Dissertations / Theses on the topic 'Medical professionalism'
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Arnold, Joanna Colleen. "Medical Professionalism as Developmental Transformation." Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/203032.
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In the past decade, designing educational environments to support medical professionalism and the development of a professional identity have become prominent issues among medical educators. This dissertation argues that medical professionalism and the construction of a professional identity is a development process. In order for students to acquire this professional identity, educators must understand the tasks associated with this development, the interaction of multiple developmental domains and the role of educational learning environments in shaping the development of professionalism.This case study describes the journey of thirty two medical students as they moved through one year of their medical education. Data for this study were collected over a one year period. Each participant engaged in two interviews that occurred over one year of his/her medical education. Collectively, the experiences documented in these interviews represent all four years of medical education.The interviews were based on the self-authorship interview (Baxter Magolda&King, 2007). Observations and engagement with students in a variety of settings were used to refine and expand insights gained from interviews and to more fully understand participants' actions and intentions in a variety of contexts. The data from interviews and observations were analyzed using the constant comparative method (Glaser&Straus, 1967).Three phases in the journey toward medical professionalism and the construction of a professional identity emerged from the participants' descriptions of their experiences. During this journey, the domains of knowledge, self and others played an important role in students' development. As students moved through the phases of their journey, each of these domains underwent qualitative changes that contributed to the development of medical professionalism and the construction of a professional identity. Throughout this journey, institutional, extra-curricular and personal contexts exposed students to a variety of forces that served to propel students forward in their development.Implications of this study suggest the investigation and documentation of the developmental nature of medical professionalism is an area worthy of continued study. In addition, a careful examination of the learning environment of the first two years is necessary in order to better support and guide students' on this educational journey.
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Lolley, Sarah. "Medical professionalism and the fictional TV medical drama House MD." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=112537.
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This thesis is an exploration and analysis of what audiences may be learning about medical professionalism from the fictional television (TV) medical drama House MD. Fictional TV medical dramas are an important form of medical narrative in that they are usually created by writers with no medical training. As such, they carry a higher risk of portraying the practice of medicine inaccurately. A review of the scholarly literature reveals that there is a precedent for fictional TV medical dramas to affect viewers' perception of the practice of medicine and health behaviours, and viewers' understanding of medical ethics issues. It also reveals strong empirical evidence that TV medical dramas can affect audience's perceptions of physicians' character. A thorough review of the first two seasons of House MD reveals 20 lessons on professionalism (i.e. lessons on interactions with colleagues and patients, medical ethics, and professional competence) that the title character, Gregory House, is imparting to viewers. All 20 lessons are in direct conflict with established charters on professionalism. Arguments are made for the programme's potential to negatively affect patient access to care, physician-patient relations, interactions between healthcare professionals, and applications to medical school.
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O'Sullivan, Anthony John Public Health & Community Medicine Faculty of Medicine UNSW. "Assessment of professionalism in undergraduate medical students." Awarded by:University of New South Wales. Public Health & Community Medicine, 2007. http://handle.unsw.edu.au/1959.4/40754.
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This thesis investigates professionalism in undergraduate medical students. Professionalism is comprised of values and behaviours that underpin the contract between the public and the medical profession. Medical errors are reported to result in significant morbidity and are in-part related to underdeveloped professionalism. The aim was to determine whether aspects of professionalism were underdeveloped in medical students. A questionnaire with 24 clinical and medical student vignettes was taken by Year 2, 4, and 6 medical students from UNSW Medicine 3801 and their responses where compared to responses from practicing Clinical Academics. Second, fourth and sixth Year medical students' responses differed from Academics in two aspects of professionalism, firstly, high ethical and moral standards and secondly, humanistic values such as integrity and honesty. A second component of this thesis was to determine whether student's responses to professionalism changed as they progressed through the medical program. Year 2 and 4 students had very similar responses except for the aspect responsibility and accountability. Similarly, the Year 2 and 6 students differed in only two of eight aspects of professionalism, that is, high ethical and moral standards and humanistic values and responsibility and accountability. These findings suggest that students' approaches to some aspects of professionalism do change slightly as they progress through a medical course, however there does not appear to be a clear decline or development of professionalism as a whole. Responses from the Year 2, Medicine 3801 and Medicine 3802 (new medical program) medical students were compared and no statistically different responses. This finding would indicate that professional behaviour was very similar between these two groups of students. Certain aspects of professionalism seem to be underdeveloped in medical students compared with Academics. These aspects of professionalism may need to be targeted for teaching and assessment in order that students develop as professionally responsible practitioners. In turn, students with well-developed professionalism may be less involved in medical error, and if involved they may have the personal values which can help them deal with error more honestly and effective.
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Finn, Gabrielle Maria. "Anatomy and professionalism in an undergraduate medical curriculum." Thesis, Durham University, 2010. http://etheses.dur.ac.uk/539/.
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Name: Gabrielle Maria Finn Title of thesis: Anatomy and professionalism in an undergraduate medical curriculum Higher degree for which submitted: Doctor of Philosophy (PhD) Year of submission: 2010 This thesis describes two themes within the undergraduate medical curriculum; innovations in anatomy teaching, and the assessment of professionalism. Methodologies from both the quantitative and qualitative paradigms were utilised. The main findings were: 1) The Virtual Human Dissector™ (VHD) was shown to be equally as effective as cadaveric prosections as a tool for learning cross-sectional anatomy. 2) Body painting was demonstrated as being a highly motivating and engaging exercise for students. Students reported that the bold colours and kinaesthetic nature of body painting promotes retention of knowledge and informed their approach to future patients when painting was coupled with simultaneous peer-physical examination (PPE). 3) Contextual learning and simulation were shown to directly impact upon retention of knowledge through the use of clothing in anatomy education. This highlighted how when implementing simulation small and seemingly trivial details, such as clothing, are important. 4) The Conscientiousness Index (CI) has been demonstrated as an objective and scalar measure of one element of professionalism, conscientiousness. The CI identified students at the positive and negative end of the behavioural spectrum, and this correlated with peer and staff judgements on the professionalism exhibited by students at these extremes of behaviour. 5) Students were able to accurately assess the conscientiousness of their peers, however were unable to self-assess conscientiousness. The reliability of such peer assessments was improved when peers assessed only those in their tutor groups, with whom they had the majority of academic contact, compared to when assessing the entire cohort. This demonstrated the importance of assessor familiarity in assessments. 6) Critical incident reporting, of extremes in professionalism, was shown to promote reflection in students. Critical incident reports, as with the Conscientiousness Index, offers faculty a tool by which outlying students can be identified. 7) Students were unclear about the constituent elements of professionalism and the contexts in which professionalism was relevant. Three contexts were identified; the clinical, the academic (University), and the virtual (online) context. The impact of professionalism assessments and the scrutiny on students has led students to struggle with identity negotiation. This was with respect to their personal and professional identities and the expectations of different stake holders, such as faculty, the media and prospective patients.
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Moneypenny, Michael. "Evaluating professionalism, teamwork and leadership in medical undergraduates." Thesis, University of Liverpool, 2015. http://livrepository.liverpool.ac.uk/2013920/.
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The complexity of healthcare is increasing due to new discoveries in the treatment of disease, the multiple pathologies of an ageing population and changes in working patterns and job roles. In addition, an increase in professional, regulatory and public scrutiny has led to revelations of poor care leading to preventable disability and death. Inquiries into sub-standard care have uncovered a number of professional lapses, in particular failures in teamwork and leadership. Medical undergraduates are future doctors. Their ability to work effectively within teams and to lead when necessary will therefore have a significant impact on the health of the population. In order to improve leadership and teamwork abilities we must be able to assess them. A literature review searching for a tool to assess teamwork and leadership in the medical undergraduate was carried out. As a consequence of an unsuccessful search, a tool was developed and evaluated, using data from existing tools and from a series of focus groups with medical undergraduates. The focus groups and an examination of the reasoning of assessment participants also informed a study on the justifications for failing to challenge poor performance by a more senior member of staff. The tool data showed adequate validity and reliability for formative assessments in a simulated environment. The focus groups and examination of reasoning highlighted the continued existence of the medical hierarchy, with steep authority gradients. This tool can be used in formative assessments, but further research is required before it is used outside the simulated environment and consideration must be given to psychometrics, feasibility and cost. The teaching and assessment of teamwork and leadership, should be given more time in the undergraduate curriculum and medical schools, regulatory bodies, deaneries and trusts should collaborate on minimising the unprofessional behaviours of senior healthcare personnel.
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Ball, Kerry Louise. "Exploring professionalism in medical educators : from model to tool." Thesis, University of Winchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.503839.
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The aim of this research was to explore professionalism in medical educators, mostly from a primary care background, in a mixed method research design. Previous research on profesSionalism has focused on medical students and doctors. However medical educators are responsible for teaching professionalism to medical students. Professionalism is a complex and developed state, which must be explored in context to a specifiC role. This study was an exploratory sequential mixed method research design, with two distinct phases. The first was a qualitative phase involving exploration into the concept of professionalism within the doctors' role of a medical educator. This exploration inCluded a literature review and open-ended survey on professionalism, which led to the development of a model of professionalism for medical educators. The second phase involved the design and piloting of a tool, the Professional Reflective Enrichment Tool (PRET), that could be used to enhance professionalism in medical educators, using the model developed in phase one to structure the tool's development. The model of professionalism offered a unique insight into the medical educator's role. In this research, a resource to encourage reflection was used to enhance aspects of professionalism. Reflection was encouraged by developing a series of scenarios, based on the model, designed to pose professional dilemmas. Formative feedback was provided based on this reflection. The PRET was piloted using both assessors and users. A high multi-rater reliability was found. The pilot testing used 53 medical educators, 75% of whom were from primary care. A three-stage model of reflective thinking was developed using existing, tested models of reflection to structure formative feedback to the PRET. Qualitative data comments indicated that the PRET did promote a state of reflection and that the formative feedback was useful. This research offers a unique resource to encourage reflective thought and professional development in medical educators. By providing a structure to this thought the educator is able to apply the resource to their own practice, in personal reflection and implicit or explicit teaching methods.
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Wimmer, Peggy Lynn. "Professionalism Among Medical Practitioners: A Case Study of Rural Physicians." Thesis, Virginia Tech, 2007. http://hdl.handle.net/10919/31321.
