Synopses & Reviews
The topic of professionalism has dominated the content of major academic medicine publications (e.g. Journal of the American Medical Association, New England Journal of Medicine, Academic Medicine, Annals of Internal Medicine, The Lancet) during the past decade and continues to do so. The message of this current wave of professionalism is that medical educators need to be more attentive to the moral sensibilities of trainees, to their interpersonal and affective dimensions, and to their social conscience, all to the end of skilled, humanistic physicians. Urgent calls to address professionalism from such groups as the Association of American Medical Colleges (representing the nation's 126 accredited medical schools and nearly 400 major teaching hospitals), the American Board of Internal Medicine, and the Accreditation Council for Graduate Medical Education, among others. In fact, at the 2004 annual meeting of the AAMC six separate presentations addressed professionalism with such titles as "Evaluating Humanism and Professionalism," Professionalism: Expectation, Education, Evaluation," or "Toward Assessing Professional Behaviors of Medical Students through Peer Observations" (note the preoccupation with assessment). Professionalism, then, has become part of the current academic medicine parlance, used by administrators, clinical faculty, residency programs, and professional organizations with an expectation of shared meanings and goals. All of these stakeholders focus on what has become a consistent list of attributes deemed to be the essence of professionalism, which usually include variations on altruism, duty, excellence, honor and integrity, accountability, and respect. In fact, most of the scholarly work to date has been listing (attributes of professionalism), describing (activities that may foster it), decrying (the environment that works against it), and measuring/evaluating it. In this collection of essays, we don't argue with these attributes. Instead, we ask questions of the discourse from which they arise, how the specialized language of academic medicine disciplines has defined, organized, contained, and made seemingly immutable a group of attitudes, values, and behaviors subsumed under the label "professional" or "professionalism." This collection aims to be a critical text, one that questions the profession's beliefs about the nature of its work and how such beliefs are enacted (or not) in medical education, particularly as they fuel the professionalism discourse. In addition, we will scrutinize how the discourse is enacted in both the formal and hidden curriculum, and in the larger medical environment.
Review
From the reviews: "This text presents an interesting counterpoint to the body of perceived wisdom on professionalism. ... The volume is most effective when it offers practical solutions to the current problems that they posit are facing the construct of professionalism and its delivery to medical students." (Alice Z. Frohna, Journal of the American Medical Association, Vol. 297 (19), 2007)
Synopsis
Professionalism in Medicine: Critical Perspectives casts a careful, and at times wary, eye on a dominant force in contemporary academic medicine that appears to have been accepted as an absolute good. Calls for developing, increasing, or maintaining professionalism not to mention the current obsession with evaluating or assessing it appear with regularity in medical journals and conference programs of all stripes. The resultant literature has defined, organized, contained, and made seemingly immutable a group of attitudes and behaviors subsumed under the label "professional" or ''professionalism" (Wear & Kuczewski, 2004). Moreover, the fixation with assessment has become a new steering mechanism that is reductionistic when it shapes the total range of possible and thinkable dimensions of professionalism. The richness, complexity, and contradictions of professionalism in medicine are being flattened into categorical attitudes or behaviors that evaluators (whose professionalism is rarely assessed) can check. As Mark Kuczewski, one of the contributors to this volume, observes, "Valuing and evaluating professionalism seem to have become equated. " This preoccupation with assessment is not indigenous to medical education. It is arising and taking hold of many institutions as new principles indeed, mandates of scrutiny and examination become acceptable, if not desirable, cultural practices. In their incisive work on audit cultures in higher education. Shore and Wright (2000) argue that coercive practices of accountability sometimes sound eerily like moves toward "exhibiting" professionalism whereby "every individual is made acutely aware that his] conduct and performance is under constant scrutiny" (p. 77)."
