chapter Summary 45

References 46

4 Assessing Healthcare Professionalism 51

Introduction 52

Why Assess Professionalism? 52

How is Professionalism Assessed? 53

What are the Key Challenges Facing Professionalism Assessment? 56

What Assessment‐related Professionalism Dilemmas are Learners Experiencing? 58

Chapter Summary 65

References 67

5 Identity‐related Professionalism Dilemmas 71

Introduction 71

How do Professional Identities Relate to Learning? 72

Are Professional Identities Easily Developed? 73

What are the Consequences of Professional Identities? 74

What are Identity‐related Professionalism Dilemmas? 75

What Identity‐related Professionalism Dilemmas Occur Across the Pre‐university to Year 1 Transition? 76

Identity Dilemmas Across Undergraduate Healthcare Education 78

Identity Dilemmas Across Transitions into Practice 81

Emotional impact and resistance 82

Chapter Summary 83

References 85

6 Consent‐related Professionalism Dilemmas 89

Introduction 90

What is Consent and why does it Matter? 90

What are the Common Myths about Patient consent for student involvement in their care? 93

What are Common Consent‐related Professionalism Dilemmas? 97

What is the Impact of Consent‐related Professionalism Dilemmas? 100

How do Students Act in the Face of Consent‐related Professionalism Dilemmas? 102

Chapter summary 103

References 105

7 Patient Safety‐related Professionalism Dilemmas 109

Introduction 110

How Have Patient Safety and Associated Terms been Defined? 110

What are the Factors that can Influence Patient Safety in the Workplace? 111

What Types of Patient Safety‐related Dilemmas Occur Across Different Healthcare Professions? 113

How can Healthcare Learners’ Actions and Roles Develop a Positive Workplace Culture of Patient Safety? 119

Chapter Summary 122

References 123

8 Patient Dignity‐related Professionalism Dilemmas 127

Introduction 128

What is Patient Dignity? 128

Why Does Patient Dignity Matter? 129

What are Dignity Violations and How do they Arise? 130

What Patient Dignity‐related Professionalism Dilemmas do Healthcare Learners Witness or Participate in? 133

What is the Impact of Patient Dignity‐related Professionalism Dilemmas? 139

How do Learners Act in the Face of Patient Dignity‐related Professionalism Dilemmas? 140

Chapter Summary 142

References 143

9 Abuse‐related Professionalism Dilemmas 145

Introduction 146

What are Equality, Diversity and Dignity at Work and Why Do They Matter? 146

What is Workplace Abuse and its Relationship with Power? 149

What are the Causes of Workplace Abuse? 151

What are the Consequences of Workplace Abuse? 152

What Abuse‐related Professionalism Dilemmas do Healthcare Learners Experience? 152

How can Workplace Abuse be Prevented and Managed? 158

Chapter Summary 160

References 161

10 E‐professionalism‐related Dilemmas 167

Introduction 168

What are the Benefits of OSNs for Professionalism? 168

What are the Challenges of OSNs for Professionalism? 169

What is E‐professionalism and Why is it Important? 170

What E‐professionalism Lapses do Healthcare Learners Commit? 172

What are the Repercussions for E‐professionalism‐related Lapses? 176

What are the Psychological, Social and Technological Factors Associated with Social Media Use? 177

What are the Regulatory Recommendations for the Prevention and Management of E‐professionalism Lapses? 180

Chapter Summary 181

References 182

11 Professionalism Dilemmas Across National Cultures 187

Introduction 188

What is Culture? 188

What Different Cultural Dimensions are there? 189

What are Eastern and Western Cultural Spaces? 191

How can we Develop Cultural and Intercultural Capability? 195

What are the Professionalism Dilemmas Across Different Cultural Spaces? 198

How are Situations Culturally Interpreted? Intercultural Dilemmas on Medical Electives by Western Students 202

Chapter Summary 204

References 205

12 Professionalism Dilemmas Across Professional Cultures 207

Introduction 208

What are the Roles of Different Healthcare Professionals? 209

How do Professionalism Dilemmas Compare Across Healthcare Students? 211

Interprofessional Dilemmas: Hierarchies, Roles and Conflict 214

How do Dilemmas Around Role Boundaries Come About? 218

What are Students’ Reactions and Actions in the Face of Interprofessional Dilemmas? 219

How can Interprofessional Conflict be Managed? 220

Chapter Summary 222

References 224

13 Conclusions 227

Power, Hierarchy, Conformity and Resistance 227

Negative Emotions, Empathy and Moral Distress 228

Looking Forward: Education, Training and Practice 229

Looking Forward: Research 231

Looking Back: Researcher Reflexivity 232

Coda 233

References 234

Afterword: Healthcare Professionalism: Improving Practice through Reflections on Workplace Dilemmas 237

Index 241

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