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In America, certain attributes and behaviors become more publicly acceptable and more prominent in personalities as an individual matures in their chosen career path. The elite position in society of medical practitioners has been threatened during the 20th Century by new and increasing market pressures. The main hypotheses addressed in this project is the determination of the directional change of the attitudes that represent professionalism as a physician gains experience in the current medical environment and whether these attitudes change as a result of rural setting or specialization in medical practice. This project will also try to determine the reliability of a Likert scale survey instrument, designed and refined through principals of organization behavior theory in the late 1960s by Richard H. Hall. Using this tool, professional attitudes were measured in an original sample of randomly selected physicians drawn from the membership of a rural medical organization and differences were examined using bivariate analyses. The additional influences of medical tenure, organizational size and discipline specialization were also analyzed using bivariate analysis to determine if life experience (tenure, location and specialty choice) positively affects core attitudes of professionalism in medical practice. Results reflect the changing market environment and population demographic changes in rural medical practice, while also demonstrating a significant difference between physicians practicing solo without the support of a group structure.Master of Science
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au, c. farag@optusnet com, and Christine Victoria Farag. "The anatomy of two medical archetypes : a socio-historical study of Australian doctors and their rival medical systems." Murdoch University, 2007. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20080625.134351.
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In this thesis it is argued that the migration of ideas and personnel from Britain to colonial Australia resulted in the reproduction of two distinctive medical archetypes, namely, the soldier/saviour and the generalist (family) physician and surgeon. These have been both conceptualised as ideal type carriers or expediters of two rival forms of medical professionalism. They each emerged in the modern era as institutional products of distinctive educational processes and work practices available for doctors in 19th and 20th century Britain and Australia. While Freidson (1988) asserts one of the problems of dealing with studies of professionalism is that researchers have failed to clearly define work patterns, he could be seen as being close to Foucault (1973) whose emphasis was on the different social spaces in which practitioners worked.
I show firstly that the career of the imperial army medical officer was revived in the 19th century so that in colonial contexts they could alternate between military and civilian servicing, especially as administrators and managers in public office. The soldier/saviour was also associated with the 19th century revival of Masonic and quasi-Masonic military and religious orders, consecrated by royal sovereigns and exported to Australia. In contrast, the Scottish pedagogues and other generalist doctors coming to Australia from Britain were influenced by Edinburgh Universitys Medical Facultys humanist traditions and design of the modern medical curriculum producing the generalist physician and surgeon who met community needs. Within wider imperial social relations, these generalist doctors were looked upon as dissenting or counter-hegemonic.
The aim of this thesis is to examine these archetypes in terms of their characteristics of rationalisation to analyse and understand their professional differences historically as well as in the contemporary period. The significance is that one does not often come across studies which specifically look at doctors within the same society in such terms. Furthermore, by locating them within wider hegemonic and counter-hegemonic social relations, links between ideas about medical professionalism and issues of human rights become evident. This follows the World Health Organizations directives to treat health or medical issues and human rights as a cross-cutting research activity. To my knowledge, no study has been undertaken in Australia of the background and impact of these different traditions.
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Spooner, Sharon. "Reflections on contemporary medical professionalism : an exploration of medical practice as refracted in doctors' narratives." Thesis, University of Liverpool, 2013. http://livrepository.liverpool.ac.uk/18175/.
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Background During a period of continuing changes in society and increasing availability of medical information, publication of patients’ views on experiences of health and illness have gained greater prominence. By contrast, studies of medical perspectives have tended to concentrate on reported discontent and implications for workforce planning while leaving broader insights and concerns under-investigated. Since the applied skills of highly trained and publicly funded clinicians are vital for safe and effective delivery of the nation’s health care, it seemed important to explore new ways to consider components of medical professionalism and to set these in current NHS contexts. Rationale and fieldwork Focussing attention on the individual perspectives of NHS doctors in order to hear and understand their experiences of work was central to development of this thesis. An interpretive epistemological approach to biographical narratives as told by a group of 12 doctors drawing on 25 years of NHS experience included use of Situational Analysis Mapping to support detailed analysis of their richly informative, first-hand accounts. As knowledgeable and reflective informants with stories from diverse clinical specialties and differing personal viewpoints, their narratives produced a range of views and observations shaped by their lived experiences as clinicians. Poetic representation of sociologically-informative narrative extracts provided an effective vehicle for engaging mixed audiences and has evoked emotionally resonant reactions from doctors. Findings Strong connections between individuals’ core principles and enacted responses were evident; doctors identified preferred working practices which they believed supportive of delivery of high quality health care. Key aspects of professionalism, including professional autonomy, self-regulation and application of clinical knowledge, were challenged by progressive introduction of new working processes and regulatory mechanisms. Increased recording of clinical and administrative data for performance monitoring and achievement of targets produced reactive strategies in individuals and teams while challenging their sense of professional position or developed medical identity. Poorly performing colleagues and difficult team interactions caused much disruption while blurred ethical boundaries exposed contestable decision-making and demonstrated the limited effectiveness of external regulatory monitoring. Conclusions This research indicates that contemporary NHS doctors may experience conflict between what is expected in managed medical practice and their interpretation of best professional performance. Better understanding of these fundamental relationships could constructively contribute to reconsideration of contemporary medical professionalism and assist with progressive workforce preparation for an effective future NHS.
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鄧軒寧 and Hin-ning Alexander Tang. "Students' perception of medical professionalism at the University of Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40721991.
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Tang, Hin-ning Alexander. "Students' perception of medical professionalism at the University of Hong Kong." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40721991.
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Harrigan, Mary Louise (Marylou). "Leadership challenges in Canadian health care : exploring exemplary professionalism under the malaise of modernity /." Burnaby B.C. : Simon Fraser University, 2005. http://ir.lib.sfu.ca/handle/1892/2350.
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Thesis (Ed.D.) - Simon Fraser University, 2005.Theses (Faculty of Education) / Simon Fraser University. Includes bibliographical references leaves 322-244. Also issued in digital format and available on the World Wide Web.
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Moralee, Simon. "Practising change in strongly institutionalized environments : using system capital, being system centric." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/practising-change-in-strongly-institutionalized-environments-using-system-capital-being-system-centric(24ca6cbd-7f3c-434d-8377-04321ee0af40).html.
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This thesis outlines a study into institutional change analysing how certain senior individuals, called opinion leaders, were able to achieve change within the strongly institutionalized environment of medical education. It is situated in the complex and contested context of the English National Health Service, which for more than 60 years has seen numerous managerial, organizational, political and professional changes, which have impacted upon the roles and relationships of medical professionals, managers and government. Adopting a retrospective case study approach, the research centres on the specific case of the Enhancing Engagement in Medical Leadership (EEML) project, which had national-level sponsorship and status, directly involving a multitude of senior NHS bodies, representatives and individuals, to embed leadership and management training into medical curricula. Medical curricula are a mediated result of cultural, social, political and economic forces (Kuper and D’Eon, 2011) rooted in the construction of professional identity and transformation from lay person to professional. Prior to this project, there had been limited attempts to engage the medical profession in leadership and management conspicuously through the curriculum, because of the difficulty of including new content into already crowded specialty curricula, given the constraints of time and resources for medical training. Using conceptual insights into agency in institutional theory, such as institutional work (Lawrence and Suddaby, 2006) and institutional entrepreneurship (DiMaggio, 1988); practice theory (Feldman and Orlikowski, 2011; Nicolini, 2012); social position (Battilana, 2011) and capital (Lockett et al., 2014; Bourdieu, 1986), this study explores how project members enacted change within medical education. It analyses the processes involved in their actions and practices and establishes how this case furthers understanding of strongly institutionalized environments. Interviews were conducted with members of the EEML project team and steering group, many of whom had positions of influence and status in other relevant organizations in this field. In addition, a review of documentary data encompassing published and non-published project materials was undertaken. An open coding and thematic analysis approach was taken to gain deeper insight into the interview data, whilst the documentary evidence was used to confirm and support the interview analysis. This case study research reveals that contextual and environmental conditions, as well as exogenous shocks and endogenous motivation led to this change initiative occurring. Routine and recognised ‘practices’ resulted in significant change through embedding the Medical Leadership Competency Framework (MLCF) into contested medical curricula space. Opinion leaders were able, with other project members, to adopt an approach to change, understanding the prevailing conditions, identifying the project’s purpose and committing to an emerging form of practice known as ‘mirroring’. Moreover, this study explores how opinion leaders achieved change through making use of theirs’ and others’ capital resources to form a cross-field collective capital, known as system capital. Using this, they adopted a disposition in their practice beyond professions known as system centrism.
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Chandratilake, Madawa Nilupathi. "Development and validation of an inventory (Dundee Barometer of Institutional Professionalism) to measure the professionalism culture of medical schools in the UK." Thesis, University of Dundee, 2013. https://discovery.dundee.ac.uk/en/studentTheses/c700bd66-c085-435c-8cb1-1b74b492aa22.
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Background: Professionalism, in today’s context, is a determinant of fitness-to-practise of doctors. Many professional and governing bodies around the world have emphasised the need for educating medical students explicitly about professionalism. In fostering professionalism, the institutional culture plays a concealed but vital role. Although the institutional professionalism culture should be explored and understood there was no suitable measure for use in the context of UK undergraduate medical education. The aim of this project was to develop a valid, reliable and practical measure of institutional professionalism culture. Methods and results: The project was conducted in two phases. In the first phase, forty six attributes of professionalism were identified in a literature review. These attributes were surveyed among a nationally representative quota sample of 954 members of the UK general public. They identified 44 attributes as important. With a principal component analysis, three facets to professionalism were identified: the relationship of doctors with patients (clinicianship) and co-workers (workmanship), and the behaviour of doctors in society (citizenship). By analysing the survey responses of 368 UK medical professionals using the Content Validity Index, 28 attributes were identified to represent each facet (clinicianship 10, workmanship 11, and citizenship 7). In the second phase, the 28 attributes were included in an online measure (Dundee Barometer of Institutional Professionalism) with a rating scale based on the Theory of Planned Behaviour (TPB), and field-tested among the faculty and students of the Dundee Medical School. Based on the TPB, questions on personal attitude, institutional expectation and achievability in relation to each attribute were included. The field-test received 212 responses. The measure demonstrated high internal consistencies at both measure and facet levels. It appeared that the professionalism culture in Dundee Medical School was patient-centred, teamwork-oriented and society oriented. A principal component analysis helped reduce the number of items to 15 with five attributes representing each facet. A generalisability study predicted a highly acceptable reliability with the 15 items. The reaction of respondents towards the measure was positive. Conclusions: The Dundee Barometer of Institutional Professionalism (DBIP) is the first quantitative measure of the culture of professionalism in UK medical schools. It was developed with the consensus of both professionals and the general public, and used a theory-based rating scale (hence high validity). It is shown to be reliable with 15 items. The DBIP is a practical measure as it is easy to administer and is acceptable to respondents. The construct validity of the DBIP and its ability to distinguish differences in professionalism culture are areas of future research.
