Professionalism in medicine in South Africa - a focus on medical students and their educators

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

Developing health science students into integrated health professionals: a practical tool for learning

BACKGROUND:An integrated sense of professionalism enables health professionals to draw on relevant knowledge in context and to apply a set of professional responsibilities and ethical principles in the midst of changing work environments 12. Inculcating professionalism is therefore a critical goal of health professional education. Two multi-professional courses for first year Health Science students at the University of Cape Town, South Africa aim to lay the foundation for becoming an integrated health professional 3. In these courses a diagram depicting the domains of the integrated health professional is used to focus the content of small group experiential exercises towards an appreciation of professionalism. The diagram serves as an organising framework for conceptualising an emerging professional identity and for directing learning towards the domains of 'self as professional' 45.OBJECTIVE:This paper describes how a diagrammatic representation of the core elements of an integrated health professional is used as a template for framing course content and for organising student learning. Based on the assumption that all health care professionals should be knowledgeable, empathic and reflective, the diagram provides students and educators with a visual tool for investigating the subjective and objective dimensions of professionalism. The use of the diagram as an integrating point of reference for individual and small group learning is described and substantiated with relevant literature. CONCLUSION: The authors have applied the diagram with positive impact for the past six years with students and educators reporting that "it just makes sense". The article includes plans for formal evaluation. Evaluation to date is based on preliminary, informal feedback on the value of the diagram as a tool for capturing the domains of professionalism at an early stage in the undergraduate education of health professional students

Judging essays : factors that influence markers

Includes bibliographical references (leaves 92-95).This thesis is an exploration of assessment with particular focus on the marking of essay assignments and the validity or soundness of that process

Developing health science students into integrated health professionals: a practical tool for learning

Abstract Background An integrated sense of professionalism enables health professionals to draw on relevant knowledge in context and to apply a set of professional responsibilities and ethical principles in the midst of changing work environments 12. Inculcating professionalism is therefore a critical goal of health professional education. Two multi-professional courses for first year Health Science students at the University of Cape Town, South Africa aim to lay the foundation for becoming an integrated health professional 3. In these courses a diagram depicting the domains of the integrated health professional is used to focus the content of small group experiential exercises towards an appreciation of professionalism. The diagram serves as an organising framework for conceptualising an emerging professional identity and for directing learning towards the domains of 'self as professional' 45. Objective This paper describes how a diagrammatic representation of the core elements of an integrated health professional is used as a template for framing course content and for organising student learning. Based on the assumption that all health care professionals should be knowledgeable, empathic and reflective, the diagram provides students and educators with a visual tool for investigating the subjective and objective dimensions of professionalism. The use of the diagram as an integrating point of reference for individual and small group learning is described and substantiated with relevant literature. Conclusion The authors have applied the diagram with positive impact for the past six years with students and educators reporting that "it just makes sense". The article includes plans for formal evaluation. Evaluation to date is based on preliminary, informal feedback on the value of the diagram as a tool for capturing the domains of professionalism at an early stage in the undergraduate education of health professional students.</p

Additional file 1 of Health Sciences students’ experience of COVID-19 case management and contact tracing in Cape Town, South Africa

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