Synopsis
The topic of professionalism in medicine has dominated the content of major academic medicine publications during the past decade and continues to do so. In this collection of essays, the authors don't argue with those attributes deemed to be the essence of professionalism. Instead, they ask questions of the discourse from which they arise, how the specialized language of academic medicine disciplines has defined, organized, contained, and made seemingly immutable a group of attitudes, values, and behaviors subsumed under the label professional or professionalism. This collection aims to be a critical text, one that questions the profession's beliefs about the nature of its work and how such beliefs are enacted (or not) in medical education, particularly as they fuel the professionalism discourse. In addition, the authors scrutinize how the discourse is enacted in both the formal and hidden curriculum, and in the larger medical environment.
Synopsis
In this collection of essays, the authors don't argue with those attributes deemed to be the essence of professionalism in medicine. Instead, they ask questions of the discourse from which they arise and question the profession's beliefs about the nature of its work.
Synopsis
In this collection of essays, the authors don't argue with those attributes deemed to be the essence of professionalism in medicine. Instead, they ask questions of the discourse from which they arise, how the specialized language of academic medicine disciplines has defined, organized, contained, and made seemingly immutable a group of attitudes, values, and behaviors subsumed under the label "professional" or "professionalism." This collection aims to be a critical text, one that questions the profession's beliefs about the nature of its work and how such beliefs are enacted (or not) in medical education, particularly as they fuel the professionalism discourse.
Synopsis
"Professionalism in Medicine: Critical Perspectives" is a brilliant collection of essays that responds to platitudinous notions of medical professionalism with theoretical clarity and curricular innovation. Drawing upon a wonderful wealth of scholars in the medical humanities, this inspirational volume seeks to transcend reductionistic conceptions of professionalism that are too easily mistaken for the real thing, simply because they are amenable to measurement. This incisive anthology will be savored by all who want to bring qualitative balance to a 'professionalism movement' that has often conflated quantitative assessment with cogent analysis." Joseph J. Fins, M.D., F.A.C.P., Chief, Division of Medical Ethics and Professor of Medicine, Weill Medical College of Cornell University and Author, "A Palliative Ethic of Care: Clinical Wisdom at Life's End." "This book makes a welcome and important contribution to the ongoing dialogue and debate about professionalism in medicine. The contributors, all distinguished authorities and experienced medical educators, challenge current constructs and suggest new approaches to understanding, teaching and evaluating professionalism. The provocative ideas presented range from the theoretical to the pragmatic. Professionalism in Medicine will engage the interest of medical educators and practicing physicians, sociologists and philosophers." Herbert M. Swick, M.D., Executive Director, Institute of Medicine and Humanities Professionalism has become a part of the contemporary academic medicine parlance, with the stakeholders focus on what has become a consistent list of attributes deemed to be the essence of professionalism: variations on altruism, duty, excellence, honor and integrity, accountability, and respect. This collection of essays steps outside this focus. Its contributors ask different questions, including how the specialized language of academic medicine and its affiliated governing and accrediting institutions define, organize, and contain the attitudes, values, and behaviors subsumed under the label "professional" or "professionalism." Each essay questions the profession's beliefs about the nature of its work and how such beliefs are enacted (or not) in medical education and practice. Anyone involved in decision-making in the undergraduate medical curriculum will find this book thoughtful, at times provocative, and in the end, useful.
Table of Contents
Introduction.- Part One.- Conceptualizing Professionalism.- The Complexities of Medical Professionalism: A Preliminary Investigation.- An Analysis of the Discourse of Professionalism.- Professionalism: Curriculum Goals and Meeting Their Challenges.- Part Two.- Teaching Professionalism.- Medical Professionalism: The Nature of Story and the Story of Nature.- Patient Respect: A Case Study of the Formal and Hidden Curriculum.- You Say Self-Interest, I Say Altruism.- The Role of Ethics within Professionalism Inquiry: Defining Identity and Distinguishing Boundary.- Medical Professionals and the Discourse of Professionalism: Teaching Implications.- Part Three.- Assessing Professionalism.- Educating for Professionalism at Indiana University School of Medicine: Feet on the Ground and Fresh Eyes.- The Problem with Evaluating Professionalism: The Case against the Current Dogma.- How Medical Training Mangles Professionalism: The Prolonged Death of Compassion.- Wit is Not Enough.- Professionalism and the Heisenberg Uncertainty Principle.- Coda .- List of Contributors.- Index .