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Underhill, Paul Kenneth. "Science, professionalism and the development of medical education in England : an historical sociology." Thesis, University of Edinburgh, 1987. http://hdl.handle.net/1842/24393.
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Gassner, Kanters Lina. "Assessment of professionalism within dental education: A review of studies." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19826.
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Assessment of professionalism is a concept which has been highlighted during the last ten years. High demands from the public and from authorities combined with an increased educational interest for the concept of professionalism has led to a greater focus on ways of implementing and assessing professionalism in dental, medical and other professional educations. Many authors point out that professionalism is an essential competence, but there is a lack of and a need for a definition of professionalism within dentistry and dental education. It is recognised that professionalism is a broad concept, which calls for different methods of assessments. The aim of this paper is to identify and describe different methods of assessing professionalism within dental education and to categorise them into a blueprint. The studies are discussed out of the perspective of validity and reliability and the methods of assessment are compared to different levels of Miller’s pyramid. Literature is sparse and a mere 16 articles were found to fit the purpose of this paper. Most studies used a traditional way of assessing professionalism, even though research has shown that this way is neither sufficient nor suitable. More research is needed and the methods for assessment need to be further explored. Validity and reliability need to be put in focus, since no method of assessment has proven to be both valid and reliable.
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Olckers, Lorna. "Professionalism in medicine in South Africa - a focus on medical students and their educators." Doctoral thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/30429.
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The notion of ‘professionalism in medicine’ has become increasingly topical globally. It is a complex and ‘slippery’ concept that is variously understood – from ideas of values or virtues that reflect aspects of ‘being’, to those that are more closely associated with behaviour and aspects of ‘doing’. More recently, issues of ‘identity formation’ have added a third dimension to these two broad areas of understanding. The lack of a shared and coherent understanding of what actually constitutes professionalism has resulted in challenges with the teaching, learning and assessment of professionalism in medicine. This has been widely reflected, including within the medical curriculum at the University of Cape Town (UCT) in Cape Town, South Africa, which provides the context for this research. The aim of this study was to explore how medical students and their educators understand and experience professionalism in medicine in the South African (SA) context. The specific objectives in relation to professionalism in medicine were to explore how aspects of being or character are understood and experienced; how aspects of doing or practice are understood and experienced; how global and profession-specific changes have influenced its understandings and experiences; how the SA context is understood and experienced in relation to professionalism in medicine; and how it is understood and experienced within the Health Sciences Faculty at UCT. The research was framed within an interpretive theoretical paradigm in order to illuminate issues of context, difference and power. Qualitative methods, specifically focus groups and individual interviews, were used with participants including medical students studying at UCT, interns who had graduated from UCT, and educators from within the university. Results from the study revealed themes that were considered against physician and philosopher Dr Edmund Pellegrino’s virtue-based understanding of professionalism in medicine that shaped the conceptual framework for the study. Four key issues formed the focus of discussion – the understanding of professionalism; its development alongside emerging identity; its relationship to power and hierarchy; and the implications of context. Unlike the discrete vision of professionalism as embedded within virtues or values as expressed by Pellegrino, the understandings and experiences of study participants reflected a multi-faceted view of professionalism in medicine as a combination of values, knowledge and skills, behaviour, and responsibilities, linked to a core relationship founded on trust between doctors and patients. This understanding was informed by issues of emerging identity, influenced particularly by the ‘hidden curriculum’ and role models, as well as experiences of power and hierarchy within the university and practice settings. Contextual realities included the commercialisation of medicine, and the increasing impact of the internet and social media. The South African context, reflected by the healthcare system and patient population, further informed this multi-faceted understanding of professionalism in medicine. What became clear was that professionalism in medicine was understood and experienced by participants as complex in both theory and practice, and that curriculum design processes and medical practice must therefore be cognisant of the interdependence of the key issues.
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Mahboob, Usman. "How do medical students and clinical faculty members from two different cultures perceive professionalism." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/8913/.
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Background: Professionalism is contextual and varies with culture. It has multiple dimensions including individual, inter-personal, organizational, and societal components. The aim of this study was to add some new perspectives to understand professionalism. Professionalism was explored in the context of two different cultures, Scotland and Pakistan, to identify similarities and differences in perceptions of clinical faculty members and medical students. Methodology: The method used was qualitative multiple case studies in a constructivist approach. Cultural Historical Activity Theory (CHAT) was used as a theoretical framework to enhance understanding of the study. Faculty members from three Scottish and three Pakistani medical schools were interviewed. Focus group discussions were arranged with groups of 7-10 medical students from each of the six medical schools. The data was analysed using a thematic analysis to identify reasons for cultural similarities and differences across two countries. Results: The results were divided into nine themes, that is, the nature of the healthcare system, models and process of professionalism, attributes of professional doctors, approach of doctors towards their patients and other healthcare professionals, working in teams, self-regulation, the role of doctors in society and within families, dealing with ethical dilemmas and legally difficult situations, and resolving conflict situations in the work place. Discussion The variance of professionalism found in this study was mainly due to the health professionals working in two different healthcare systems. The cultural differences between the two countries were reflected in these systems and the activity of professionalism included conflicts and dilemmas, self-regulation, and professional attributes. Medical professionals were found to adopt different institutional models of professionalism when they perform their daily activities. Conclusions: This study showed that doctors and medical students from both countries have mostly similar perceptions about professionalism with some dissimilarities resulting from differences in the culture, history, institutional ethos, daily activities and the role of religion. There is a lack of training in professionalism and a need to include it in the formal curriculum in Pakistan. A training programme could be organized and incorporated into the curriculum using the themes, models and process of professionalism with attention to culturally sensitive situations to prepare medical students for their early professional years in both countries. A focus needs to be on the preparation of communication skills in different contexts and the improvement of the internal environment, which is within the control of every individual. A faculty development programme, with similar objectives, needs to be introduced for medical staff to enhance their understanding of professionalism.
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Foster, Christabel Anne. "Factors influencing notions of professionalism: insights from established practitioner narratives." Thesis, The University of Sydney, 2012. http://hdl.handle.net/2123/8944.
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The aim of the research is to explore the ways in which the meaning of professionalism is increasingly understood during the process of professional socialisation into medicine. The major work is in the analysis of the accounts of senior doctors and a sociocultural approach looks at their perspectives on the factors in their learning which have impacted on their own practice, on their notions of the meaning of professionalism and on their roles as teachers. Such an analysis is not without its challenges. Much of the existing literature on professionalism has taken a positivistic turn, for example focusing on developing ‘efficient and effective’ ways to teach and developing instruments to assess traits deemed likely to contribute to professionalism. Conflicts faced by students or new doctors when they encounter professional dilemmas are also extensively studied. From some areas of the literature it is increasingly evident that medical professionalism is a complex and dynamic construct ever-changing in meaning depending upon context. Accordingly, interpretive methods are highly suited to give a rich analysis of the central issues of this thesis. Three separate analyses of the data provide new insights into the meaning of professionalism in medicine and how it may best be passed on to new generations of doctors. This work adds to the literature on the nature of professionalism by giving a retrospective perspective from established practitioners. In exploring the complexity of the humanistic and broader professional side of medical practice it seemed appropriate to seek the perceptions of senior clinicians. Unlike medical students or junior doctors, more senior professionals are able to discuss these matters with the benefit of real experience and from a position of relative phronesis. The major educational influences that are investigated are relationships with professional role models, the hidden curriculum and the learning atmosphere. A central tenet of this thesis is that the current dominance of a positivistic paradigm in medicine and the power relationships inherent in medical education run counter to the humanistic environment needed to nurture the development of characteristics essential to deliver patient-centred medical care. The currently prevailing culture in which medical education is conducted is rule-driven, competitive, self-serving and uncaring. I assert that in order to produce the caring, supportive and collaborative doctors needed by a twenty-first-century global society, a radical change in culture within medical education is needed.
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Passi, Vimmi. "How does positive doctor role modelling influence the development of medical professionalism in future doctors?" Thesis, University of Warwick, 2013. http://wrap.warwick.ac.uk/62713/.
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Background There has been an explosion of interest in medical professionalism over the past decade but at present there are no evidence based guidelines on how to effectively develop medical professionalism in future doctors (Passi et al. 2010). Role modelling has been highlighted as an important method to help develop professionalism but there is no current theory regarding the process of role modelling (Passi et al. 2013). Therefore, the aim of this PhD was to investigate how positive doctor role modelling influences the development of professionalism in future doctors. Methods A qualitative methodology using the grounded theory inquiry approach of Strauss and Corbin (2008) was used to generate a general explanation (a theory) of the process of role modelling shaped by the views of the participants. The study involved focus groups with final year medical students, semi structured interviews with consultants and semi structured interviews with consultants and final year medical students immediately after outpatient clinics. This systematic approach used involved open coding, axial coding and selective coding to reveal the processes involved in role modelling, which is illustrated in a coding paradigm diagram. Results The results revealed a new theory of doctor role modelling which is described as follows – Doctor role modelling is an important process in medical education that involves conscious and subconscious elements. It consists of an Exposure Phase followed by an Evolution Phase. The exposure phase involves demonstration of professional attributes by the doctor role models (clinical expertise; relationships with patients, students and colleagues; personality and inspirational characteristics). The evolution phase begins with observation of the role model by the modellee, following which the modellee makes a judgement whether or not to trial the observed behaviours of the role model. When the decision to trial is reached, this then leads to the Model Trialling Cycle which involves 5 stages of assembly, emulation, experimentation, adaptation and assimilation. The outcome is the evolution of a professional doctor who has developed their unique professional identity and career aspirations. Conclusion This detailed qualitative study has provided a new theory of doctor role modelling in medical education. The impact of role modelling is in the development of medical professionalism professional identity and the influence of career choice. The theory can now be incorporated in medical curriculums worldwide to enhance the development of medical professionalism. Detailed recommendations for clinical practice and future research are described.
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Holub, Peter. "The Influence of Narrative in Fostering Affective Development of Medical Professionalism in an Online Class." NSUWorks, 2011. http://nsuworks.nova.edu/gscis_etd/179.
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Medical educators, clinical trainers, and professional organizations that have responded to the need to humanize medicine have not explored prospects for affective development in distance education. In this dissertation, the author explored narrative as an affective learning technique. Medical fiction, lay exposition, autobiography and other written forms of patient narratives, as well as multimedia presentations, movies, music, song, and visual arts were explored and analyzed for use in teaching medical professionalism to online health science students. A collection of narratives and learning activities for teaching medical professionalism in an online class were presented.
Finally, a comparison study evaluated the use of narrative medicine to foster professional development in an online class. The use of narrative to introduce professionalism and help online students internalize the humanistic values of empathy and compassion was grounded in affective theories of moral development. Quantitative evaluation of medical professionalism was performed using the Jefferson Scale of Physician Empathy (JSPE), a psychometrically sound instrument designed to measure empathy in the context of patient care. Comparisons of mean changes in empathy suggest that the treatment group experienced significant changes in total empathy, reflected by increased scores in all elements of the JSPE. These results were validated by a qualitative review of student discussion posts, course evaluations, and instructor feedback.
The goal was to explore affective development and the educational value that narrative brings to teaching medical professionalism in the online class. The study helped to clarify the role of narrative in transformative learning. The implication is that online students can benefit from exposure to narrative. The relationship between narrative and medical professionalism may have applications for educational theory, medical and allied health practice, public policy, and future research.
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Thor, Danielle Claire. "Ethics in Emergency Medical Services: A Contextual Analysis." Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/592304.
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Urban BioethicsM.A.
The modern concept of Emergency Medical Services (EMS) has grown from its humble volunteerism origins to a multidisciplinary enterprise, outstretched into the realms of both healthcare and public service. As the American EMS community continues to assume greater responsibilities and further develop its professional standards, the moral foundations of this field open themselves to more thorough scrutiny. Upon examination, the major deficit in the ethical structuring of EMS becomes glaringly obvious: it exists as a piecemeal collection of its medical and militaristic counterparts unified by theoretical generalizations that avoid its inherently unique structure. If EMS wishes to matriculate into complete professionalism, or even continue its assumption of critical responsibilities surrounding the health and safety of others, then it must also develop and maintain its own individual ethical framework from which it operates. In doing so, an urban bioethical approach rooted in context-driven analysis and pragmatic solutions may provide the best guidance and protections for all those who interact with the EMS system while respecting the values of this distinctively prideful service.
Temple University--Theses
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Persson, Beata, and Elin Törnblad. "Professionellt förhållningssätt på sociala medier. En enkätstudie på tandläkarstudenter vid Malmö Universitet." Thesis, Malmö universitet, Odontologiska fakulteten (OD), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19873.
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Syftet med denna studie var att undersöka tandläkarstudenters syn på professionellt förhållningssätt på de sociala medierna Facebook och Instagram. Det finns tidigare forskning inom området, som är utförd i andra länder såsom Storbritannien och USA, däremot har vi inte funnit några svenska studier inom området. Den tidigare forskningen består framförallt av enkätstudier bland medicinstudenter. Vår studie är en enkätstudie bland tandläkarstudenter på termin 6, 8 och 10 på Odontologiska fakulteten i Malmö. Enkäten delades ut vid ett utvalt tillfälle i varje kurs och totalt svarade 122 studenter, vilket motsvarade 73 % av studenterna i de utvalda kurserna. Ett av studiens fynd var att 37 % av studenterna hade sett olämpligt beteende hos en annan tandläkarstudent på Facebook. I studien framkom också att endast 22 % av studenterna kände sig helt eller delvis välinformerade om vad som enligt Tandvårdshögskolan är acceptabelt beteende på sociala medier. I stort sett alla studenter var ovetandes om Tandläkarförbundets råd om professionellt agerande på sociala medier, och 58 % uppgav att de önskar ett inslag i utbildningen som belyser hur man kan använda sig av sociala medier på ett professionellt sätt. Studiens slutsats är att det bör tillkomma ett inslag i utbildningen som hjälper studenter till ett mer ansvarsfullt och professionellt användande av sociala medier.The objective of this study was to analyse dental students’ points of view regarding professional behaviour on the social media platforms Facebook and Instagram. Previous studies have been performed in countries such as Great Britain and the USA. We have not found any Swedish studies on the subject. Most of the previous studies are survey studies amongst medical students. Our study is a survey study amongst dental students in the sixth, eighth and tenth semester at the Faculty of Odontology at Malmö University. The survey was distributed at one occasion in each grade. 122 students responded, which covers 73 % of the total number of students in the chosen grades. One of the study’s most important results was that 37 % of the students reported they had seen inappropriate behaviour by other dental students on Facebook. Only 22 % of the students felt partly or completely informed what the Faculty of Odontology would classify as acceptable behaviour on social media. Almost all students (96 %) were unaware of the Swedish Dental Association’s advice for behaviour on social media. Just over half of the students reported that they wanted more education about how to use social media in a professional way. The conclusion of this study is that the dental education should guide students towards a more responsible and professional use of social media.
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Gregg, Amy L. ""Nineteenth-Century American Medicine:The Implications of Professionalism, Capitalism, and Implicit Bias"." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1492473135829899.
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Birden, Hudson H. "Professionalism in medicine. What is it and how can it be taught?" Thesis, The University of Sydney, 2012. http://hdl.handle.net/2123/8665.
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This study examines the conceptual framework and teaching of medical professionalism from the perspectives of the literature on the subject, clinicians engaged in clinical teaching regarding professionalism, and medical students. I begin with a brief history and overview of the concepts of professionalism in medicine. I follow that with a Best Evidence in Medical Education (BEME) systematic review of the literature to identify the best evidence for how professionalism should be defined and taught. This review found that there is as yet no overarching conceptual context that is universally agreed upon. The development of ways to teach and assess professionalism has been encumbered, and failed to progress, in large part because of this amorphous nature of the various definitions promoted. The review also found no unifying accepted theory or set of accepted practice criteria for teaching professionalism. Evident themes in the literature are that role modelling and personal reflections, ideally guided by faculty, are the important elements in current teaching programs, and are widely believed to be the most effective techniques for developing professionalism. While it is generally agreed that professionalism should be part of the whole of a medical curriculum, the specifics of sequence, depth, detail, and the nature of how to integrate professionalism with other curriculum elements remain matters of evolving theory. No teaching methodology has been demonstrated in the literature to be effective or accepted for use across a wide range of medical schools. I next developed and carried out qualitative studies to discover what conceptual understanding (mental models) of professionalism medical students and clinical educators held, how these two groups view current professionalism training as a component of medical education, and how they think it should be taught. I found that medical students achieve professionalism through the influence of their exposure to seasoned professionals and through informal peer reflection. The doctors in my study group achieved professionalism not through any formal training they received, but as a result of the actions and attitudes they witnessed during their training, which created a path to reflective practice that they have sustained. I conclude by proposing a conceptual model for instilling professionalism through medical education. This model captures the formative influences on professionalism and provides a framework for understanding professional performance. The teaching of professionalism should be integrated into all years of the medical curriculum, and across all disciplines included in the curriculum. Some attributes of professionalism, such as ethics and communication skills, can be introduced in early years. Mentoring and exposure to positive role models hold the most promise as effective teaching methods. Guided reflection turns transient incidents and experiences into true learning moments, solidifying and honing professionalism. Ultimately professionalism should be viewed as an ethos. I hope that my findings will improve our ability to instil professionalism in our students.
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Ingram, Hilary. "Gender, professionalism and power: the rise of the single female medical missionary in Britain and South Africa, 1875-1925." Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=18456.
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This essay will examine the recruitment of single British women by leading Protestant missionary societies during the late nineteenth and early twentieth centuries to assess what motivated women to apply and what qualifications and training were required before they were deployed to the mission field. Single female candidates accepted into missionary service negotiated boundaries between gender and class and worked to redefine their position within religious missions, gradually becoming more professionalized as the years progressed. This thesis places particular emphasis on the study of British female medical missionaries. Throughout, it examines key themes regarding gender and professionalism and the interaction between gender and race on the mission field. Using South Africa as a case study to examine the interaction between female medical missionaries and their African trainees, in the final section the paper analyzes how white female medical missionaries defined themselves as professional women in the field.Cet essai examine le recrutement par les principales sociétés protestantes de missionnaires de femmes britanniques célibataires au cours de la fin du dix-neuvième siècle et du début du vingtième. Il cherche à comprendre ce qui motiva les femmes à postuler, ainsi qu'à découvrir la formation et les qualifications exigées d'elles avant qu'elles ne soient envoyées en mission. Les candidates célibataires qui furent acceptées comme missionnaires eurent à affronter les barrières de classe et de genre, et travaillèrent à redéfinir leurs positions au sein des missions religieuses, se professionnalisant graduellement au fil des ans. Cette thèse porte un accent particulier sur l'étude des femmes missionnaires britanniques oeuvrant dans le champ médical. Elle accorde une place prépondérante à l'étude de thèmes touchant au genre et au professionnalisme, ainsi qu'à l'interaction entre genre et race sur le terrain des missions. Dans sa dernière section, le texte analyse par le biais d'une étude de cas de l'Afrique du Sud la manière par laquelle les femmes missionnaires ainsi que leurs apprentis africains se définirent en tant que femmes professionnelles sur le terrain des missions.
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Jones, Claire Louise. "Between commerce and professionalism : The changing form, role and significance of the medical trade catalogue in Britain, 1880-1914." Thesis, University of Leeds, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.531620.
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Thomas, David Gervaise. "The Rise and Recession of Medical Peer Review in New South Wales, 1856-1994." University of Sydney. Policy and Practice, 2002. http://hdl.handle.net/2123/480.
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The exercise of autonomy and self-regulation is seen in the literature as one of the basic criteria of professionalism. Since in modern states Medicine has generally been the occupational grouping which has most completely attained that status, it is seen as the model or archetype of professionalism. This study focuses on just one aspect of medical autonomy, that relating to the right of medical professionals to be accountable only to their fellow professionals as far as the maintenance of practice standards are concerned. In this thesis, the theory underlying this system of "peer review" is examined and then its application during the course of the 20th century is traced in one particular jurisdiction, that of the State of New South Wales in Australia. The reason for the focus on NSW is that in this jurisdiction, medical autonomy existed and was exercised in a particularly pure and powerful form after it was instituted in 1900. However, it was also in NSW that for the first time anywhere in the world, an institutional challenge to medical disciplinary autonomy emerged with the establishment in 1984 of the "Complaints Unit" of the Department for Health. The thesis of this study is that as a result of this development, which within a comparatively short space of time led to the emergence of a system of "co-regulation" of medical discipline, medical disciplinary autonomy and peer review had within a decade, been so severely challenged as to be almost extinct in this State. In the light of theoretical frameworks provided by Weber, Habermas and the American scholar Robert Alford, the study examines the long drawn out struggle to institute medical autonomy in NSW in the 19th century, its entrenchment by subsequent legislation over the next eight decades and the "counter-attack" staged by the emergent forces of consumerism, supported by the forces of the ideology of "Public Interest Law" in the last two decades of the century. The study concludes with a discussion of the implications for definitions of professionalism which might result from the loss by Medicine in NSW, of its right to exclusive control of medical discipline and the consequent disappearance of medical peer review.
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Sorensen, Ros Public Health & Community Medicine Faculty of Medicine UNSW. "The dilemma of health reform : managing the limits of policymaking, managerialism and professionalism in health care reform." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2002. http://handle.unsw.edu.au/1959.4/33194.
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Hospitals worldwide are under pressure to perform and models abound to remedy poor performance. Reform, however, is contested, uneven and slow. One reason is that few models address a core issue in reform: the management of clinical work. A further reason is that stakeholder groups, specifically policymakers, managers and clinicians, limit opportunities for collaborative problem solving as they seek to impose their own frame of reference in the struggle for control. I hypothesise that performance will be relatively better in hospitals that have in place strategies of agreement to set the objectives of reform, such as participative problem identification, problem solving and decision making, together with a method to manage clinical work. This hypothesis was tested in twelve public hospitals in three Australian states between 1999 and 2001 using both quantitative and qualitative research methods. Government and hospital policy documents were assessed and semi-structured interviews were conducted to gauge the attitudes and practices of managers and clinicians regarding health care reform. The results of the research show that hospitals with inclusive strategies for change, principally strategies of agreement, joint education and skills development, team-based incentives to direct and reward effort and a method of clinical work management, performed better than those without. Findings indicate that policy was developed and communicated as a rational top-down process that tended to exclude diverse views. Although the effect of different jurisdictional policy processes on hospital performance was not clear, they had considerable impact on the environment of reform. Cost containment and patient safety dominated as policy objectives. These alone did not engage clinician interest or address service quality. The connection between the quality of care and its cost did not appear to be understood. Organisational structures and processes necessary to support reform, that is communication forums for objective setting and performance review, integrated clinical and corporate accountability systems and organisational capacity building were not in place in the majority of hospitals studied. An organisational model of clinical work management was developed to improve cost-effectiveness by balancing clinical autonomy and clinical accountability based on the research results.
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Marlowe, Elizabeth P. "“I JUST NEED TO GET MYSELF SUPERVISED:” EXPLORING TRANSFORMATIVE LEARNING IN THE DEVELOPMENT OF PROFESSIONALISM AMONG PHYSICIANS IN THE FIRST YEAR OF GRADUATE MEDICAL EDUCATION." VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4327.
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The study explored the learning experiences of first-year resident physicians during the first year of graduate medical education. The experiences of four intern physicians in the first year of residency training at an urban academic health system provided the site for the research. An exploratory case study research design was employed to examine the learning experiences of these new physicians. A qualitative approach was used to analyze data from interviews and ethnographic observations. The findings of this research study provide evidence surrounding how and what these physician trainees learned regarding professionalism during the first year of residency training.
The findings indicate these first-year resident physicians experienced significant learning related to professionalism through incidental learning in the clinical environment, particularly from role models and the hidden curriculum. The interns learned both positive and negative professional behaviors from attending physicians. The findings illustrate the increases and decreases of confidence due to the development of clinical skills, increase in responsibilities, and increase in autonomy experienced by all four participants across the first year of residency training. Additionally, the findings highlight the important role of critical incidents, particularly memorable patient encounters, as potentially transformative learning experiences for these interns. Finally, the findings enumerate the pervasive influence of the hidden curriculum of graduate medical education on what these new physicians learned about professionalism, particularly the unprofessional social norms transmitted through attending physicians and others within the context of clinical learning.
The findings of the research study support the conclusions that a) incidental learning experiences during the first year of residency education directly influenced how and what these new physicians learned regarding professionalism; b) these intern physicians experienced non-transformative learning during the first year of residency, but critical reflection and critical self-reflection after critical incidents did hold the potential to result in learning that was transformative; and c) the ubiquitous nature of the hidden curriculum significantly impacted what these first-year residents learned about professionalism. These conclusions contribute to the literature related to the development of professionalism in the new physician and the power of the hidden curriculum in medical education to influence professional identity development. Implications for medical educators and recommendations for future research are also identified.
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Brink, Peter. "Det osynliga är uppenbart : En kvalitativ metasyntes med fokus på grupphandledning." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-17622.
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Det livslånga lärandet har stor betydelse för framtidens sjukvård. Dessvärre reagerar sjukvården alltför långsamt på denna förändring. Möjligen kan en kombination av grupphandledning och vårdvetenskap vara rätt medicin. Grupphandledning fungerar som en förändringsprocess med syfte att tillvarata och utveckla gruppens samlade kompetens med den lärande är i fokus där vårdvetenskapen mycket väl skulle passa in. Vårdvetenskapen i sin tur är en humanistisk vetenskap som karakteriseras av en holistisk människosyn som stöttar människans grundbehov och tar hänsyn till dennes personliga värderingar och erfarenheter. Syftet med studien är att klargöra om det finns något gemensamt mellan vårdvetenskapen och innehållet i yrkesmässig grupphandledning för vårdpersonal. Studien är en kvalitativ metasyntes där resultatet redovisar fyra grundteman; lära i gemenskap, stärkas som person, ta in den andre och samhörighet vilket tillsammans beskriver vilken påverkan grupphandledningen har för professionalismen. Dock finns det inget gemensamt mellan vårdvetenskapen och innehållet i grupphandledningen, vårdarna utför vården i en vårdvetenskaplig anda utan att vara medvetna om det. Det gemensamma mellan vårdvetenskapen och innehållet i grupphandledningen liknas därför vid ett isberg vilket också är studiens centrala metafor. I syfte att skapa en bättre vård bör grupphandledningen förankras i vårdvetenskapen och då kanske hejda den cynism, nonchalans och arrogans som dessvärre går att hitta i dagens sjukvård och ersätta dem med vårdvetenskapliga begrepp som tillit, förtroende och trygghet.Program: Specialistsjuksköterskeutbildning med inriktning mot ambulanssjukvård
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Gates, Madison Lamar. "THE NATURE AND MEANING OF CULTURE IN PRIMARY CARE MEDICINE: IMPLICATIONS FOR EDUCATION, CLINICAL PRACTICE, AND STEREOTYPES." Lexington, Ky. : [University of Kentucky Libraries], 2009. http://hdl.handle.net/10225/1174.
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Thesis (Ph. D.)--University of Kentucky, 2009.Title from document title page (viewed on June 2, 2010). Document formatted into pages; contains: ix, 193 p. : ill. (some col.). Includes abstract and vita. Includes bibliographical references (p. 172-189).
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Heyns, Louis. "Undergraduate teaching and assessment needs in ethics and professionalism on clinical ward rounds involving medical students, Faculty of Health Sciences, Stellenbosch University (SU) : a nonexperimental descriptive study." Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/17963.
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Thesis (MPhil)--Stellenbosch University, 2011.ENGLISH ABSTRACT: Background: The theoretical / cognitive component of ethics and professionalism teaching to undergraduate medical students at Stellenbosch University (SU) is well developed, but a concern exists about the need for teaching and assessment of clinical ethics and professionalism on ward rounds. Some teaching does take place during clinical rotations in the form of role modelling as part of the hidden curriculum. Opportunities should be created for explicit teaching of ethics and professionalism beyond the hidden curriculum. Assessment of the cognitive component of ethical and professionalism occurs, but assessment of clinical ethics and professionalism during clinical rotations remains a challenge. Methods: This was a non-experimental study and included three subgroups of undergraduate medical students in their clinical years as well as a random sample of educators involved in clinical training. Questionnaires were distributed to the students and educators. This was followed by focus group interviews among the students. Results: A majority of the students (88%) had indicated that they had experienced ethical and professional dilemmas while working in the wards or during ward rounds. The main dilemmas revolved around inadequate consent processes, lack of confidentiality and privacy, disrespect for patients, poor communication and students being expected to perform tasks they were not trained for. An average of 64% of students indicated that ethical and professional issues were not discussed during the clinical rotations in hospitals. Seventy-eight percent of students indicated that they did not feel free to discuss their own feelings or beliefs on ward rounds. All of the educators felt that there was a need for increased teaching and assessment of the medical students during their clinical rotations. Conclusions: Deliberate opportunities need to be created for teaching ethics and professionalism on clinical ward rounds. This could be a shared responsibility between the clinical departments with continuous input throughout the clinical years of study. Strong institutional support and commitment are necessary to make the teaching sustainable and successful. Structured opportunities need to be developed where students can discuss ethical and professional issues in a safe environment. Further research is needed for the development of an appropriate curriculum and assessment tools.
AFRIKAANSE OPSOMMING: Geen opsomming
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Lindberg, Ola. "'Let me through, I'm a Doctor!' : Professional Socialization in the Transition from Education to Work." Doctoral thesis, Umeå universitet, Pedagogiska institutionen, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-53434.
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Based on four articles, this compilation thesis analyses the demonstrated com-petence defining a medical doctor, to the extent to which he or she acquires a high status and high level of employability in professional practice. Overall, the thesis aimed to describe and analyse professional socialization during doctors' transition from education to work. Questions addressed included how higher education should be understood as preparation for professional practice, how ideals of the future professional were conceived and how these ideals differenti-ated 'good' from 'bad' doctors in professional development and recruitment. The research employed a version of practice theory as its theoretical framework, developed with the aid of work by Pierre Bourdieu, Judith Butler, John Dewey and Theodore Schatzki. Throughout the individual studies, ideals were con-structed and understood as moral imperatives, stating how doctors are expected to perform in professional practice. Article I explored the ideals of academia and higher education practices in a general sense. In this study, the ideals involve the perceived function of higher education in relation to work. Three different and conflicting perspectives were constructed with the aid of a literature study. Arti-cle II was a survey investigation of how two cohorts (n=169) of recent graduates from a Swedish medical programme viewed their competence and the prepara-tion they received for work through the medical programme. The results show that graduates might be overly prepared from a knowledge perspective, while lacking in practical skills and preparation for difficult situations in the work-place. Article III investigated the ideals of the medical programme using an interview study with eight medical students and eight medical teachers. The ideals constructed show how conflicting ideals, such as strength and humility, shape conceptions of the future professional. Finally, Article IV reports an inter-view study with recruiters of medical interns in Sweden's 21 most popular hospi-tals. Results showed that the most attractive candidates balanced two traits: orientation towards performance and orientation towards human relations. They also successfully demonstrated possession of these qualities in their appli-cation and subsequent interview. Overall, the results from the studies indicated that there are great differences between views of proper preparation for work and views of the highly-employable doctor. While medical knowledge and skills were seen as important in preparation for work, they were absent in the views of the highly-competent and employable doctor. Instead, generic attributes, such as drive, curiosity, cooperativeness, warmth, maturity and reflectiveness, char-acterised descriptions of the most accomplished medical professionals. These attributes also were seen primarily as developed before or 'beside' the formal medical education programme.
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BARELLO, SERENA. "IL COINVOLGIMENTO DEL PAZIENTE NEL PROCESSO DI CURA: VERSO UNA RIDEFINIZIONE DELL'ETICA E DELLA PROFESSIONALIZZAZIONE MEDICA NELL'ERA DELLA MEDICINA PARTECIPATIVA." Doctoral thesis, Università Cattolica del Sacro Cuore, 2015. http://hdl.handle.net/10280/6216.
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In un contesto in cui il coinvolgimento e la partecipazione dei consumatori/clienti di prestazioni sanitarie è oggi più che mai all’ordine del giorno, il concetto di “patient engagement” si è sempre più imposto nella letteratura scientifica e manageriale come call to action in risposta alle sfide epidemiologiche – legate all’aumento della cronicità – ed economiche – connesse all’aumento dei costi sanitari e alla riduzione delle risorse disponibili - a cui i sistemi sanitari contemporanei devono necessariamente rispondere per evitare il collasso. Per ciò, a fronte di una letteratura sul tema ancora parziale e frammentata, definire il concetto di “patient engagement” e le sue implicazioni a vari livelli diviene cruciale per passare da una dichiarazione di intenti ad una concreta strategia di azioni volte a promuoverlo. Alla luce di queste premesse, il progetto di ricerca ambisce a rispondere ad una necessità fondativa sia da un punto di vista teroico che empirico di questo concetto e ad evidenziare possibili linee di sviluppo e ricadute applicative per una rinnovata professionalizzazione dei clinici che devono oggi riadattare le proprie pratiche professionali e ripensare alla propria identità in funzione di un paziente sempre più attivo e partecipe rispetto alle scelte legate alla gestione della propria salute.The expectancy of patient living with chronic disease has improved significantly in the recent years due to advances in medical sciences. To address the burden of this growing demand of care, patient engagement is considered crucial as it contributes to improve health outcomes and control healthcare costs. However, many gaps still exist for its implementation starting from the lack of a shared definition and shared guidelines for medical practice based on the direct patients' care experience. In the light of this premises this dissertation will propose a sequential research design generally aimed at improving the knowledge and understanding of patient engagement and its implications for the medical practice and professionalism. To answer the overall aim of this thesis both literature reviews and qualitative methodology were used. Chapter 1 was aimed to set scene and give the readers an overview of the global cultural and societal scenario that justifies the need to deal with the topic of patient engagement. Chapter 2 and 3 consist in in-depth literature reviews aimed at shading light on the concepts featuring the participatory medicine movement and, more specifically, the one of patient engagement. An in-depth qualitative study according to the grounded theory principles was conducted and reported in chapter 4 and was aimed at deepening the heart failure patient’s perspective towards engagement in their care in order to build and experience-based model of this phenomenon. The last two chapters, based on the insights emerged from both the literature analysis and the grounded theory study, were aimed at discussing the implications of patient engagement for the clinical decision making process (chapter 5), and for training health professionals in patient engagement strategies and improving the effectiveness of their communication and relational habits with this aim (chapter 6).
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BARELLO, SERENA. "IL COINVOLGIMENTO DEL PAZIENTE NEL PROCESSO DI CURA: VERSO UNA RIDEFINIZIONE DELL'ETICA E DELLA PROFESSIONALIZZAZIONE MEDICA NELL'ERA DELLA MEDICINA PARTECIPATIVA." Doctoral thesis, Università Cattolica del Sacro Cuore, 2015. http://hdl.handle.net/10280/6216.
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In un contesto in cui il coinvolgimento e la partecipazione dei consumatori/clienti di prestazioni sanitarie è oggi più che mai all’ordine del giorno, il concetto di “patient engagement” si è sempre più imposto nella letteratura scientifica e manageriale come call to action in risposta alle sfide epidemiologiche – legate all’aumento della cronicità – ed economiche – connesse all’aumento dei costi sanitari e alla riduzione delle risorse disponibili - a cui i sistemi sanitari contemporanei devono necessariamente rispondere per evitare il collasso. Per ciò, a fronte di una letteratura sul tema ancora parziale e frammentata, definire il concetto di “patient engagement” e le sue implicazioni a vari livelli diviene cruciale per passare da una dichiarazione di intenti ad una concreta strategia di azioni volte a promuoverlo. Alla luce di queste premesse, il progetto di ricerca ambisce a rispondere ad una necessità fondativa sia da un punto di vista teroico che empirico di questo concetto e ad evidenziare possibili linee di sviluppo e ricadute applicative per una rinnovata professionalizzazione dei clinici che devono oggi riadattare le proprie pratiche professionali e ripensare alla propria identità in funzione di un paziente sempre più attivo e partecipe rispetto alle scelte legate alla gestione della propria salute.The expectancy of patient living with chronic disease has improved significantly in the recent years due to advances in medical sciences. To address the burden of this growing demand of care, patient engagement is considered crucial as it contributes to improve health outcomes and control healthcare costs. However, many gaps still exist for its implementation starting from the lack of a shared definition and shared guidelines for medical practice based on the direct patients' care experience. In the light of this premises this dissertation will propose a sequential research design generally aimed at improving the knowledge and understanding of patient engagement and its implications for the medical practice and professionalism. To answer the overall aim of this thesis both literature reviews and qualitative methodology were used. Chapter 1 was aimed to set scene and give the readers an overview of the global cultural and societal scenario that justifies the need to deal with the topic of patient engagement. Chapter 2 and 3 consist in in-depth literature reviews aimed at shading light on the concepts featuring the participatory medicine movement and, more specifically, the one of patient engagement. An in-depth qualitative study according to the grounded theory principles was conducted and reported in chapter 4 and was aimed at deepening the heart failure patient’s perspective towards engagement in their care in order to build and experience-based model of this phenomenon. The last two chapters, based on the insights emerged from both the literature analysis and the grounded theory study, were aimed at discussing the implications of patient engagement for the clinical decision making process (chapter 5), and for training health professionals in patient engagement strategies and improving the effectiveness of their communication and relational habits with this aim (chapter 6).
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Almeida, Fabio de Oliveira. "Ondas de interiorização do profissionalismo médico e o desenvolvimento em São Carlos." Universidade Federal de São Carlos, 2016. https://repositorio.ufscar.br/handle/ufscar/8320.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
This research analyzed, in the local power of São Carlos (SP), the connections between medical professionalism, urban and industrial development and the political centralization of the Brazilian nation state, which conditioned specific waves of interiorization of medical professionalism, as well as particular professional rip current. The focus is oriented to the period of 1889 to 1988, when have occurred three waves of interiorization of medical professionalism and two professional rip currents. The first wave (1889-1930) happened at the beginning of the Republic, in the context of a decentralized political system (coronelismo) and of a parallel growth of the São Carlos’ coffee production. This allowed the first impulse of the local urban economy, the emergence of some new public health and medical assistance services and the establishment of an initial but effective medical market. Some new physicians arrived in the locality, whose specialization was commonly in general practice. Very soon, these professionals were integrated into the local social stratification, working as liberal professionals and in the Santa Casa de Misericórdia de São Carlos. The second wave (1948-1966) was characterized by the local effects of the political centralization of the state and its new role in the Brazilian urban and industrial development as well as in the organization of a national health system. The preview alliance between physicians and the São Carlos’ coffee elite became less important than in the past. The central state became more powerful and begun to compete with the local elites in the countryside of Brazil. This is the moment of the medical reaction to the socialization of medicine, when local physicians create the Sociedade Médica de São Carlos. In this period, there was an important historical trend of young local citizens (born in São Carlos), who went out to study medicine, but returning back later to work as physicians. As their antecessors, these young professional worked in the general practice. Otherwise, the third wave (1970-1988) arose since the reaction of physicians against some problems with the medical assistance of the state pension system. Indeed, the period also verified the organization of a new hospital, Casa de Saúde e Maternidade São Carlos, as well as the construction of a new building for Santa Casa de Misericórdia. São Carlos observed a relevant urban and industrial growth, paralleled by the increase of groups of industrial workers and urban middle classes. Aside the interiorization of medical faculties, professionals who have studied in these new faculties arrived São Carlos, not to act in general practice, but as specialists. Since a tied and smaller medical market as well as the condition of exporter of patients, São Carlos became polo of attraction for professionals and patients from other localities. This favored the creation and expansion of the UNIMED São Carlos, which responded to the higher demand for local medical services, the crisis in the medical assistance of the pension system and new obstacles from the market of private medical group sector. Both UFSCar and USP São Carlos intertwined with the growth of the locality, as well as with physicians, in order to increase the hospital services of São Carlos. As professional rip currents, between the first and the second waves, and between this one and the third wave, some reverse social processes acted historically in an opposite way in relation to each mentioned wave, favoring the occurrence of the next one. At the end of this period, emerged a combination of historical factors, such as: increase of the medical group sector (specially the UNIMED); the worst of the state medical assistance; political movements of physicians; emergence of the collective health; different role of industries in the Brazilian development; democratization; and decentralization of the national health system, which led to the creation of SUS.
Este trabalho analisou, no contexto do poder local de São Carlos (SP), as conexões entre o profissionalismo médico, o desenvolvimento urbano-industrial e a centralização política de Estado brasileiro, o que condicionou específicas ondas de interiorização do profissionalismo médico, assim como certas correntes profissionais de retorno. O foco do trabalho dirigiu-se para a investigação dessas questões no período de 1889 e 1988, quando se verificaram três ondas de interiorização do profissionalismo médico e duas correntes profissionais de retorno. A primeira onda (1889-1930) aconteceu em meio ao início da República, à relativa descentralização política do coronelismo e ao paralelo crescimento da economia cafeeira paulista e, em particular, por sua pujança em São Carlos, que provocou o primeiro impulso da economia urbana local, a criação dos primeiros serviços de saúde pública e assistência médica e pelo estabelecimento de um inicial, mas efetivo mercado médico local. Houve a chegada dos primeiros médicos a localidade, com perfil generalista e que logo se inseriram na estratificação social local. Neste caso, predominou a atividade médica liberal e junto à Santa Casa de Misericórdia. A segunda onda (1948-1966) foi caracterizada pela centralização política do Estado, seu papel no desenvolvimento urbano-industrial e no sistema de saúde nacional. Diante dessas mudanças, as anteriores relações de aliança dos médicos com, especialmente, a elite agrária local, deixam de ser tão decisivas, já que o Estado central passou a rivalizar com o poder das elites locais. Este é o momento de uma reação médica à socialização da medicina, a partir da criação da Sociedade Médica de São Carlos. Houve um movimento importante de filhos de famílias são-carlenses que saíram do município para estudar medicina, voltando a São Carlos para desenvolver suas carreiras. Os profissionais ainda apresentam o predomínio do perfil generalista. Já a terceira onda (1970-1988) decorreu, em parte, da reação médica frente aos problemas da assistência médica previdenciária. Este período foi marcado pelo surgimento da Casa de Saúde e Maternidade São Carlos, assim como pela ampliação da Santa Casa de Misericórdia, em meio a um maior desenvolvimento industrial e urbano local, com ampliação de setores operários e de classes médias urbanas. Favorecido ainda pela interiorização de cursos de medicina, este período verifica a chegada de novos profissionais especialistas formados em cursos mais novos. De um mercado menor, fechado e exportador de pacientes, São Carlos tornou-se polo de atração de profissionais e pacientes de outras localidades. Isso impulsionou a criação e expansão da UNIMED São Carlos, em resposta a maior demanda por serviços médicos locais, à crescente crise da assistência médica previdenciária e às pressões de certos setores de convênios médicos privados. No período, a UFSCar e a USP São Carlos se articularam ao crescimento do município, envolvendo-se com outros grupos locais e médicos e em melhorias no sistema hospitalar são-carlense. Como correntes profissionais de retorno, entre a primeira e a segunda ondas, e entre a segunda e a terceira, observou-se a ocorrência de fatores sociais que, enquanto contra processos sociais, arrefeceram, relativamente, cada prévio movimento de onda de interiorização, favorecendo a emergência, em cada caso, de uma nova ondas de interiorização. No final do período analisado, ainda se nota o crescimento dos convênios médicos, em especial da UNIMED São Carlos, bem como piora na assistência médica estatal, movimentos médicos de reinvindicação trabalhista e movimentos de grupos envolvidos com a ascensão da saúde coletiva, que buscavam a reforma do sistema nacional de saúde, já no contexto de crise do desenvolvimento urbano-industrial, de redemocratização do país pós-ditadura militar e de ações descentralizadoras da área da saúde, que desembocaram na emergência do SUS.
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Verma, Arun. "Intersecting identities in healthcare education : exploring the influence of gendered environments on healthcare students' workplace learning, retention and success." Thesis, University of Dundee, 2018. https://discovery.dundee.ac.uk/en/studentTheses/f65344e8-5be5-46c8-b9ee-ae904b399ab3.
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Equality and diversity legislation across the UK and Australia has stimulated the health profession sector to make workplace equality and diversity policies transparent to service users (Wadham et al.2010; RCN 2016; GMC 2016; WGEA 2012). However, research literature has identified inequalities within the healthcare workplace as reported by health professions students. Specifically, research has identified issues concerning identities (gender, age, sexuality etc.) adversely interplaying with students' workplace learning experiences (Rees & Monrouxe 2011; Illing et al. 2013;Monrouxe, Rees, et al. 2014). Such negative learning experiences (i.e.discrimination, abuse) have been found to affect students' retention and success (Northall et al. 2016). Despite research shedding light on these issues, studies have typically explored individual identities and demographics and neglected how students' intersecting identities shape their learning experiences, retention and success. Furthermore, research has only offered recommendations for enhancing retention and success of students, rather than exploring the issues affecting retention and success in health professions education. This thesis explicitly explores what and how multiple intersecting personal and professional identities shape healthcare students' learning, retention and success in the context of gendered environments and professions (i.e. male- and female-dominated contexts). Underpinned by social constructionist, narrative and feminist methodologies (Kitzinger 1995; Hunting 2014), I conducted a large secondary analysis on 2255 workplace learning experiences from across the UK and Australia as well as multiple health professions. To follow on from the secondary analysis, I led a multi-site longitudinal audio diary study across two sites in the UK, to explore health professional students' workplace learning experiences in the context of male- and female-dominated environments. Multiple cross-sectional and longitudinal qualitative approaches were employed to explore the data, including thematic, narrative, positioning, and case-study analytic methods. Novel findings from my thesis highlight how participants narrated their intersecting personal and professional identities within male- and female-dominated contexts. I found how recurrent tensions and power imbalances between intersecting identities, learning experiences and environments across time led to an adverse impact on healthcare participants' thoughts and reflections about their learning, retention and success in the health professions. Sensitising the participants to tensions concerning how they negotiate their intersecting personal and professional identities are valuable for understanding and influencing their retention and success. Furthermore, findings from my thesis provide critical recommendations to enhancing healthcare students' workplace learning, retention and success in the health professions, through incorporating intersectionality into healthcare education curricula. The recommendations made in this thesis contribute to helping understand and support a diversifying healthcare workforce and shed light on potential issues around healthcare workforce shortages, which can be addressed through enhancing health professions' educational policies and practice.
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Gustavsson, Sara, Emma Johansson, and Emelia Larsson. "Varför dokumentera? Två möjliga förklaringar till ökad dokumentation inom sjukvården." Thesis, Högskolan i Borås, Institutionen Handels- och IT-högskolan, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-17611.
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Tidigare studier visar att sjuksköterskor lägger allt mer tid på omvårdnadsdokumentation.Forskningen tyder på två rationella förklaringar till detta fenomen. Den ena förklaringenbehandlar den ökade dokumentationen som en effekt av sjuksköterskors professionalisering.Samtidigt som lagkravet på sjukvårdsdokumentation trädde i kraft startade enprofessionaliseringssträvan för sjuksköterskor. Vikten låg på att som sjuksköterska ständigtsöka större skicklighet inom sitt yrke för att kunna erbjuda patienter bästa möjliga vård. Dettagjorde dokumentationen till en del i ett kollegialt kommunikationsverktyg för att säkrapatientsäkerheten.Den andra förklaringen till ökad dokumentation kan se fenomenet som en effekt avgranskningssamhället. New Public Management och konkurrensbaserad sjukvård har drivitsjuksköterskor att dokumentera om patienters vård och omvårdnad för att kunna styrka att rätthandlingar ä gjorda och därmed klara en granskning.Tidigare studier visar att både professionalisering och granskningssamhället har uppvisateffekter som kan förklara den ökade dokumentationen i sjukvården. Denna kvantitativa studiehar därför låtit sjuksköterskor från fyra avdelningar på Södra Älvsborgs Sjukhus (SÄS) svarapå en enkät om varför de dokumenterar. Detta för att vi studerat vilken av de två förklarandesom gjort sig gällande och därmed dominerar. Studien har även lagt fokus på vilken påverkanålder, erfarenhet och avdelningsform (planerad och akut) har på sjuksköterskors uppfattningom dokumentation och tid som läggs på den.Resultatet visar att båda förklaringarna är av betydelse för de tillfrågade sjuksköterskorna,men med något större värdering på professionaliseringsförklaringen. Bakgrundsvariablernaålder, erfarenhet och avdelning har även visat sig vara av betydelse för tiden som läggs pådokumentation där dokumentationsomfattningen tycks öka med högre ålder och erfarenhet.Resultatet visar även ett samband där sjuksköterskor från planerade avdelningar lägger mertid på dokumentation än sjuksköterskor verksamma på akuta avdelningar gör. Det är utifråndessa resultat vi kan dra slutsatsen om att dokumentation framförallt kan verka som ettredskap för kollegial kommunikation och samarbete, där skicklighet och erfarenhet förmedlas.
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Candlish, Karol, and Genevieve Young. "Medication Reconciliation at an Academic Medical Center: Perceptions from Medical Professionals." The University of Arizona, 2012. http://hdl.handle.net/10150/623590.
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Class of 2012Specific Aims: The goal of this project was to assess perceptions of medication reconciliation from medical professionals who perform them. Specific areas of interest included the perceived: amount of time spent on medication reconciliation; process complexity; and effectiveness of the current process. Opinions concerning the use of alternative processes were also solicited. Methods: This prospective qualitative study involved four focus group sessions at one tertiary referral teaching hospital in Tucson, Arizona. Nurses involved in admissions medication reconciliation in the emergency department were invited to participate, and their perceptions were categorized and summarized. Main Results: Participants reported a range of times to complete the medication reconciliation from zero to greater than 20 minutes. According to the participants, the time spent on each patient depended on patients’ medication knowledge and the complexity of their regimens. Participants wanted the medication list entry screen to be easier to use, and they also suggested patients’ medication lists from previous visits and from outpatient clinics associated with the medical center be easily accessible. Participants felt that emergency triage may not be the most ideal time in which to perform medication reconciliation, and they expressed concerns about accuracy of these medication lists. While some were interested in the possibility of using a patient medication database and expected that it would improve accuracy and save time, others were less open to a perceived additional step. Concusions: Participants provided suggestions for changes in the current medication reconciliation process that they feel could improve patient satisfaction and increase efficiency.
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Candlish, Karol, Genevieve Young, and Terri Warholak. "Medication Reconciliation at an Academic Medical Center: Perceptions from Medical Professionals." The University of Arizona, 2012. http://hdl.handle.net/10150/614457.
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Class of 2012 AbstractSpecific Aims: The goal of this project was to assess perceptions of medication reconciliation from medical professionals who perform them. Specific areas of interest included the perceived: amount of time spent on medication reconciliation; process complexity; and effectiveness of the current process. Opinions concerning the use of alternative processes were also solicited. Methods: This prospective qualitative study involved four focus group sessions at one tertiary referral teaching hospital in Tucson, Arizona. Nurses involved in admissions medication reconciliation in the emergency department were invited to participate, and their perceptions were categorized and summarized. Main Results: Participants reported a range of times to complete the medication reconciliation from zero to greater than 20 minutes. According to the participants, the time spent on each patient depended on patients’ medication knowledge and the complexity of their regimens. Participants wanted the medication list entry screen to be easier to use, and they also suggested patients’ medication lists from previous visits and from outpatient clinics associated with the medical center be easily accessible. Participants felt that emergency triage may not be the most ideal time in which to perform medication reconciliation, and they expressed concerns about accuracy of these medication lists. While some were interested in the possibility of using a patient medication database and expected that it would improve accuracy and save time, others were less open to a perceived additional step. Concusions: Participants provided suggestions for changes in the current medication reconciliation process that they feel could improve patient satisfaction and increase efficiency.
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Holmström, Inger. "Gaining professional competence for patient encounters by means of a new understanding /." Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5297-3/.
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Immonen, K. (Kati). "Continuing professional development of medical laboratory professionals." Bachelor's thesis, University of Oulu, 2018. http://urn.fi/URN:NBN:fi:oulu-201805221864.
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The aim of the bachelor study was to find out what kind of experiences continuing professional development (CPD) has received in medical laboratories and how it has been implemented through a literature review. The purpose of the study was to find and compile the literature review as up-to-date research data on the importance of continuing education in medical laboratories.
The literature review has been carried out by adapting a systematic literature review. The literature review material was obtained utilizing nursing reference databases from CINAHL, PubMed, Ovid Medline, Scopus, Medic and a few international journals. Research material (n = 8) was selected for the material, whose main subject was continuing professional development and medical laboratory.
CPD is used to improve knowledge and skills with various categories and tools but there is similarities and differences in CPD implementation. CPD must be continuous throughout the professional career and it should be based on time- cycles of reasonable duration. Medical laboratory professionals with dozens of years of experience feels that they need less CPD activities than recently qualified laboratory professionals. The laboratory professional keeps important to increase their learning and development of their skills with continual encouragement.
Research has shown that CPD has been recognized as an important part of professional development and the use of various tools, such as internet-based, makes it effective. The use of a systematic CPD program should be constantly evaluated to identify the most effective ways of developing professional skills. CPD should be time bounded but there is variation in duration and volume. The use of time and experience years will affect the successful implementation of the CPD.
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Schnoor, Jörg, Christoph-Eckhard Heyde, and Mohamed Ghanem. "Ethical challenges for medical professionals in middle manager positions." Universitätsbibliothek Leipzig, 2015. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-176082.
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Background: Demographic changes increase the financing needs of all social services. This change also generates new and complex demands on the medical staff. Accordingly, medical professionals in middle management positions hold a characteristic sandwich position between top management and the operational core. This sandwich position often constitutes new challenges. In the industrial field, the growing importance of the middle management for the company’s success has already been recognized. Accordingly, the growing demand on economy urges an analysis for the medical field.
Discussion: While there are nearly no differences in the nature of the tasks of medical middle manager in the areas of strategy, role function, performance pressure and qualifications compared to those tasks of the industrial sector, there are basic differences as well. Especially the character of “independence” of the medical profession
and its ethical values justifies these differences. Consequently, qualification of medical professionals may not be solely based on medical academic career. It is also based on the personal ability or potential to lead and to manage. Summary: Above all, the character of “independence” of the medical profession and its ethical values justifies medical action that is based on the patient’s well-being and not exclusively on economic outcomes. In the future, medical
middle managers are supposed to achieve an optimized balance between a patient-centered medicine and economic measures. It will be a basic requirement that middle managers accept their position and the resultant tasks putting themselves in a more active position. Because of that, middle managers can become “value-added bridge-builders”.
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Studnek, Jonathan R. "Evaluation of Back Problems among Emergency Medical Services Professionals." The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1225909761.
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Crowe, Remle. "An Assessment of Burnout among Emergency Medical Services Professionals." The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1531751856368551.
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Farah, Farah, Katty Wiklund, and Amina Aden. "Experiences of Patients with HIV/AIDS in Meeting with Healthcare Professionals : A literature review." Thesis, Jönköping University, HHJ, Avd. för omvårdnad, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-51953.
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Nikolopoulos, Marios. "Health care professionals’ perceptions about family engagement in rehabilitation process. : A mixed method study." Thesis, Jönköping University, Högskolan för lärande och kommunikation, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-54188.
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Angel, Mickaela. "le tourisme médical au Maroc : enjeux et nouvelles compétences des professionnels de santé." Thesis, Université Paris-Saclay (ComUE), 2016. http://www.theses.fr/2016SACLV105/document.
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Le développement du tourisme médical concerne aujourd'hui plusieurs pays en voie de développement. le Maroc en a fait un acte stratégique. Plusieurs instituts de soins sont impliqués dans ce développement et nous chercherons à identifier comment ont évoluées les compétences des acteurs intervenants et des modalités de leur acquisition. Cette dimension est complémentaire des changements organisationnels qui ont été entrepris pour proposer des prestations à une clientèle de plus en plus diversifiéeThe development of medical tourism involves several developing countries today. Morocco has made the strategic act of the medical tourism. Many care institutions are involved in this development and we seek to identify how the skills of actors involved and the terms of their acquisition. This dimension is complementary to the organizational changes that have been set to offer services to a customer base increasingly diverse
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Soler, Ranzani Mònica. "Desenvolupament del professionalisme en educació mèdica: l'avaluació formativa de valors i actituds professionals en l'aprenentatge basat en problemes (ABP)." Doctoral thesis, Universitat de Barcelona, 2015. http://hdl.handle.net/10803/370855.
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Malgrat que el professionalisme, entès com el conjunt de principis ètics i deontològics, valors i conductes que sustenten el compromís dels professionals de I a medicina amb el servei als ciutadans, ha estat considerat clau en l'educació de grau de medicina en els llibres blancs de l'educació mèdica locals i internacionals, molt poques facultats el tenen en compte. La Facultat de Medicina de la Universitat de Girona (UdG) és una d'elles atès que el mètode docent que s'hi utilitza, l'Aprenentatge Basat en Problemes (ABP), permet el desenvolupament de valors i actituds professionals així com la seva avaluació.
La formació i avaluació del professionalisme és, doncs, un camp molt emergent que requereix de l'aportació de la recerca per nodrir el seu desenvolupament amb rigor metodològic. És per això que aquesta tesi té per objectiu analitzar la pertinença contextual de l' escala d'avaluació formativa de valors i actituds professionals (EAFVAP) en tant que l'escala utilitzada és un manlleu provinent de la Universidad Nacional del Sur de Bahia Blanca (Argentina) i posteriorment adaptada per l'expert en ABP Luis Branda per a la Facultat d'Infermeria de la Vall d'Hebron de la Universitat Autònoma de Barcelona, i modificada posteriorment per a la seva utilització a la Facultat de medicina de la Universitat de Girona. D'altra banda pretén estudiar el desenvolupament dels valors i actituds professionals, mitjançant l'evolució dels estudiants de I a facultat de medicina de Ia Universitat de Girona formats i avaluats en professionalisme amb l'instrument. L''EAFVAP consta de quatre dimensions, amb diversos ítems o preguntes cadascuna, que són les següents: a) habilitats d'aprenentatge, b) comunicació, c) responsabilitat i d) relacions interpersonals.
La tesi desenvolupa mètodes qualitatius i quantitatius per respondre a l'objectiu que es planteja. Per valorar la pertinença contextual es duu a terme un estudi qualitatiu mitjançant qüestionaris estructurats de preguntes obertes a experts en educació mèdica. D'altra banda, per estudiar l'evolució dels alumnes la metodologia a utilitzada és quantitativa. S’analitzen les puntuacions obtingudes pels estudiants amb l’EAFVAP, d’una mateixa cohort d’alumnes de medicina en dos cursos diferents, essent la primera administració del’ EAFVAP a segon curs i la darrera a tercer curs dels estudis de grau.Even though professionalism, understood as the set of ethical principles and professional ethics, values and behaviours that nourish the commitment of medical professionals with public service, has been considered key in medical education in white local and international books, very few schools have taken it into account. The Faculty of Medicine of University of Girona (UdG) is one of them because its teaching method, in which the Problem Based Learning (PBL) is used, allows the development of values and attitudes as well as their professional evaluation. Training and assessment of professionalism is, therefore, a very emerging field that requires the contribution of research to nourish its development with methodological accuracy. Thus, on the one hand, the main objective of this thesis aims to analyze the contextual relevance of the assessment scale training of professional values and attitudes (EAFVAP) as the scale used at the Universidad Nacional del Sur in Bahia Blanca ( Argentina) and later adapted by the expert Luis Branda ABP for the School of Nursing in Vall d'Hebron at University Autanoma de Barcelona, and later modified for its use at the Faculty of Medicine of the University of Girona. On the other hand, it aims to study the development of professional values and attitudes through the development of students of the UdG-Faculty of medicine taught and evaluated with the instrument. The EAFVAP has four dimensions, each one with several questions or items, which are: a) learning skills, b) communication c) responsibility and d) relationships. This thesis develops qualitative and quantitative methods to achieve the main objective initially planned. To be able to assess contextual relevance, a qualitative study using structured open questions to experts in medical education has been carried out. Moreover, in order to study student's evolution, the methodology used is quantitative. Scores obtained by students with EAFVAP are analyzed, a single cohort of medical students in two different courses, being the first administration of the EAFVAP in the second last year and the third year of undergraduate studies.